Paper for councillors re rough sleepers working party set up on 4.5.17
1 Summary of the problem of rough sleepers
There are now about 1,000 persons sleeping rough in the city of Brighton and Hove, (hereafter called the city) They are heavy users of public services, such as police stations (where they may get locked up inappropriately in police cells), housing departments, GP surgeries, A&E departments, hospitals, social care, drug and alcohol units, criminal justice services, prisons, etc) Each one can cost £100,000 pa for most of their life, (totalling £ many millions) until their death at an average age of 47 provides a merciful release for both them, public service staff, and the taxpayer.
2 Summary of the proposed solution Vanguard system
Empower the above mentioned health and care authorities to socially prescribe effective interventions which address all the co-determinants of health and wellbeing, including isolation, safe housing, nutritious food, employment, detoxification and rehabilitation from addiction, and effective talking therapy for mental sickness.
Provide Social Prescription Vouchers Accommodation (SPVAs) for rough sleepers in books of 10, (see annex 1) which would be cashable in a free market (like taxis and pharmacies) to ensure high standards. If they need more, they could apply for a repeat prescription.
Provide more beds (perhaps 200) for them in licenced Community Homes (CMs).
Provide each of them with 3 nutritious meals per day, sourced from supermarket waste.
Provide employment and volunteering opportunities, so that they recover their self esteem.
Under a separate, but connected scheme, provide Social Prescription Vouchers Treatment (SPVTs) for effective treatment for addiction at Community Care Centres (CCCs) (as described in the companion Vanguard manifesto for a primary Mental Health Service (MHS) published as paper 9.114 of www.reginaldkapp.org)
3 What would be the outcome of this intervention?
For rough sleepers (and other mentally sick): improved health and wellbeing.
For citizens and tourists: improved amenity and reduced health inequalities.
For those working with rough sleepers (police, GPs, A&E departments, hospitals prisons, dry houses, etc, empowerment to discharge them into safe accommodation (rather than back onto the streets) thereby reducing bed blocking, and inappropriately locking them in police cells overnight.
Spending the £6,600 Rough Sleepers Social Impact Bond (see paragraph 35) on 30 rough sleepers (totalling £198,000) could provide each of them with 11 weeks of free accommodation and meals and 75 hours of effective treatment, which would enable most of them to get a turning point to exit the revolving door of relapsing.
Spending the £5.5mpa that the Council now spends on rough sleepers could provide 1,000 of them with the same interventions as a) above, with the same outcomes, and create 160 permanent full time jobs at 1.5 times the living wage, plus 500 voluntary jobs in licenced community homes (CHs)
Spending the £2.3 mpa Locally Commissioned Service (LCS) budget of the CCG on treatment in Community Care Centres (CCC) could provide an additional 70 full time jobs and 200 more voluntary jobs.
We estimate (paragraph 33) that every £1 invested in SPVAs and SPVTs combined would save £3 overall in public sector costs.