Community Links

Community Links blog

Archive for the ‘Housing’ Category

We can’t address ‘the burning injustice of mental illness’ without proper social investment

Tuesday, January 10th, 2017

Yesterday Theresa May made some welcome announcements about the government’s future direction on preventing mental illness and promoting positive mental health.

She rightly identified that not only is mental health a social justice issue, but that the best way to improve it is by making it “an everyday concern for all of us, and in every one of our institutions”. Taking an early action approach is therefore imperative to preventing mental illness, and in doing so “transforming the way we deal with mental health problems at every stage of a person’s life”. In doing so she recognises, rhetorically at least, that the current crisis in mental health is as much a social crisis as a medical or funding crisis.

Thriving Minds: Acting early on mental health

Just before Christmas the Early Action Task Force published its latest report looking at how we can act earlier on mental health. Central to the argument of Thriving Minds is that as mental health underpins so many aspects of our lives, we need a far ranging response that goes beyond simply reforming mental health services.

A useful way of thinking about this was best put by report co-author Rosie Hayes, when she asked is mental illness the ‘Great Stink’ of our time? She highlighted that since the 19th century the government has recognised the benefit of investing in physical infrastructure such as the sewer system to improve public physical health, arguing that today we face a comparable situation in mental health. Therefore, similarly to the areas identified by the Prime Minister, we argue in Thriving Minds that schools, the workplace, communities, money, and the criminal justice system are important areas for early action beyond – and in collaboration with – mental health services.

We would also add private renting to the Prime Minister’s list, as renters are 75% more likely to experience serious anxiety and depression than homeowners. This is largely down to insecurity in the private rented sector, itself a consequence of unaffordability, short-term tenures, and poor living conditions. If we don’t tackle these issues – and the issues identified in the other 5 areas mentioned above – then it is unlikely we will be able to prevent mental illness, let alone promote positive mental health. Legislative approaches like those found in Scotland with the Private Housing (Tenancies) (Scotland) Act 2016 and more local initiatives like co-regulation of private landlords are promising starts, but more must be done.

Was it all just rhetoric?

As other commentators have pointed out, we should be sceptical of these pledges – however welcome they are on the surface – when previous governments have at best consistently failed on mental health provision and, at worst, actively damaged it with cuts. David Robinson wrote on our blog yesterday that announcements like this – and Blair’s “Giving Age” – are sometimes pure rhetoric entirely lacking in policy substance. The mere fact that mental health was given such prominence in the Prime Minister’s first proper speech on social policy makes us optimistic, but equally we are wary about aspirational announcements with no new money to back them up. Only time will tell how serious this government really is about addressing our current mental health crisis and, ultimately, long-term investment in key social infrastructure such as schools, the workplace, and communities is the most likely thing to yield a triple dividend: enabling people to lead thriving lives, costing less, and contributing more.

Six ways society can act earlier for mental health

Friday, November 25th, 2016

On the 9th December, the Early Action Task Force will be publishing its newest report: ‘Thriving Minds: Acting Early on Mental Health‘. Within the report we’ve focused on six areas, although we could have doubled this list as mental health runs through everything in a circle of cause and effect. Below is a snapshot of our thinking on how society can act early on mental health.

 photo Six ways to act early on mental health_zpsndcbvjeb.jpg
1. Education

Half of all diagnosable mental health conditions in adults begin before the age of 14

Given the above statistic, our school years present a significant opportunity to promote positive mental health early. School can take measures to promote positive mental health, such as the whole-school approach of the Mancroft Advice Project. Local and central governments also need to ensure that their policies are focused on promoting positive mental health in children through collaboration with local services and reducing the pressure of exams.

2. Work

Mental health problems account for 47% of long term absences from work

If people felt they wouldn’t be stigmatised for having a mental health problem, they’d be much more likely to disclose this and take time off earlier to prevent their mental health from reaching crisis point. Training in Mental Health First Aid can aid understanding and reduce stigma, whilst organisational approaches such as ‘happier@work’ can make workplaces a more mentally positive place to be. Of course, some people may still fall ill and need time off work, so it’s also important that employment support services are tailored to those with mental health needs to enable them to get back into sustainable, good quality work.

3. Money

Problem debt makes a person twice as likely to develop a mental health problem

At present, a significant number of people are caught up in a vicious cycle of mental health problems and problem debt. By reducing the amount of problem debt people take on, improving early access to advice, and changing debt collection practices, we can act earlier to ensure the cycle is broken. CAB’s ‘Healthy Advice’ scheme is a good example of how services are innovating to ensure they are reaching the people who need advice as early as possible.

