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Districts and county launch tender for 'troubled adults' service

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Three Hertfordshire councils are tendering for a Troubled Families style service for adults with “complex and chaotic” needs, in partnership with the local police, NHS and housing associations.

The joint funded ‘preventative and intensive support service for adults with multiple complex needs’ will be piloted in Hertsmere BC and Three Rivers DC, with support from Hertfordshire CC.

Like the national Troubled Families programme, which has been credited with improving the lives of more than 100,000 families, it will provide intensive support for costly users of public services. However, it will focus on individuals rather than families.

In his autumn statement chancellor George Osborne said the government was considering rolling out the Troubled Families approach to other groups with complex needs. Nothing has been proposed at a national level although other areas are believed to be exploring the approach.

The Hertfordshire contract will be worth between £2m and £4m over four years. The advertisement says the “vision” for the service is to provide “supportive relationships, appropriate accommodation and fulfilling daily activities for adults with complex and multiple needs, through a more cost effective use of collective resource”.

It says the successful provider must be able to deliver services to “complex and chaotic clients” as well as providing analysis “which will help influence the delivery of public services in Hertfordshire”.

Donald Graham, chief executive of Hertsmere and chair of the project steering group, told LGC it had grown out of a realisation among frontline public service workers that they were all dealing with the same repeat service users.

An analysis of the costs to local agencies found the 20 most frequent users of public services in Hertsmere and Three Rivers cost more than £1.3m between them over two years (see table). One individual cost almost £80,000, including £36,538 on property damage, more than £16,000 on arrest and police custody and over £10,000 on hospital services.


Agency / SectorTotal Spend on 20 most frequent users
Housing / Supported Living£133,000
Social Services (children in care)£229,000
Criminal Justice£431,000
Borough / District Councils£81,000


Mr Graham said: “There is obviously a financial imperative but the driving force behind this is improving the outcome for the client otherwise you have a never ending cycle. If you’re spending that amount on one individual it’s not sustainable.”

West Hertfordshire Clinical Commissioning Group and Hertfordshire Constabulary are contributing the most financially, at around £120,000 a year, reflecting the greater costs incurred by their services. Hertfordshire CC has pledged £60,000 a year while the two districts have each pledged £20,000 annually. Three local housing associations have pledged between £2,500 and £10,000 per year.

It is hoped the pilot will deliver services to about 60 individuals who can be referred by the agencies involved. If the pilots are successful there are plans to roll it out elsewhere in the county.

Mr Graham said learning and evaluation of the Hertfordshire programme would be published so other areas could learn from it.

“For Hertfordshire this will be a model for all the agencies but it could possibly be of national significance as well.”


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