The Scottish Government

« Previous | Contents | Next »

Listen

Executive Summary

Introduction

1. Rationale Supporting People, introduced in Scotland in April 2003, is a fund allocated to local authorities specifically for housing support services. It replaced a mix of client-led and programme funding streams, including an element contained with Housing Benefit (latterly designated as Transitional Housing Benefit). The level of funding for housing support in Scotland has risen markedly over the last few years: from c. £80m in 2001 to £217m in 2002/03, and to £426m by 2003/04 ¹. The funding level is now being contained, at around from 2005/06 through to 2007/08. Critically, at the same time as funding has been reduced, the distribution of funding in Scotland is being reformed, to ensure that the allocation of grant has a better fit with relative need ². As a consequence, over the three year period to 2007/08, a number of authorities will experience a marked decline in the level of grant, while others will receive increased grant.

2. Study objectives. The study aims to explore the costs and benefits of housing related services provided by the Supporting People programme across the range of clients receiving services. In addition, the study aims to assess the value for money of the programme and consider at what point increases in programme funding stops producing corresponding improvements in outcomes/benefits. Finally, the research provides recommendations on how the benefits, costs and impacts of Supporting People services could be more effectively measured.

3. Approach. The approach taken for the research comprised: a review of the main services provided to each client group, the level of resources required to achieve that level of provision, the actual or intended benefits, and analysis of evidence on programme performance and impacts/benefits. We had intended to undertake the analysis at the level of Supporting People client group. However, limitations in the available data have meant this was not possible (these are explored in depth in Chapter 2). Instead, we have developed a "super-group" approach, which groups together those client groups that overlap within the dataset:

• Older people and physical disabilities
• Mental health and related groups
• Learning difficulties
• Homeless and related groups
• Other ³

Supporting People - Activities and Costs

4. An estimated 172,616 people were assisted under Supporting People funding in 2004/05, equivalent to around 4% of the total population aged 16 and over, with total expenditure estimated at £405.8 million ⁴. This gives an average cost per client of around £2,351. This figure masks a wide variation in the average expenditure per client on Supporting People projects between local authorities, which ranges from £1,100 per client supported in Angus to £5,800 in Argyll and Bute. Overall, a total of 6 authorities record an average cost more than 50% above the national average, while 3 authorities record an average less than half that of Scotland as a whole.

5. Overall, four client groups account for 84% of total expenditure on Supporting People services and for almost three quarters of all clients supported - these are people with a learning disability, older people, people who are homeless or sleeping rough and people with mental health difficulties. The pattern of provision varies markedly between local authorities. Thus, while older people account for almost half of all Supporting People clients across Scotland as a whole, at a local authority level this varies from 13% of all clients in Renfrewshire to 89% of all clients in East Dunbartonshire. Similarly, the proportion of clients recorded as having learning disabilities ranges from 2% in Angus to 14% of all clients in North Lanarkshire.

6. Further, there appear to be wide disparities in the average cost of providing services to client groups. For example, people with mental health problems and people with a learning disability account for a far higher proportion of expenditure than of clients supported, indicating an above average unit cost of provision. At the same time, services to older people account for only a quarter of all expenditure but almost half of all clients receiving supporting people services, indicating a relatively low unit cost. Thus, these variations in the "mix" of provision by client group appear to account for much of the variation in cost per client (unit cost) between local authorities noted above.

Assessment of benefits

7. There is a fairly substantial body of qualitative evidence that housing support services provide benefits to recipients (and to society) in terms of enhanced capacity to maintain an independent life and in terms of an improved quality of life. The strongest objective evidence of significant impacts relates to the effects of housing support in:

• Enabling people, especially older people and people with severe disabilities, to avoid the alternative of being moved into (more) supported accommodation or residential care
• Reduced length of hospitalisation for older people suffering illness or injury
• Improved quality of life (reduced anxiety, improved mental well-being) for households of various types.

8. For other groups - people homeless or at risk of homelessness, women escaping domestic violence, people with mental health problems and learning disabilities, there is certainly a widespread belief among providers that housing support creates worthwhile benefits but the literature and research evidence is limited.

9. However, for all benefit types and client groups there is serious lack of quantitative measures of impact. Further, where work to measure is undertaken to value "benefits" - for example to explore benefits of residential care, for healthcare, for costs associated with homelessness and for costs of crime - the work in fact has assessed "avoided costs", as opposed to costing benefits. Thus the work has not quantified the value of the quality of life impacts of the services.

Development of Supporting People

10. Around 600 new Supporting People projects have been commissioned since 2003/04. More than half of these were commissioned in 2003/04, suggesting that project development is more likely to reflect pipeline proposals rather than strategic planning. Greatest growth has been in services for people with learning disabilities and older people - although notably, the increase in services for older people was high only in 2003/04.

