Chronic exclusion pilots yield better outcomes for adults in need

A Cabinet Office programme to improve support for adults with multiple needs and chaotic lifestyles is reporting “promising” early results.

An interim report into the three-year Adults Facing Chronic Exclusion (ACE) programme, which has a £6m budget, has found improvements in clients’ physical and mental health, benefit take-up and relationships with friends and family after four to six months’ engagement with the pilot programmes.

However, there were fewer gains in their employment prospects, financial situation and the well-being of their children.

The programme was established in 2007 as a cross-government collaboration to test new ways of working with adults who faced chronic exclusion and did not access statutory services.

It set up 12 pilots, which are run by organisations such as homeless charities St Mungo’s and Thames Reach and social enterprise Turning Point.

The aim is to achieve better outcomes for individuals and communities and find out whether this can be done more cost-effectively than existing approaches.

In the main, the client group is in its thirties, white and light users of health services. Most are unemployed, long-term sick or not working for another reason.

Further evaluation is to be carried out into the cost-effectiveness of the pilots. But initial evidence shows that total costs per pilot ranged considerably, from more than £96,300 to nearly £315,000. The average total cost is nearly £195,000.

Unit costs per hour varied widely from £9.93 to £24 with large differences in the number of staff employed.

The report said: “Promising as these interim results are, they are of the programme as a whole and have yet to address the principal aim of the evaluation which is to assess whether the pilots are succeeding or not in delivering their projected outcomes for service users in a cost-effective manner.”

It added: “It is recommended that that, in the remaining months of the evaluation, attention turns to understanding the pilots individually in terms of their costs and outcomes to assess whether the pilots are succeeding or not in delivering their projected outcomes for service users in a cost effective manner.”

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