Complex needs and complex systems: presentation about severe and multiple disadvantage at Darabeers Warwick at the University of Warwick 14 June 2018

1. Complex needs and
complex systems
Making sense of the world of
severe and multiple disadvantage
Si Chun Lam
Presentation to DatabeersWarwick
14 June 2018

2. Background
What is happening
Descriptive analytics
Why is it happening
Diagnostic analytics
What is likely to happen
Predictive analytics
What should we do
Prescriptive analytics

3. What are multiple complex needs?
Determine current needs and
service provision
Pilot new
interventions for
people facing MCN
Evaluate interventions
and make
recommendations for
systems change
Coventry multiple complex needs programme

4. Council: social care, tax & benefits
Coventry and Warwickshire
Partnership
NHS Trust
University Hospital
Coventry and Warwickshire
NHS Trust
West Midlands Ambulance Service
NHS Foundation Trust
Coventry and Rugby
Clinical Commissioning Group
Health: hospitals, GPs, mental health
Probation
Housing and homelessness
Police, fire and regional groups
Voluntary sector and multi-agency advice and support
…but haven’t we got lots of services?
Substance misuse

5. Supporting People
via
1,005
Homeless
OASys
via
1,393
Offending
1,530
Substance misuse
1,211
Offend+
Subst
457
Homeless+
Subst
297
Homeless+
Offend
891 (SP)
SMD3
480 (OA)
6,601
SMD1-3
West Midlands Ambulance Service
NHS Foundation Trust
Coventry and Rugby
Clinical Commissioning Group
University Hospital
Coventry and Warwickshire
NHS Trust
120
(Sep 2016)
7,030
call-outs (Sep 2016)
1,657
(Dec 2016)
150
Aquarius(2016)
2,000
AddAction (2016)
60
older people accessing
floating support
(2016)
150
Compass (2016)
8,000
CAMHS(2016)
200
16-24 supported accommodation
(2016)
100
CAF (Sep 2016)
653
children’s social care contacts
(Apr-Sep 2016)
400
accessing
tenancy support
(2016)
311
statutorily homeless
(Apr-Sep 2016)
500
homelessness
prevented
(Apr-Sep 2016)
1,695
homelessness clients
(2015/16,up 25%)
Severe and multiple disadvantage in Coventry
IMD 2015 WMP Sep 2016 NPS Sep 2016
Ignite/social care Mar 2016 Benefit cap Sep 2016 HB/CT Aug 2015 (some data quality issues)
Male healthy LE 2009-13 Female life expectancy 2009-13 Female healthy LE 2009-13
SWMCRC Dec 2016
Male life expectancy 2009-13
Mapshttps://smarturl.it/cov-mcn-maps
The most common characteristic is
age
26-34
gender
male
ethnicity
white
british
39% 95% 69%
0
10
20
30
40
50
18 - 20 21 - 25 26 - 34 35 - 49 50 - 64 65+
Female Male
69%
4%
3%
3%
2%
2%
2%
1%
1%
1%
1%
12%
White British
Black African
Mixed White/Black…
White Other
White Irish
Asian Indian
Asian Chinese
Asian Other
Black Other
Black Caribbean
Mixed Other
Not stated
Characteristics
Coventry Multiple Complex Needs
n=120
Offending-related risks
Risk of serious harm
2%
57%
42%
Low
Medium
High
OASys General reoffending Predictor (OGP) score
47%
36%
14%
3% Very High
Low
Medium
High
Coventry Multiple Complex Needs
n=120
Offending-related needs
Number of need categories per person
2
7
17
20
24
16
21
11
2
2
3
4
5
6
7
8
9
10
The most common needs are…
needs
six
category
thinking &
behaviour
20% 99%
thinking & behaviour 119
Frequency of needs
lifestyle&associations103
attitudes91
relationships83
alcoholmisuse77
emotionalwellbeing67
accommodation54
financial
management&
income54
drugmisuse53
EET*35
*employment, training & education
Grouped need categories
social & family (100%)
health & physical (94%)
financial & housing (71%)
employment & education (29%)
Criminogenic needs are identified from a criminogenic needs assessment. For instance, a criminogenic need of
relationships” are identified and scored if close personal relationships ( ie with family or partners) generate
difficulties/conflict that contribute to that individuals risk of harm or risk of reoffending.
Coventry Multiple Complex Needs
n=120
People being supported by SWM Community Rehabilitation Company in Coventry
Current cases on OASys December 2016
Offending-related needs
Coventry Multiple Complex Needs
n=1,657
1534
1142
585
502
475
426
423
347
306
227
Thinking and behaviour
Attitudes
Lifestyle and associations
Relationships
Employment/training/educ…
Alcohol misuse
Financial management &…
Drug misuse
Emotional wellbeing
Accommodation
89 93
488
369
160 177 123 72 58 23 5
0 1 2 3 4 5 6 7 8 9 10
The most common needs are…
needs
two
category
thinking &
behaviour
29% 93%
Number of need categories per person
Frequency of needs
Criminogenic needs are identified from a criminogenic needs assessment. For instance, a criminogenic need of
relationships” are identified and scored if close personal relationships ( ie with family or partners) generate
difficulties/conflict that contribute to that individuals risk of harm or risk of reoffending.
People being supported by SWM Community Rehabilitation Company in Coventry
Current cases on OASys December 2016
Characteristics
Coventry Multiple Complex Needs
n=1,657
The most common characteristic is
age
26-49
gender
male
ethnicity
white
british
68% 86% 48%
0
200
400
600
800
1000
18 - 20 21 - 25 26 - 49 50 - 64 65 +
Female Male
796
57
52
52
47
37
29
28
23
13
11
8
7
6
3
1
151
336
White British
White Other
Asian Indian
Asian Chinese
Black African
Black Caribbean
Mixed White/Black…
Asian Other
Asian Pakistani
Black Other
White Irish
Mixed White/Asian
Asian Bangladeshi
Mixed White/Black African
Mixed Other
White Gypsy/Traveller
Not stated
Not recorded
Low
18%
Medium
45%
High
1%
Unknown
36%
People being supported by SWM Community Rehabilitation Company in Coventry
Current cases on OASys December 2016
Offending-related risks
Risk of serious harm
Coventry Multiple Complex Needs
n=1,657
OASys General reoffending Predictor (OGP) score
Low
29%
Medium
17%High
7%
Very
High
2%
Unknown
45%
Coventry repeat demand data from West Midlands Police
Incidents recorded and police call-outs in September 2016
Incidents and call-outs
Coventry Multiple Complex Needs
n=7,030
20.35
Citywide
7.61
Wainbody
10.27
Whoberley
30.26
Henley
40.93
St. Michaels
31.23
Foleshill
3.41
Upper Stoke
1.60
Wainbody
1.81
Earlsdon
3.83
Foleshill
5.24
Henley
4.49
Binley & W’hall
2.23
Bablake
3.05
Citywide
5.38
St. Michaels
Incidents Recorded crimes
(rate per 1,000 population) (rate per 1,000 population)
Coventry repeat demand data from West Midlands Police
Incidents recorded and police call-outs in September 2016
Frequent callers
Coventry Multiple Complex Needs
n=7,0300
5
10
15
20
25
30
5,372
incidentswithphonenumbers
4,036
uniquephonenumbers
1.24
incidentsperphonenumber
76%
(4,330 includingwithheld numbers)
54 calls from four
residential numbers
ASB + mental
health
37 calls from
Council monitoring
unit and parking
services
16 calls from
National Express
garage (mostly
ASB)
⛽11 calls about
bilking at ASDA, 38
total petrol station
calls
28 calls from two
children’s homes
(mostly missing
kids)
10 calls from a
special school
(abscondingkids)
52 numbers responsible for five or more calls
totalling 419 calls
12 numbers responsible for ten or more calls
totalling 177 calls
14.75 incidentsper
phonenumber
8.06 incidentsper
phonenumber
Coventry repeat demand data from West Midlands Police
Incidents recorded and police call-outs in September 2016
Frequent locations
Coventry Multiple Complex Needs
n=7,030
Kasbah Nightclub (12)
Swanswell Street (22)
Caludon Centre (14)
Salvation Army (22)
St Nicholas Street (16)
Vincent Wyles House (18)
Henley Road (10)
Ricoh Arena (15)
Tesco(10)
Beaconsfield Road (13)
B&Q (13)
Longford Park (13)
Sainsbury’s (12)
Co-op (12)
Caradoc Hall (16)
Signals Drive (20)
Stoney Stanton Road (10)
Kirkdale Ave (10)
L
C
P
C
O
Vio
Th
Su
Dr
Fr
Bu
Ot
Ot
Cr
Ind
Ro
Uns
Sex
C
In
G
E

