Intensive family support through prevention and family empowerment in Coventry

Learning points

The approach remains innovative, even improvised, as there is no standardised approach or list of recommended interventions – this may be part of its success. However, as the programme progresses, it may be possible and desirable to develop a template of possible interventions to help the staff in the different agencies involved.

It has been recognised nationally that the impact of the Troubled Families programme on supporting Early Help has been limited by the narrowness of the national criteria that determine eligibility for the programme. Consequently, the Phase 2 of the programme is intended to give better support for interventions with families before they reach crisis point. This is exactly what the Intensive Family Support initiative offers.

Again under Phase 2 of the national programme and for the purpose of Early Help, Health is intended to become a much more prominent partner. The links that have already been forged across Coventry through the development of the Acting Early Project which amalgamates Children’s Centres, Midwives, Health Visitors, Family Nurse partnership and school nurses to work together to identify families needing support much earlier should provide a good starting point for this, but much remains to be done. The programme will also need to work further with adult services in relation to adult mental health to ensure children are fully supported.

Finally, the programme has shown that the current Payment by Results process is resource intensive, involving examination of cases from many delivery agencies, undertaking manual checks against the national criteria to determine eligibility for the programme and manual checks against the Payment By Results Outcomes. This is not cost-effective, so new approaches will need to be found. The development of a generic national database will be very cost effective especially if there is the possibility for all agencies to be able to input their data onto one system. We can then measure like with like.

In regards to Payment by Result, the likely future is that Payment by Result will be rolled out across the public and private sectors – this will possibly be through Social Impact Bonds (SIBs) which encourages organisations and large companies to invest in communities to help them build resilience by providing up-front cash for results. This will take the fiscal burden away from central government placing the success or failure of communities firmly in the hands of local government and communities, making them responsible for their own outcomes and futures.

With schemes like Payment by Result there is always a moral dilemma of ‘cherry picking’  or truely wanting to see sustainable change with the most complex families, which in turn will affect the quality of life for the communities in which they live. For Coventry there was always the propensity to ‘cherry pick’. However, there were other more prominent drivers around reducing the number of children in Social Care and on Child Protection plans which requires whole systems change. Partners also needed to be on board working in the whole family way with everyone taking responsibility for their part in helping families to change their behaviour rather than referring or passing them onto other agencies.

Agencies need to look at what needs to change to get the required outcomes especially in this time of economic austerity – as the footprint of agencies decrease capacity needs to be built with partners rather than through people resources and duplication. Both are very costly but cultures are hard to break.