The following article was published on the MJ website on the 6th January:
During the election campaign, the focus was on Brexit and spending on public services. Now that the election is over and the Conservative Party has won a majority, we need to look at the next level of detail in the manifesto and ascertain what this means. In particular, there was a significant focus on prevention. For sure people want to know that public services are there and functioning well if they need them – but given the choice they aren’t queuing up round the corner to get into their local hospital or to have their children cared for by the State. They’d rather be healthy, purposeful and enjoying life with their families. The directors of children’s services, adults’ services and public health we engage with around the country get this more than anyone.
On this note, the manifesto featured the idea of ‘Family Hubs’. But unfortunately it didn’t get much attention during the campaign. As a reminder, the manifesto stated: ‘We will improve the Troubled Families programme and champion Family Hubs to serve vulnerable families with the intensive, integrated support they need to care for children – from the early years and throughout their lives.’
In essence Family Hubs would provide one-stop support for vulnerable families. You can trace this idea back to the work of Hilary Cottam, who has deservedly received an OBE in the New Year’s honours list. Hilary’s work (outlined in her excellent book, Radical Help) is based around a number of public service ‘experiments’ which created local groups of public service professionals working together to support specific groups of vulnerable people. The core idea being that a mixed team of police, community nurses, social workers, housing officers etc. would spend time really understanding a family or a person and what they needed to thrive. The Hub teams would have the freedom and time to try different approaches. If one approach doesn’t work then it is still a good investment of time and effort to try something else.
Some of you reading this may say that none of this is new and many places have tried similar things before. I don’t disagree that the idea of multidisciplinary meetings (and even teams) have been tried before and are in existence. However, I think the level of individual commitment to the hub team (rather than the feeling of just being on ‘loan’) is relatively new. I also think that the idea of a single team gripping and taking responsibility for the entirety of a family’s engagement with public services is relatively new.
Perhaps the best manifestation of this idea is in Wigan where they have put in place community based weekly ‘huddles’ (Family Hubs in all but name) which meet weekly to discuss how to support specific families and individuals. This type of local co-operation between previously siloed services can stop families and individuals being passed from pillar to post and also prevent difficult cases falling between the cracks. There are plenty of examples of individuals or families with a whole range of challenges who don’t quite meet any individual public service threshold. This is a weakness in how local services are organised rather than a particular weakness with any individual element.
For Family Hubs to work they will need two things – freedom and funding.
Freedom – It’s interesting that the government’s manifesto talks about ‘improving’ the Troubled Families programme. For a start this shouldn’t just be a programme with a start and an end – it should be the way local public services are delivered – full stop. The Troubled Families programme was actually inspired by the work of Hilary Cottam following a visit to one of her projects by the then Prime Minister David Cameron. Following the tried and tested approach to scaling and spreading a good idea, central government took the basics of this very localised project and applied standardisation, incentivisation and competition. However, Hilary Cottam is very clear that this approach killed the essence of what made her work successful. The commissioned providers of the resulting programme often gamed the system. In her book, Hilary Cottam quotes a senior council leader ‘We know the Troubled Families referrals were not the most needy families. It was a numbers game.’ The change was not sustained and once the Troubled Families programme had blown through ‘like the hot winds of a desert storm’ the families and front line staff went back to what they had been doing before.
Family Hubs need to be allowed to grow organically in a way that works for local communities and without the perverse incentives generated by a crude payment-by-results system.
Funding – In Wigan, there was excellent council officer leadership but six years ago Wigan also had reserves which they dug into to allow the investment in the new way of working whilst still providing statutory services. Prevention takes time to flow through to an actual reduction in demand for services and the associated saving.
Today, not many councils have the reserves to invest in such intensive prevention activity. Wherever it comes from (locally raised, centrally provided or a mix of both), funding will be needed in order to set up Family Hubs in parallel to continuing business as usual. There has rarely been a more appealing invest to save case.
It seems clear that the Government will pursue this potentially radical idea and I would very much encourage local public service leaders to think about the potential of Family Hubs and how their own experiences of multi-disciplinary working could influence how they develop.