4. Criminal Justice

90% of prisoners have a mental health problem

The criminal justice system is host to many people at the sharp end of the collective failure to act earlier for mental health. Yet the system can play a role in creating an alternative for these people. We’ve come across excellent examples of Street Triage and Liaison & Diversion schemes which divert people away from the criminal justice system and into the care they need. Acting earlier also means making prisons mentally healthy environments, so they aren’t creating or exacerbating mental health problems for offenders who will eventually leave prison. Finally, the majority of offenders do not go to prison, so it is important that probation services are equipped to provide support in the community, as well as ensuring offenders are ready to re-enter society.

5. Housing

Renters are 75% more likely to experience serious anxiety and depression than homeowners

Insecurity in the private rented sector, as a result of a lack of affordability, short-term tenures, and poor conditions, is a significant damaging factor to private renters’ mental health. Accordingly, it is important that these issues are tackled in order to reduce the likelihood of mental illness and promote positive mental health – the Private Housing (Tenancies) (Scotland) Act 2016 is a promising start but more needs to be done.

6. Communities

Chronic loneliness is a comparable risk factor for early death as smoking 15 cigarettes a day

Local services can play an important role in preventing loneliness and fostering social connection, ranging from highly formal services explicitly aimed at connecting people, to the more incidental connections that are created through the varied community spaces and events that we might engage with on a day to day basis for other purposes entirely. Building these connections can positively influence the way that we think about ourselves and our communities, in turn promoting better mental health, as demonstrated by Haringey Thinking Space.

 

It is evident that if we are to act earlier to promote positive mental health, we need to be acting before people need to engage with mental health services. In order to achieve this, it is essential that we recognise the current crisis in mental health as a social crisis, as opposed to simply a healthcare crisis. In acknowledging that mental health is everyone’s responsibility, sectors should act together to share the cost of early action, as well as the resultant benefits – the triple dividend of enabling people to lead thriving lives, whilst costing less to public services and contributing more to our economy.

If you’re interested in the ideas we’ve raised here and would like to know more, please sign up to our mailing list to ensure you receive a link to the report when it is published. You can also attend our discussion on early action for mental health, hosted by the Big Lottery Fund, on Friday 9th December from 9.30am-12pm. For further information and to register for a free ticket, please visit our Eventbrite page.

Surviving today, jam tomorrow

Monday, November 21st, 2016

Speaking today at the Confederation of British Industry (CBI) conference, Jeremy Corbyn will argue for long-term public intervention for “the common good”He will highlight how the Prime Minister’s mantra of people “just about managing”, now known as ‘Jams’ in Whitehall, doesn’t ring true for many who instead find themselves “just about surviving”. A combination of policy changes and market failures mean this group are forced to continuously cope with immediate challenges rather than being enabled to find sustainable ways out of poverty.

Back in 2014, we published our third report analysing the cumulative impact of welfare reform in East London. It was called “Just About Surviving”, and explored the ways in which individuals and families were struggling to cope with changes to the social security system.

We found that the reforms were putting people into highly stressful situations, often left feeling powerless and trapped in poverty. People were cycling in in and out of poorly paid and precarious employment, constantly juggling diminishing incomes, and making choices that no-one should be forced to make; going without meals so that their children could eat, washing clothes by hand as they couldn’t afford to replace a broken washing machine, and walking long distances to work in the early hours of the morning.

These coping strategies meant that most of them were just about getting by. But only just. People were living on the edge, drawing on finite sources of support where it was available, and increasingly reliant on friends and family as official support was – and is – cut closer to the bone.

The worsening situation

As Corbyn will note, low wages, precarious employment, and high housing costs are pushing these strategies beyond breaking point. Our research shows that this isn’t a new story, and has been a feature of life in the UK for several years now. Structural issues with the labour and housing markets combine with regressive and counter-productive social security reforms to ensure that people are trapped in a cycle of survival; making short term choices that just about keep them afloat for another week or two, but often reduce their possibility of escaping in the future. This short-termism is mirrored in policy making. Measures such as Discretionary Housing Payments (DHP), for example, provide a vital lifeline for many, but rarely come with the support to make sustainable improvements to their lives like finding secure and adequately paid employment or more affordable housing.