6. Experts by experience
• To understand why, we need to work with people with “lived
experiences” of homelessness, substance misuse and offending
behaviour
• This is:
• not just a “nice to have” – but an essential part of the programme;
• not “big data” but still a crucial part of gathering intelligence
11/17/14 2/25/15 6/5/15 9/13/15 12/22/15 3/31/16 7/9/16 10/17/16
Interventions for Client X Nov 2014-Oct 2016
Sherbourne Fields – Training/Public
Evolution 3 – Training/Voluntary
Hospital/GP/NHS – Health/Public
West Midlands Police – Police/Public
West Midlands Fire Service – Fire/Public
Foodbank – Food/Voluntary
Cyrenians – Housing/Voluntary
Valley House – Housing/Voluntary
Placements Team – Housing/Public
Salvation Army Lifehouse – Housing/Voluntary
The Foyer – Housing/Voluntary
St Basil – Housing/Voluntary
Whitefriars Housing/Caradoc Court – Housing/Public
Housing Benefits – Housing/Public
Social Care (Children's, Adults, All Ages Disability, MASH, CLDT) – Social/Public
Newfield Trust – Money/Voluntary
Concentrix – Money/Private
Royal Bank of Scotland – Money/Private
Severn Trent Water Big Difference Scheme – Money/Voluntary
Justice System (Courts) – Money/Public
DWP / Job Centre Plus (Benefits including JSA, ESA, IS, PIP) – Money/Public
Coventry Law Centre – Advice/Voluntary
Grapevine – Advice/Voluntary
Citizens Advice Bureau (CAB) – Advice/Voluntary
Each dot represent a contact
24 agencies in two yearsProfessionals have the keys to the doors…
…but experts by experience know where each of the doors lead to!

7. Coventry’s multiple complex needs programme
MCN Board
MCN Operational Group
Housing First
Steps for
Change
Making Every
Adult Matter
Experts by
Experience
Case
Management
Forum
Evaluation

8. Contact
Si Chun Lam
Insight Development Manager
(Place and Public SectorTransformation)
Coventry City Council
Email: SiChun.Lam@coventry.gov.uk
Twitter: @SiChunLam