” Understand the Economics of Real Help Systems By Karl Robinson Stoke-on-Trent City Council 17 th...

”Understand the Economics of

Real Help SystemsBy

Karl RobinsonStoke-on-Trent City Council

17th October 2013

What Does Success Look Like?• Problems We Wanted to Solve– Does this way of working improve things for our

residents?– Is this way of working Affordable and Scalable?– Will it reduce demand on the whole system?– What are the links to the Cross Economy system and

the Problems they have to solve e.g.• Health – Reducing the demand on A&E admissions• Police – Reducing the number of both uniformed

and non uniformed staff without compromising the service• Social Care – Getting better results with less resources i.e.

impact of having Children in Care

Understand the Customer

“C” “W”

0123456789

10

Help me to feel betterabout myself

Help me to provideequipment to support

my childs education

Help me to getnecessary repairs to my

property

Help me to getemployment

Help me to maintain mygarden

Help me to getnecessary furniture for

my home

Help my ex-partner withhis housing need so he

can see his children

Help me to manage myfinances

Help me to get trainingfor future employment

"C"

Jan-13

Mar-13

Aug-13

0123456789

10

Help me with suitable andbigger accomodation for my

large family

Help me with my debts

Help me with managing myfinances

Help me to get employment

Help me with basic food

Help me with problems at mysons school with bullying

Help me with my relationshipand trust issuesHelp me with my benefits

Help me with problems thatchildren are causing on the

estate with my son

Help me to get rid of myrubbish

Help me with my childrenstravel to school

Help me to provide/get freeschool meals for my children

Help me with my childrenstransfer to a new school

"W"

Jan-13

May-13

Aug-13

Demands in Context

Comparing Old and New Costs• We needed a way to understand the costs both

before and after working with citizens in a different way.

• Options We Explored:– Develop a new cost model

• Too complex and time consuming to produce a robust model;

– Identify an already available cost model that is:• Already validated and nationally recognised;• Easy to understand and adapt as we learn more about

systemic economics

• Solution we Identified• The DFE Cost Calculator Model

The Approach To Understanding Costs• Old World– Identify all activity that had been carried out on

individual citizens for a 2 year period prior to working with them in a different way

– Collect all this data across partner agencies

• New World– Activity based on resolving ‘Demand in Context’ at

individual level– People presenting through:

• Rent Arrears, Police, etc• Locality = 1 Ward in Little Chell and Stanfields

Result:Cost Comparison at Individual Level

Yr1 Q1 Yr1 Q2 Yr1 Q3 Yr1 Q4 Yr2 Q1 Yr2 Q2 Yr2 Q3 Yr2 Q40

50

100

150

200

250

Cummulative Comparison of Pre and Post-Intervention Activity: K

Pre-Interventioin Transactions (Cummulative) Post-Interventioin Transactions (Cummulative)

Yr1 Q1 Yr1 Q2 Yr1 Q3 Yr1 Q4 Yr2 Q1 Yr2 Q2 Yr2 Q3 Yr2 Q4 £-

£5,000 £10,000 £15,000 £20,000 £25,000 £30,000 £35,000 £40,000 £45,000 £50,000

Cummulative Comparison of the Number of Pre and Post-Intervention Transactions: K

Pre-Interventioin Cost (Cummulative) Post-Interventioin Cost (Cummulative)

Developing the Measures Framework• Approach– Identify set key strategic measures• 35 key measures identified including Rent Arrears no’s,

Rent Arrears £’s, Police ASB No’s, Rent Notices of Serving Possession (NOSP’s), etc

– Feed in cases to the Locality Team from Little Chell and Stanfields

– Produce data to compare Little Chell and Stanfields with City wide and 2 control groups in capability chart form to understand how the new way of working impacts on the measures

What we Learnt from the Measures

Strategic Measures

Individual Measures

?• How do we know

who to intervene with?

• Can we make these people visible? -

The Missing Link Tier 2

The Tier 2 Matrix

Street number Street name PoctcodeCYP Referral

CYP Re-referral

CYP asst. to service

Rent Arrears YAMH ASB VA Crime

Count of Flags

A CARSON ROAD ST 6 7BG Y N N Y N N N Y 3B CROSSLEY ROAD ST 6 7AJ Y N N Y N N N N 2C BARNETT GROVE ST 6 6NA Y N N N y N N N 2D CROSSLEY ROAD ST 6 7AJ Y Y Y N N N N Y 4E CROSSLEY ROAD ST 6 7AJ Y N N N N N N Y 2F CROUCH AVENUE ST 6 7HT Y N N N N N N N 1G GALLIMORE CLOSE ST 6 4DZ Y N N N N N N N 1H GREENBANK ROAD ST 6 7EY Y N N N N N N Y 2I HUNTILEE ROAD ST 6 6EP Y N N N N N N N 1J IRENE AVENUE ST 6 7HB Y N N N N N N N 1K IRENE AVENUE ST 6 7HB Y Y N N N N N N 2L NORRIS ROAD ST 6 7AS Y N N N N N N Y 2