As research by Policy in Practice shows, families are set to be £2,500 a year worse off by 2020 due to welfare reform. Whilst this is an important figure and illustrates the scale of the problem, it only tells us part of the story. It doesn’t get at crucial information such as what kinds of coping strategies people may or may not have exhausted. It won’t tell us how the cuts affect individual adults, children, or communities. Nor does it tell us the broader effect on local organisations who are already struggling to meet demand in an increasingly difficult funding environment. We will therefore continue to shed light on these issues through our qualitative research on the cumulative impact of welfare reform, focussing in particular on how Universal Credit affects both those in and out of work.

We are also going to start looking at some of the underlying issues that cause and exacerbate problems for those who are just about surviving. Over the next year we will be conducting in-depth research into the private rented sector, aiming to understand how poor quality housing, overcrowding, and unaffordability can affect people’s health, education, employment and communities. We hope that by doing so we will be able to show that a lack of action by government on these issues is self-defeating and short sighted, as not only will it damage lives, but will increase costs as the demand for services continues to soar.

Moving beyond survival

The problem with the depiction of people as “just about managing” is that it evokes an image of relatively secure individuals and families who face the occasional high fuel bill. It insinuates that they can easily work their way out of their predicament if they just put their minds to it. In turn this leads to policy responses that are partial, short-term, and ultimately unable to enable people to find a sustainable route out of poverty. These responses are also unlikely to solve our low productivity problem, also highlighted in Corbyn’s speech.

The reality for those who are “just about surviving” is far worse than the Prime Minister seems willing to admit. Until we act earlier on the root causes of the problems that this group faces, any progress made via tweaks to the system is likely to stutter and stall before too long. If we want people to thrive, then a long-term investment in society is what we desperately need; more affordable housing, greater job security, better relationships, and a social security system that promotes opportunity rather than acts as a last resort.

Wales: Good reasons to be hopeful

Monday, June 13th, 2016

I met Sophie Howe – the Future Generations Commissioner for Wales – last week. Sophie started work at the helm of the newly minted Commission 4 months ago. I had been looking forward to our meeting for some time. The Act which created the Commission had been in gestation from the earliest days of the Task Force in 2011. Now the powers and responsibilities of the new Commissioner are wider and probably stronger than any of the small number of offices elsewhere in the world that are at all comparable.

Peter Davies previously held a much more limited role as the Commissioner for Sustainable Futures. He was a prime mover in the development of the legislation which created the Future Generations Commission and has been generous in his acknowledgement of the influence of the Early Action Task Force: “The work of the Early Action Task Force has been really influential in the development of the Well – being of Future Generations Act. The concept of early action should be at the heart of sustainable development. The Triple Dividend perfectly captured the essence of this approach and brought much needed focus on action that can take place now, preventing long term consequences and setting a pathway for a more sustainable future.”

Five “ways of working” were outlined in the act. Public bodies need to be demonstrating these in order to show that they applying the sustainable development principle. In essence it is the Commissioners job to ensure that they are and to help them do it well

These “ways of working” are intended to “help us work together better, avoid repeating past mistakes and tackle some of the long term challenges that we are facing”:

1) Long term: The importance of balancing short term needs with the need to safe guard the ability to also meet long term needs

2) Prevention: How acting to prevent problems occurring or getting worse may help public bodies to meet their objectives.

3) Integration: Considering how the public bodies well-being objectives may impact upon each of the well-being goals, on their objectives, or on the objectives of other public bodies.

4) Collaboration: Acting in collaboration with any other person (or different parts of the body itself) that could help the body to meet its well – being objectives.

5) Involvement: The importance of involving people with an interest in achieving the well-being goals and ensuring that those people reflect the diversity of the area which the body serves.”

It would be understandable if many of the leaders of those public bodies, and the list that are named in the act is very comprehensive, felt dispirited by a fresh set of demands on staff teams and departmental budgets that are, almost invariably, smaller now than they were when the Senedd first began to talk about the bill. However I spoke to a mainly public sector audience at the Equality and Human Rights Exchange Annual Conference in Mid Wales earlier in the day and, in the margins of my contribution, discovered that delegates were well informed about the purpose and the requirements of the act and almost unanimously enthusiastic. One told me that the act was “the most positive development in public services since devolution” and another that it was “the boldest thing that the Welsh government has ever done.” Ruth Marks CEO of the Wales Council for Voluntary Action, who I met on Wednesday, had been similarly affirmative.

