Bolton Council

Complex Lifestyles

Briefly describe the initiative/ project/ service

Research by the PH Intelligence team had highlighted that a relatively small number of vulnerable individuals consumed a disproportional amount of resources by presenting to varied health service providers on a regular basis. It was noted that individuals would be treated individually for the specific issue at the time, but underlying causes were not dealt with.
Dealing only with clients who repeatedly used emergency interventions and presented with 3 or more of the 4 following issues:
Alcohol/drugs misuse – Mental ill health – Offending or risk of offending – Homelessness
A coordinated service that was responsive and specific to each individual client, providing a holistic approach could potentially break this cycle by co-ordinating the various disparate approach.
Through initiating a multi-agency collaboration inc. Emergency Services, GP’s, Bolton NHS A&E, Mental Health services and homeless agencies, Lifeline has provided a holistic response to some of the most vulnerable individuals in our communities.
The service works flexibly and proactively to engage clients in the service, reducing the likelihood of them being at further risk of harm to themselves and to reduce their need for and use of emergency interventions

Why do you think it should win this award?

Through initiating a multi-agency collaboration with a number of agencies, inc. Emergency Services, GP’s, Bolton NHS A&E, Mental Health services and homeless agencies, Lifeline has provided a holistic response to some of the most vulnerable individuals in our communities.

Through the use of a key worker approach Lifeline the service provider, works flexibly and proactively to engage clients in the service, reducing the likelihood of them being at further risk of harm to themselves and where applicable to others, and to reduce their need for and use of emergency interventions. This has involved actively engaging with difficult to reach clients that need time and patience to breakdown barriers and establish trust. 96% of all service users are remaining engaged with the service, despite the level of complexity that they are presenting with. This is testament to the tenacity of the staff.

Pathways have been created with referral agencies and the team has an active presence with local GPs, Bolton NHS A&E, Bolton RAID team, Bolton NHS Mental Health Services and the Integrated Neighbourhood Teams.
Positive feedback has been received from GMP, GPs and service users themselves

What are the key achievements?

The Complex Lifestyles Service has, using 3 key workers had 103 clients referred through its pathways since March. All have been deemed to have complex needs, with drugs/alcohol and mental ill health being the main presenting issues.

Due to the complexity of needs & the difficulty in engagement, Lifeline’s key workers, have to frequently go above and beyond to actively seek engagement with vulnerable clients, who can be mistrusting of services and be difficult to develop trusting relationships.

Lifeline has been able to evidence through case studies and from partner agencies that the service has made a contribution in reducing the cycle of complex needs and freed up resources within partner agencies.

With a budget of £99,000 a year, a cost benefit analysis over the first 6 months operation has shown a saving of £15,000-£20,000 per client. With one individual estimated by GM Police as saving over £30,000 through engagement with the service.

With partner agencies currently evidencing saving of £140,000 this is projected to be £280,000 after 12 months. This is a benefit return ratio of 3:1 and more importantly has broken the cycle of need for individuals exhibiting complex needs