Tier 2 Challenges

• Data Sharing

• Partner Data

• Measuring changes to cases meeting Rebalance Me triggers

Cost Analysis Comparison

PoliceSocial Services Health ServiceLocal Authority Education

£2k

£6k

£10k

Historic Approach

Principles-Based Approach

£ 83,649

£ 824

£ 3,379£4k

£8k

£12k

£14k

£80k

£ 646

£ 2,859

£ 214

£ 3,818

£ 33 £ 493

Principles-based Approach£ 2,210

2%

£££99%

£££81%

£££93%

£££99%

£ 106,777 Historic Approach

Multi-agency Mtngs

0

2

4

6

8

10

I am listened to and heard

I have more confidence

My financial problems are

sorted

My children can sleep in their

own room

My children have space to

play

I have some space of my

own

I am able to manage my

home better

Our sleeping arrangements do not affect …

Start

29.06.12

24.09.12

Tier

1 –

Indi

vidu

alO

utco

mes

/ Ec

onom

ics

Tier

2 -

Geo

grap

hyCa

paci

ty /

Scal

abili

ty

Tier

3 –

Str

ateg

icD

eman

d Re

ducti

on

& C

ost R

emov

al


CYP Re-referral



Count of Flags


16 %

75 %

I could go either way

I am in balance but I need a little help

6%

I am in need of serious help

Our New Measures Framework

Tier 3

Tier 2Tier 1


CYP Re-referral



Count of Flags


Cost Analysis Comparison

PoliceSocial Services Health ServiceLocal Authority Education

£2k

£6k

£10k

Historic Approach

Principles-Based Approach

£ 83,649

£ 824

£ 3,379£4k

£8k

£12k

£14k

£80k

£ 646

£ 2,859

£ 214

£ 3,818

£ 33 £ 493

Principles-based Approach£ 2,210

2%

£££99%

£££81%

£££93%

£££99%

£ 106,777 Historic Approach

Multi-agency Mtngs

0

2

4

6

8

10

I am listened to and heard

I have more confidence

My financial problems are

sorted

My children can sleep in their

own room

My children have space to

play

I have some space of my

own

I am able to manage my

home better

Our sleeping arrangements do not affect …

Start

29.06.12

24.09.12

What Does the Measures Framework Tell Us About Working in the New Way?

Impact on the Strategic Measures – Tier 3

Rent Arrears - Housing tenants in arrears (amount)City Pilot Geography

Comparative Geography 1 Comparative Geography 2 0.8% Increase

5.5% decrease

13.9% decrease

1.27% decrease

Rent NOSPsCity

6.1% increase 1.56%

decrease

33% increase

No changeComparative Geography 1 Comparative Geography 2

Pilot Geography

Police ASB reported casesCity ASB

21% increase 5.2%

decrease

5.9% increase

23.8% increase

Comparative Geography 1 Comparative Geography 2

Pilot Geography

Crime reported casesCity Crime

8.8% increase

No change

9.2% increase 14.9%

increase

Comparative Geography 1 Comparative Geography 2

Pilot Geography

Impact at a Systems Economic Level – Tier 1

Tier 1 – Whole System Activity and Economics

0

50

100

150

200

250

Pre-intervention post-intervention

99% 174%

10%

80%

95%150% Pre: 0

Post: 4


Local Author-ity

40%

NHS18%

Police40%

Local Author-

ity84%

NHS7%

Police4%

Pre Intervention Activity Post Intervention Activity

Fire11%

Fire Service4%

Local Author-ity

36%

NHS41%

Police17%

CAB1%

Pre Intervention Activity Post Intervention Activity

Police31%

NHS13%

Local Auth. 6%

CriminalJusticeSystem49%

Fire Service 1%


Cumulative Pre & Post Intervention Activity: 7 Cases

Pre-Intervention Activity(Cumulative)

Post-Intervention Activity(Cumulative)

Tier 1 – Activity and Economics


1,480


Difference : 470


1,480

1,010


Cumulative Pre & Post Intervention Cost: 7 Cases



£337,000



Difference : £104,000£337,000

£233,000


Is it Scalable?

Tier 2 – Matrix

• Key findings from the matrix:• The data suggests that there is a total potential for 5482

Rebalance Me cases across the city.• Using the model of 16 ongoing cases per worker, we would need

368 workers to deal with these cases over a 12 month period. • Using the model of 16 cases per worker, we would need 119 staff

to deal with the total caseload over three years. • For the test area of Little Chell and Stanfields, there are 176 cases

now identified through the matrix.

1. We can estimate the total potential caseload and demand types across any geography from a street to whole city level

2. We can use the matrix to identify and prioritise caseloads for allocation to staff, ensuring we can approach those who need help, rather than relying on picking them up through a presenting demand anywhere within the system

Triangle of Need

1,2051%

18,05217%

88,24382%

6%

28%

65%

Specialist, Multiple NeedsRe-balance MeBAU-Housing

I am living my life well

I could go either way

I’m in need of

serious help.

Is It Affordable?

Tier 1 – Activity and EconomicsEconomic Comparison (liner chart over time):

£337,000

£233,000

Difference : £104,000

A Summary of the Potential Savings

• The model estimates savings of around £104,000 for the seven cases reflected. This would equate to an average saving of £14,857 per case.

• Potential savings of around £81.5m (across the partnership) that could be delivered in line with roll-in plan.

• Note– Small sample size and needs to be validated as cases are added

into the analysis to make it more statistically robust. – This goes back to one of the data sharing issues we highlighted

earlier.

” Understand the Economics of Real Help Systems By Karl Robinson Stoke-on-Trent City Council 17 th...

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