Of course at the moment everyone was talking about the potential. It will be at least two years before anyone can begin to consider consequences but appetites were keen

The government guidance note answers its own question “Why do we need this law?” with this statement:

“Wales faces a number of challenges now and in the future, such as climate change, poverty, health inequalities and jobs and growth. To tackle these we need to work together. To give our children and grandchildren a good quality of life we need to think about how the decisions we make now will impact them. This law will make sure that our public sector does this”.

It is an ambitious objective and I left Cardiff conscious of the burden of expectation now resting on the Commission but also, and most importantly, impressed by the level of commitment on all sides. There are good reasons to be hopeful.

Displacement is not prevention: acting earlier to prevent homelessness

Tuesday, June 7th, 2016

Homelessness is a problem that has often been met with strange solutions. Take the so-called ‘homelessness prevention spikes’ that we’ve written about before, in which spikes are fitted near buildings to prevent rough sleeping. Rather than deal with the causes of that person’s homelessness and enable them to take steps towards finding a home, it merely displaces them somewhere else to be somebody else’s problem.

It is no wonder that many individuals find it hard to escape homelessness when such approaches not only exist, but are deemed suitable ways to address the issue. I was reminded of this ‘prevention’ technique when reading about Bournemouth Council’s homelessness strategy, which claims to be putting £200,000 towards “assertive techniques and procedures”. Part of this involves buying rough sleepers one-way train tickets to move them out of the area. As with the spikes, rather than dealing with causes of homelessness this strategy deals with their consequences; rendering rough sleepers invisible (to the residents of Bournemouth) and foisting their problems on somebody else. By this logic as long as rough sleepers are not in ‘our’ area then they are no longer ‘our’ problem.

A different approach

Over the past six months we’ve been collecting stories of early action, exploring how individuals and organisations are acting one step earlier in order to solve the root causes of social and economic problems such as homelessness.

To be fair to Bournemouth, their Housing Strategy does go into a bit more detail about their use of the central government Homelessness Prevention Grant (although, slightly worryingly, that has now been absorbed into general council funding) and provide some additional services for those experiencing or at risk of homelessness. Information is scant, however, and other areas seem to be taking a much more proactive, systemic and partnership based approach.

Most recently we heard about the Active Inclusion project in Newcastle (AIN). By working in partnership, AIN enables people to avoid homelessness wherever possible by making advice, information, and support from a range of organisations far easier to access. It works primarily on three levels, from primary prevention (‘information and support for all to identify risks and prevent crises’), through secondary prevention (‘specialist support, accommodation and advice for those at risk’), to crisis activities (‘for people who are literally homeless’). As a result of activities – which can be anything from welfare and debt advice to emergency accommodation – AIN has helped prevent 4,192 potential cases of homelessness in 2014/15.

Another example is Dundee City Council’s Homeless Service Unit. This unit runs a range of services targeted at those at risk of homelessness, from raising awareness among 16 year olds about planning for independent living, to giving people leaving care or prison support through a key worker. They make between 1,000 and 1,500 homelessness assessments each year and it adapts services to reflect need; for example one of the fastest growing reasons for homelessness is insecurity within the private rented sector (stay tuned for our private rented sector briefing that will be published in the coming weeks).

The Passage – a London based charity highlighted in our latest report – have also taken an explicitly preventative approach (whilst also maintaining essential crisis-oriented services). Most notably their Hospital Discharge Service identifies homeless patients (or those at risk of homelessness) who repeatedly present at A&E and refers them to more appropriate services that deal with their underlying crisis. After working with 300 people last year through this service, 70% of them ended up going into accommodation after leaving hospital. They also run a Home for Good service that enables formerly homeless people to connect with local voluntary and community sector organisations, with 97% of the people they worked with retaining their homes after 12 months (as opposed to 84% without this intervention).

Prevention is about more than displacement

These three examples – by no means the only ones to exist across the UK – highlight that homelessness prevention can (and indeed should) be about more than displacement. Early action at its core is about enabling people to flourish, rather than merely preventing them from experiencing negative outcomes (or, in some cases, simply displacing their problems elsewhere).

