Ending the Revolving Door of Care for Society's Unwanted

Abbie's ending is a happy one but it shouldn't all be down to circumstance and luck. Through these 12 partnerships and the learning they generate, we hope to permanently change the odds in favour of the thousands of other people across the country who desperately need our help.
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Like many people, Abbie started her 20s married with children and a decent job. Unfortunately though, she started to experience severe mental health problems, which led to the breakdown of her marriage and her moving out of the family home. Unable to cope, she resigned from her job and, in a relatively short space of time, had moved from 'normal' family life to an existence underpinned by alcoholism, drug addiction and self-harm. This was to continue for many years. Every time she sought help, she found herself relapsing on her return. Things went from bad to worse when she also suffered domestic violence and was eventually sectioned. She was discharged but again with no aftercare in place ended up in an even worse situation: Abbie was in intensive care for ten days after an almost fatal overdose. This was not to be her only attempt at suicide.

There are an estimated 60,000 people with a story like Abbie's - individuals struggling with a combination of profound and complex problems such as mental ill health, addiction, homelessness, and reoffending. Like Abbie, these individuals end up rotating through our welfare and justice systems - no one service is able to help them effectively: many providers find these people's combined needs too great to tackle or face resource constraints that limit the care that they alone can deliver.

As Abbie found, the revolving door of care can deepen people's problems at huge cost personal cost. It hits society hard too - both socially and financially - as people move from one crisis to another, affecting not only the individual but those around them.

As a distributor of National Lottery funding for the voluntary and charitable sector, we hear about people like Abbie all too frequently, funding thousands of projects each year that provide vital support to help people in need like her. It was many of these projects and organisations that asked us to help them do things differently, and use our National Lottery funding in a different way to ensure that people like Abbie can experience better connected and more effective help the first time around.

Today, voluntary sector-led partnerships in 12 areas across the country will receive our funding to try this new approach as part of an innovative, long-term National Lottery investment to intervene, support and help those with multiple and complex needs.

The funding we are awarding is substantial - totalling £112million over eight years. It will ensure that in 12 areas, services are joined-up and coordinated to prevent these very vulnerable people from being turned away or overlooked. It is a simple idea, but one that requires some funding upfront to make the case for it - and that's where we come in.

With the money comes a requirement that in each of the 12 areas, people like Abbie are central to the plans and have a voice in their development and delivery. Beneficiary involvement in designing services can be regarded as irrelevant or too costly a process, but for us is key to meeting needs first time and is arguably then the most cost effective approach.

If partnerships can redesign the system and make it more effective, it will mean much better outcomes for thousands of individuals but, just as importantly, will help to build a compelling evidence base for what works. Their findings could have significant implications for the way that services are designed, commissioned and delivered in the future. As well as the clear social value, this new way of working could be financially prudent too, reducing the need for costly reactive health, emergency and other services needed day in, day out by many individuals with multiple and complex needs.

After suffering years of problems, Abbie was lucky enough to come across the Islington Specialist Alcohol Treatment service and was referred to the Single Homeless Project where she began to get holistic care for all her issues. It was the first time that she had experienced such support and credits it with her recovery. Abbie has now been drug and alcohol free for eighteen months and slowly is rebuilding her life and relationships with her family.

Abbie's ending is a happy one but it shouldn't all be down to circumstance and luck. Through these 12 partnerships and the learning they generate, we hope to permanently change the odds in favour of the thousands of other people across the country who desperately need our help.