Introduction

The event in the London was held with the London Partnership on multiple disadvantage on 9 December 2010 and attracted a wide audience of staff from both the statutory and voluntary sector including Care Trusts, Registered Providers, Charities, Service Users and Community Interest Companies.

The Chair of the event Ian Winter, Deputy Regional Director, Department of Health introduced the day, providing a helpful context as to what the event hoped to achieve. Joanne Fearne from the Cabinet Office Senior Policy Advisor provided an overview of the Government focus on reducing disadvantage and the Cabinet Office project. Ann Skinner from the Department of Health spoke on meeting the needs of those experiencing multiple disadvantage in London and the work of the London Partnership. 

 Vic Rayner, Chief Executive Officer made a joint Sitra and National Housing Federation presentation “Joining up the dots of the new landscape” to enable participants to have an overview of the policy environment prior to the debate on multiple disadvantage and the Big Society and attending the workshops which included lessons learned in tackling multiple disadvantage, GP commissioning, personal health budgets and personalisation in practice.

Adults experiencing multiple disadvantage on the outside looking in at the Big Society

A highlight of the day was the panel discussion on Adults experiencing multiple disadvantage on the outside looking in at the Big Society. The open floor debate by a panel included Dr Rachel Perkins, Ex-Director of Quality Assurance and User/Carer Experience South West London and St George's Mental Health NHS Trust and Jeremy Swain, CEO, Thames Reach.

Unfortunately Martin Cheeseman OBE, Director of Housing and Care, Brent Council, Anna Coote, Head of Social Policy, New Economics Foundation were unable to attend however Selina Douglas, Strategy and Commissioning Manager, Westminster Council and Andrew Van Doorn, Housing Lead for the National Mental Health Development Unit generously stepped in, and the panel was effectively chaired by David Brindle, editor public services, Guardian.

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Key themes from the debate

  • The key challenge to the Big Society is to ensure that those most excluded and mist disadvantaged have a role in it and become active citizens.  A significant part of this challenge is that these people are not ‘nice’ to help we need to embrace the people no-one else wants to embrace. 
  • There is a huge mileage in peer support services run by socially excluded people for socially excluded people.  Peer services need investment it is not getting something on the cheap however it can deliver real savings
  • It is difficult to disagree with the concept of Big Society, local communities want more power but they also want good services.
  • Services need to stop operating in ‘silos’ where it becomes easy to pass people around and difficult to find ownership of services for people with multiple disadvantage
  • Housing cannot be considered separately from everything else it is integral to resolving other needs and can contribute to improving outcomes in other services e.g. health and care.  There must be attention paid to the current context however and its impact on housing, decreasing capital available, benefits cuts, lack of employment etc.  There also neds to be consideration paid to the fact that people may end up staying in supported housing longer than they need to as they will be unable to move anywhere else.
  • Primary contractors should be compelled to pass work down to those who work with people with multiple disadvantage
  • Those who work with people with multiple disadvantages often have low expectations and aspirations of what people are able to achieve for example employment and home ownership.  This work needs a highly skilled workforce who has the expertise, knowledge and skills to work with this client group. It needs to be specified in each contract commissioned that staff have the competence to carry out this work
  • One solution would be to take money out of each silo, accept that people fall out of services and use the money to navigate them back in.
  • This work requires joint teams not just joint commissioning if it is going to deliver services that people want, for example, services at weekends
  • The changes for example GP commissioning could become a commissioning ‘train crash’ however this does provide opportunities providers should be remodelling their offer and have dialogue with commissioners about the really good services they can offer.

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