It also raises an important point about what we measure and how this drives activity. In much the same way as certain types of policing – traditionally driven by the enforcement model (i.e. charging around under blue flashing lights, making arrests, and ‘kicking down doors’) – can drive up arrest statistics, Bournemouth’s attempt to reduce levels of rough sleeping may well ‘work’ when we look at the statistics in a year’s time. But will their ‘assertive’ train-ticket buying ‘techniques’ have actually achieved anything positive for those at risk of or experiencing homelessness? Will they be securely housed and leading happier, healthier and more productive lives? Unless they catch a train to Newcastle or Dundee, I’d guess probably not.

Early action on homelessness in Wales

Thursday, May 19th, 2016

The Welsh government has recently introduced a Housing Act with a new focus on early action to prevent homelessness. This post explores further how such a model can help people to lead thriving lives, while contributing more and costing less.

At Bow County Court in Newham, not far from Community Links, a young couple were recently handed down an eviction notice. The Shelter Housing Advisor at hand advised them that the bailiffs would not come for a few weeks and they should stay in their property until that time. As the article they were featured in described; “such is the madness and complexity of the UK’s housing rules that if you leave your property a moment before the bailiffs come to evict you, you’re “voluntarily” homeless and ineligible for support.”

This is just one example of the flaws in the social security system that Community Links’ Early Action Force is trying to transform. The idea is to build “fences at the top of the cliff, rather than waiting for the ambulance at the bottom”.

It is a welcome announcement then, that the English government has begun to consider the possibility of introducing an additional ‘prevention duty’ for local authorities working on homelessness. This additional duty was inspired by the new approach that the Welsh government has taken towards homelessness, as outlined in the Housing (Wales) Act 2014.

The new Act revolutionises the Welsh government’s approach to homelessness, focusing on preventing the problem, rather than waiting for it to occur and then dealing with the consequences. It is a new, inclusive system designed to help everyone at risk rather than just those in priority groups. The significant early action elements are new preventative duties to help anyone threatened with homelessness within the following 56 days by preventing situations from escalating and to enable any homeless person to secure a home.

Of course, this approach is extremely new so it is difficult to fully evaluate the success of the model. However, reviews so far describe the “overall picture [of the Welsh approach as] an encouraging start with homelessness being successfully prevented for the majority of households.”

Enabling people to lead thriving lives

A major strength of the Welsh approach to homelessness is the focus on earlier action; assisting anyone at risk of homelessness before they lose their home. This means the very real impact of ensuring that people do not have to go through the traumatic experience of eviction and homelessness. Although some of this prevention work was being carried out previously by local authorities, the new legislation now gives people a legal duty to assistance and ensures this is measured. Between July and December 2015 3,605 households were assisted under the new prevention duty with a success rate of 64.8 per cent.

The new legislation also requires local authorities to take a person-centred approach through the use of Personal Housing Plans which are jointly developed with the client. These plans don’t just evaluate immediate housing problems but also consider underlying issues, with the intention that resolving these issues should help reduce any future possibility of facing the risk of homelessness again.

Contributing more

Evidence from Shelter Cymru highlights that despite an increase in people facing homelessness, their caseworkers are achieving better prevention rates than ever before. They credit the new Act for assisting them in achieving a prevention rate of 93% – a new record for the charity.

Data from the Welsh Government also indicates that single people are benefitting more from the new legislation. Between July and December 2015 the success rate for single households was 57.6 per cent, only slightly lower than the figure for all households. This is a significant achievement for Welsh local authorities given the shortage of single accommodation in Wales; demonstrating that they are embracing the duty to help households prevent homelessness on an equal basis, despite single households previously having few rights to homelessness assistance.

Source: Shelter (April 2016)

Costing Less

It is clear that the transition to a preventative approach towards homeless would need additional funding at the outset. In Wales, the Welsh Government has provided an extra £5.6 million in funding to local authorities, with the money to be spent at the authorities’ discretion, provided it prevents or relieves homelessness.

It may initially appear that the early action approach comes at a higher price; however, the significant direct and indirect costs of homelessness must be considered. The staffing and legal costs required to carry out evictions are huge. There are also the indirect costs caused by homelessness on the NHS, the police and justice system, and social services. A government evidence review on the cost of homelessness in 2012 put the figure at around £1bn (gross) annually and this is only likely to have increased given the rise in homelessness over the past four years.

There has not yet been any research conducted on the financial impact of the Welsh homelessness model but as with other preventative action and given the high costs of homelessness, it is likely to prove more cost effective than acute spending in the longer term.

A preventative model that works(?)

The Housing (Wales) Act 2014 is certainly a trailblazer in homelessness prevention, and the early feedback seems positive.