11. This conclusion is supported by the consultation with case study authorities. The short timeframe for the change-over to Supporting People funding in April 2003 made it difficult for authorities to take a strategic overview to service planning. Priority was given to ensuring that clients continued to receive support services, that providers continued to receive payment, and opportunities to develop new services were taken where possible. These fairly limited objectives were hampered by the delayed guidance; missing information on some SP1/2 returns ⁵; and inaccurate/delayed from the Transitional Housing Benefit returns. Further, none of the authorities felt that the Supporting People Strategy produced had had a strong independent strategic focus: there had not been time to compile detailed needs assessments, although they had used information from existing sources and from consultation with providers and partners; and all had drawn heavily on existing documents and strategies, as well as work with providers and partners, to establish strategic objectives. Nonetheless, there was a common view that the next round of strategies will have a much stronger strategic focus.

12. The early phase of the Supporting People was devoted to establishing the structures needed to administer Supporting People and to agreeing - or to attempting to agree - contracts. This almost universally failed, so letters of agreement or skeleton contracts were used instead. All authorities were of the view that contracts should be signed following the service reviews that are currently underway.

Analysis of costs and benefits

13. The cost of the programme is c. £402m. The research has allowed us to quantify and place a monetary value on benefits amounting to £441 million. Moreover, this figure is incomplete as a measure of benefit; the figures that are quoted for each SP supported service are typically "costs avoided", and do not in most cases quantify the quality of life effects of the expenditure - either for the client or their carers/family. It is also possible that we have not fully quantified all of the costs avoided.

Table 1 Monetary Costs and Benefits by Supergroup

14. Studies of the costs and benefits of SP have also been carried out recently in England and Wales by Capgemini and Matrix Consulting. To facilitate comparison, we have applied the assumptions on the benefits of SP used in the Welsh study to the Scottish data and the results of that exercise are reported in Table 2. As can be seen, the adoption of the assumptions from this study produces largely similar estimates of financial benefit to those of the present study. The CapGemini results from England's Supporting People programme are not due to be published till 2008, however an initial draft that was passed to this study team assumed much higher benefits from Supporting People than we have set out in this report. We therefore consider that our study has adopted a cautious and evidence-based approach to estimation of benefits and we regard our estimates of financial benefits as robust.

Table 2 Monetary Benefits by Supergroup - Matrix (Wales) vs Present Study's Assumptions

Conclusions and recommendations

15. We consider that the effects of SP can be considered in terms of three types of effect - support to "move on" to an independent life; support which enables the recipient to live in the community; and support which improves the likelihood that a household will be able to live independently. The benefit of any SP intervention is measured in terms of the benefit which will accrue if the intervention is effective, the likelihood that the intervention is effective and the value of the benefit.

16. The data available to assess these elements are generally limited. There is a lack of information on the effects of many programmes and data to value benefits is even more scant. For the client groups who clearly require support to maintain independent living or a reasonable quality of life, there can be confidence that practically all clients are receiving some tangible benefit - though the scale and value of that benefit is not always clear. For other client groups and services the effect of SP support is less certain. Broadly, for any individual, an "insurance" or risk reduction approach applies and SP has the effect of reducing the probability of an adverse effect occurring or increase the probability of a successful outcome. In these cases the study has calculated the effects of SP on the risk of outcomes - and the cost/benefit of those outcomes - using available information.

17. Using these procedures, we have been able to assess the benefit of £402 million of SP spend and have concluded that benefits equivalent to almost 110% of this sum can be identified. Given that there are also unquantified benefits of SP, this gives confidence that overall SP is delivering Value for Money.

18. Because of the limitations of the cost data, we have not been able to assess the comparative costs and benefits of detailed elements of the SP programme to the degree we would have wished. This has also limited the scope for assessment of the balance between cost and benefit at the margin of programmes

19. Recommendations: Recommendations arising from the study relate to the strategic focus of the programme and to improvements in information and assessment and to further investigation of costs and benefits at the programme level.

20. In relation to strategic focus it is recommended that:

• A more strategic, Scotland-wide view of the development of SP services is taken with particular attention to analysis of need and to targeting.
• Use of SP resources to support "one off" programmes for very small numbers of clients within needs groups should be reconsidered.

21. In relation to analysis it is recommended that:

• Collection of data on expenditure and client numbers by the Government are made consistent and built up from the project level so that it is possible to identify the numbers supported in each client group and the expenditure on services to those individuals.
• Data are collected on outputs from projects where possible - e.g. outcomes for homeless people assisted by SP
• More specific research is undertaken on the effectiveness of SP interventions in altering outcomes for clients.
• Priorities for the above research should be work on the benefits of SP resources in areas/client groups where the impact of support is likely to be complex because of the multiple problems faced by some clients ( e.g. homelessness and behaviour related problems such as drug abuse and offending).
• A further research priority should be analysis of services to older people with the aim of improving the targeting of resources for this group
• Objectives and performance indicators should be developed for SP which are based around the concepts used in this report of "moving on", maintaining ability to live in the community and arresting decline - appropriate indicators being applied to each type of project.

« Previous | Contents | Next »