The time for talk is over – but still we talk

Cambridge Local Health Partnership

The papers for this meeting are available here

Once again a very well attended meeting at the guildhall in Cambridge, accompanied by a not so good trumpet player in the market square. Cambridge really does need a better class of busker!

A large part of the meeting was taken up by linked discussions about what is now termed street life issues and the resultant problems of anti-social behaviour, addiction and housing. To the lay person this is homelessness, but that does not cover the whole issue as many of those who appear homeless do have a place to stay in a hostel or in a flat, so I will use the street life tag as it seems to take into account the whole gamut of issues.

The City Council, through the community safety partnership, have commissioned some research into anti-social behaviour and street life, at the same time there have been issues with hostel spaces as the city’s biggest hostel is refurbished and reconfigured. This has coincided with a spike in the number of rough sleepers.

The city council report that is part of the meeting papers is excellent and proves what I am sure that many of those working in the field knew all be it anecdotally. Some key facts were that many of those who fall into this category are suffering from multiple issues of mental health, addiction etc as well as being homeless. It also points out that there are a number of different categories of person who have different support needs that present at the different organisations working in this area. There are a hard-core of people with the most severe problems who have significant issues and who are responsible for a lot of anti-social behaviour and who take up a lot of organisational time, some of these have been in this category for a number of years and despite repeated input from different services have not moved on. There are a lot of agencies working with this client group from councils, health and the voluntary sector – in fact one individual was seen to have 11 organisations working with them at one time.

The report makes some good recommendations, the most important one is to look at a more person centred approach to individuals problems and look at better ways to join up services (This is watered down a bit in the report but the sentiment is there).

Discussions from all parties agreed that this was a good idea, and there was a lot of input from everyone. The health people agreed that it would be a good idea and could reduce spending on some services, the housing people agreed, the councillors agreed, and so, you will be pleased to hear, did I. The VCS has a massive role to play and already provides many of the services that it is grant funded or contracted to from statutory partners. What the meeting could not agree was how this joined up system should work, who should lead or even who would be responsible for starting the process. What was agreed was a summit to take this forward – yet more talking, but with a more definite outcome I hope. There is a genuine desire to improve, but I sense a fear that increased costs in one area may be an issue, even if they reduce overall spending in total. The different statutory agencies have got to find an answer to this issue as it is a major stumbling block in this area as well as in many other areas where this joined up thinking has to work.

The other thing to remember is that any joined up work has to be specified in contracts and funded through grants. The VCS is generally happy to play its role, which can include being the lead of cases or services, but we have to be funded to do this.

This is an issue that CCVS will continue to monitor and will actively look to find solutions that can work, as we believe it can bring immense benefits to the sector and more importantly immense benefits to the people accessing services.

The meeting also spent some time looking at some of the local projects funded by the council to improve health, and again a number of good reports are included in the papers. What is clear is that council funding for these projects is going to reduce, and that funding from other statutory partners is uncertain, even if the activities do reduce their overall costs. Once again there needs to be some better joining up of working and an understanding that by public health investing in a scheme it may cost them but will save more than that even if is from a totally unrelated budget (health care for instance). My question is ‘what mechanism can be devised to share some of the savings from one area with the area in which the initial investment was made?’ I guess many people have tried to crack this problem and I am sure there are some good examples out there that could help us resolve it in Cambridge. In the meantime CCVS will happily help those services that are becoming social enterprises to identify funding and improve their governance.

So a good meeting where everyone was in broad agreement, but no real change in practice. This makes me wonder what the role of the partnership is, if it is as a catalyst to getting the right people in a room to thrash out real changes in practice then I hope this summit will do this. If the summit does not do this then all we have done is set up another opportunity to talk, agree and ultimately change nothing!

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