There has been some criticism of elements of the Act such as the removal of priority need for prison leavers, and the introduction of the ability to discharge duty once tenants have been in private sector accommodation for more than 6 months or if they ‘fail to cooperate’ with their Personal Housing Plans. There is also evidence that local authorities are not adopting the legislation in a consistent manner. It remains to be seen if these issues will prevent the Act from providing a sustainable solution to homelessness in Wales.

However, the paradigm shift in thinking by the Welsh government should be welcomed and it is very encouraging to see this early action approach adopted at a systemic level. We hope that the new Act will further influence the English government to consider a homelessness prevention duty, to ensure that our housing system allows people to lead thriving lives, contributes more, and costs less.

Food for thought

Friday, April 29th, 2016

With record numbers of people in work, why are more and more people relying on foodbanks?

This month the Trussell Trust foodbank issued a press release stating that foodbank use remains at a record high, yet almost in the same breath we hear that UK unemployment is at a decade low and benefit sanctions are down. Surely the use of foodbanks – a last resort for those struggling to put food on the table – should be dropping in such an economic climate?

Community Links isn’t a food bank, but in recent years we have been providing food bags for those who come through our doors and who are most in need. As with the Trussell Trust, we have experienced a growing demand for our relatively small stockpile of food, so much so that between June and September last year we actually ran out of provisions and had to turn people away.

For the communities we support in Newham work is no longer a certain route out of poverty as stagnating pay and the increasing cost of living, especially in London, make life less and less affordable. These everyday realities are reflected in the Trussell Trust’s data on the reasons for referrals to their foodbanks. Between 2013/14 and 2015/16 the number of low income referrals rose from 20.3% to 23.3% whilst benefit delays dropped from 30.9% to 27.9% for the same period. Similarly the University of Hull’s Mapping Hunger report found that foodbank use is higher in areas where there are more people in skilled manual work, where people are unable to work due to long-term sickness or disability and areas that are deprived. These findings resound in a place like Newham, where deprivation is high and over half the borough’s residents work for below the London living wage.

No one knows and understands these realities better than Jane, who heads up our reception at Community Links and who is the first point of contact for many local people coming to us for help, advice and support:

“We can’t see people starve – so we give them food. We get people from all walks of life; some people have had their benefits stopped, other people are on low incomes; they’re actually working but can’t afford food for their families. When we haven’t got any food that is a real problem; we give out foodbank vouchers but we know the foodbank is really overrun.”

Generous donations from harvest festival collections in over half-a-dozen schools across Newham make our modest food bags possible, however, there is a limited supply and a growing demand for food. Critically the solution to the escalating issue of food poverty won’t be solved by charities like Community Links and the Trussell Trust providing more food, but by Government addressing the root causes of poverty in our communities. For us these are high housing costs and insecure accommodation, low pay and insecure work, and the problems people face accessing benefits.

In 2013 we blogged on whether foodbanks were becoming part of our welfare system. Since then the number of people turning to the Trussell Trust for emergency food has increased from 346,992 to 1,109,309, with an increasing number of these people being in work. Reflecting on these shocking figures it’s fair to say that consecutive governments have failed to stem the flow of people relying on foodbanks. Even the welcome introduction of the new mandatory national living wage this year will do little to counteract the impact of escalating housing costs, insecure work and the predicted losses for low-income working families on Universal Credit.

To avoid the increasing reliance on foodbanks it’s no longer enough for governments to talk about making work pay and affordable housing. Instead we need to act earlier and build a social security system which values and invests in people’s strengths and capabilities, ensuring they’re secure and ready to both seize opportunities and deal with setbacks. Key to this is ensuring a house is a home, especially for vulnerable families who too often see their employment, education and social opportunities dashed as a result of accommodation insecurity.

Don’t read this blog

Monday, April 18th, 2016

There is so much to be learnt from the seven early action stories which we published last week that your time would be far better spent reading the report than reading this blog…

Back again so soon? Well no doubt you will have your own list of favourite insights from the case studies, but here are mine:

1) Early action CAN be measured:

Early action sceptics and naysayers often argue that you can’t count what doesn’t happen, and that even if you could count it, you wouldn’t be able to assess the saving with any accuracy. Boilers on Prescription did both. They can show very clearly that, within 18 months and as a direct result of their work, the need for GP appointments for their chronically sick client group had fallen by 60% and that the number of people admitted to hospital had fallen by 25%. Given that each doctor’s appointment costs £50 and each admission costs £2500 it isn’t difficult to understand how they justify the claim that their investments in household heating improvements are recovered within 9 months. Other featured projects could be similarly precise about the “business case” for their work. We really must stop tolerating the idea that early action can’t be measured.

