Saving Money through Holistic Services

As the nights draw in and temperatures finally begin to fall, rather than focus on the doom and gloom of the challenging times in which we find ourselves, let us think about a win-win opportunity that could both save money and offer better services.

Let’s move away from working with people according to each of their needs and move towards a more holistic approach.

Hilary Cottam’s book, Radical Help, talks of one family (not in Surrey, I am pleased to say) who had 72 different workers trying to help them. Can you imagine what that would be like for any of us, let alone a vulnerable family? How confusing and overwhelming it must be. Not only does this sound unmanageable for the family, but surely it is also not an effective use of money either? Whilst this might be at the extreme end of the scale, there are still plenty of examples of families in Surrey being offered a range of services that are independent of each other rather than working holistically. Unfortunately, having a large number of workers doesn’t always mean that a family begins to thrive, some still have severe challenges. It’s not easy to commission in a holistic way – it is much more straight forward to commission in a siloed way, commissioning a service for each need that a family might have – e.g. ASD, domestic abuse, school non-attendance. But the result is that residents with several needs are offered several services. Can they all be offered at once to a family or does there need to be an order – it appears that sometimes some vulnerabilities trump others; so whilst there may be a service that is really needed, in some cases it won’t – or can’t – be offered. Occasionally, none of the services offered may work.

We need to consistently look at a child and their family holistically and really listen to them to understand what would be helpful for them. Often there will be a service/charity out there somewhere which does consider the whole person and offer the support that child or family are looking for. But it may not be a commissioned health and social care service offered to that child or family. Therefore, we try and fit a square peg in a round hole.

Is there a way to have less funding tied up in pre-defined offers and more funding available to have focused help that will support the whole person holistically? Indeed, at the very least what people need most often is someone that they trust – ideally one person walking alongside them, listening, advocating and acting as a navigator. Do we need to think holistically in the way we commission, perhaps routinely pooling funding from different areas (health, social care, education, etc.), to provide residents with a more coherent offer which meet their specific needs.

A starting point for all of this is co-production – families, service providers and commissioners coming together to listen, converse and figure out how best to holistically support within a complex commissioning framework.

If you are working in Surrey and would like help to explore what is out there, please do get in touch with us.

– Cate Newnes-Smith

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