2) A better today as well as a better tomorrow:

The numbers also emphatically dismiss the other urban myth about early action – that preventative activity always takes a very long time to bear fruit. The Passage “Homes for Good” project works to prevent repeated homelessness and has, over the last year, enabled 97% of its formerly homeless clients to retain their homes as opposed to 84% of the clients who received no such support. People are befitting within 12 months. As NCT chief executive Nick Wilkie said at the launch of the report yesterday “we are often told that we have to choose between dealing with a problem today or preventing it tomorrow. Actually that isn’t so. Early action is about a better today and a better tomorrow”.

3) The value of light touch relationships:

We have noted before that strong relationships are frequently part of the most effective early action programmes. Relationship based projects like the Ceredigion Specialist intervention Team  and Includem featured in the report and reinforce this point, but the experience of Detecting Cancer Early shows that, in some circumstances, this approach doesn’t need to be as intensive, and therefore as expensive, as we might first imagine. A sympathetic phone call, as opposed to a dessicated text, is increasing take up of cancer screening appointments in east London by 15%.

4) Partnerships with unlikely friends:

There are lots of reasons why partnership working is frequently a sensible thing to do but invariably this means working with people like us and organisations like ours. The remarkable Call and Check initiative in Jersey utilises the “delivery platform” of the postal service to improve health and social care on the island and the Passage’s Before you Go programme has partnered with, amongst others, embassies in Bulgaria, Lithuania, Romania and Poland. Whether it is the postie or the ambassador stretching our imaginations to work with unlikely friends brings new and quite different resources to the mission.

5) Building on strengths:

Launching the report yesterday Big Lottery Fund CEO Dawn Austwick noted that funders too often ask “what’s the matter with you” rather than “what matters to you?” In other words grant makers and commissioners and indeed many policy makers and practitioners, look for a deficit to fill rather than an asset to build on. All the featured projects, in their different ways, flipped this around looking for strengths sometimes in improbable places. Nowhere is this more evident than in Jobs, Friend and Houses where the “recovery community” in Blackpool are working together on renovating and renting out derelict properties . Most are ex offenders with a history of alcohol or drug dependency. After 2 years 5% have relapsed, none have reoffended. These are people who are, often for the first time in their lives, focusing on what they can do, clearly very well, not on what they can’t. “We look at today and tomorrow” says CEO Steve Hodgkins “not yesterday”.

These seven stories are the first in a new gallery of case studies that we will be building up over the coming months. Do please get in touch if you are part of a story that should be told.

Join us on 14 April to hear Early Action Insights from the frontline

Thursday, March 31st, 2016

Back in early November we asked you to share your experiences of early action; services or activities, in any sector and for any age, that stop a social problem from getting worse or arising altogether. Since then we’ve collected over twenty examples of projects that are acting earlier; enabling people to lead thriving lives, costing less and contributing more.

On 14 April we’re launching our report A Rough Guide to Early Action: How society is acting earlier, featuring some of the examples we think showcase how early action is a different approach to public services that are delivering financial, social and economic benefits.

The event will also be the first in our Early Action Insights series – seminars for practitioners, policymakers and funders to discuss how implementing early action can practically be achieved. In this meeting we’re showcasing Boilers on Prescription and The Passage in an open discussion chaired by Dawn Austwick, CEO of the Big Lottery Fund.

Boilers on Prescription is getting doctors in Sunderland and Durham to prescribe home heating improvements for people with chronic respiratory diseases. After 18 months, their doctor’s appointments have fallen by 60% and visits to A&E by 30%. The Passage is a London homelessness charity that’s made prevention a key aim in a sector often pushed into managing crisis. Responding to increasing repeat homelessness, one of its projects – Homes For Good – connects formerly homeless people with community organisations, enabling them to build a social support network that helps them keep their homes. Over the last year, 97% of the people it supports are still living in their own homes.

By hearing from the practitioners that are making these projects happen, we’ll share insights on the practical challenges facing others seeking to put early action into practice. That’s why Boilers on Prescription will shed light on how to engage partner organisations to deliver early action. The Passage will help show how resources can be reinvested to run prevention alongside acute services. And we’ll also discuss how early action can be implemented in austerity, how to measure its impact and how organisations can use their frontline experience to design early action services.

In such austere times, having a platform to discuss how we can make a common sense idea like early action common practice is more important than ever. With increasing funding cuts to public services, early action is a long-term strategy that will reduce our need for costly acute services and make better use of existing spending in the meantime. People who are not facing problems are healthier, happier and more able to contribute at work, support their families and get involved in their communities. This is good for individuals, good for society and good for our economy.

As it is, George Osborne’s budget announcement that an additional £3.5 billion needs to be cut by 2019/2020 is forcing already tight budgets (over a third smaller in real terms since 2010) to breaking point. It’s a short-sighted approach that will not only increase our need for acute services later down the line, it’s effecting policies that are failing to address some of the systemic reasons why people continue to face problems in the first place, including a disproportionate squeeze on low-earnersgrowing housing insecurity and rising health inequalities.

We hope our Rough Guide to Early Action will inspire you to start thinking differently about how services can be delivered. There’s a lot to be done at governmental level, but growing momentum for early action also depends on building our knowledge of what works, and sharing what’s possible from the bottom-up. Localism does not limit its ambition. As Boilers on Prescription and The Passage show, early action is getting traction with big players such as the NHS. It’s by sharing how this was achieved and how other projects have amplified their work that we’ll start seeing services acting earlier. That’s why we hope our Early Action Insights series will be a space for practitioners to get inspired and equipped to make early action a reality in their areas.

We welcome you to join us on 14 April 2016 in London for the first Early Action Insights,
book your place
 here.

 

With many people on low incomes facing housing insecurity, this is not a budget for future generations

Wednesday, March 16th, 2016

George Osborne has coined this year’s budget as one ‘for the next generation’. But apart from successfully grabbing headlines with his ‘sugar tax’ on soft drinks, he’s delivered very little that’ll breakdown the structural barriers facing younger generations.

 photo George Osborne_zpsaxk1xack.jpg

The Chancellor’s plan to help us save does not address the reasons why many of us struggle to save in the first place. For low to middle income workers the government’s ‘Help to Save’ scheme is a sticking-plaster as declining incomes forecasted for the poorest 25% of households, cuts to child tax credit and increasing conditionality on benefits means that many families are living on less week-by-week, let alone saving for the future. People earning between £10,000 and £19,000 rarely ever save money, according to the Citizen’s Advice Bureau. Rather than helping low and middle income families, the ‘Lifetime ISA’ will only benefit those who can already afford to save.

Home-ownership is similarly unattainable for younger generations. Osborne has given a tax-break for people renting out their properties online but has done nothing to address the chronic housing shortage, leading to burgeoning numbers of families living in the expensive private rented sector, crowded multiple occupancy tenancies or waiting years to get into social housing. Renters pay almost half their income on rent, and that rises to over 70% for London renters, according to the English Housing Survey. This is locking in a generation to a lifetime of renting, making it harder to keep consistent employment or education and fuelling anxiety caused by precarious month-by-month tenancies.

For those without even basic shelter, the £115m earmarked to support rough sleepers is too little too late. Over 40% of homelessness services have faced severe funding cuts over the past year, according to Homeless Link, with very few able to provide preventative services ensuring people don’t become homeless in the first place. In a sector still dominated by crisis management, £115m is a drop in the ocean for enacting the kind of serves that’ll mean homelessness isn’t an issue in future generations.

In our last blog we reported on the bleak outlook for the young and working-age, with levels of poverty rising sharply among 16-24 year olds and incomes for pensioners rising ten times faster than for young people since 2002. Osborne says he’s delivered a budget ‘backing people who work hard and save’, but there is little in this budget to tackle the reasons why people are in precarious employment, out of work altogether, or unable to save. These are some of the key drivers of poverty and without a plan now, Osborne is not building the foundations to benefit the next generation.

From our experience of working with low and middle income families in Newham, where 40% of people are under 25, we need more investment to address problems earlier. For job insecurity this means incentivising businesses to reduce zero-hours contract and supporting people to progress in work, rather than waiting until they’ve been out of work to offer employment support. For housing insecurity this means regulating the private rented sector, making sure people have secure rental contracts enabling them to plan for the cost of accommodation, rather than needing crisis support after a long period of housing insecurity. If we address these issues now we will be far closer to Osborne’s vision of a future generation of hard working savers.