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6. Conclusions and Recommendations
Conclusions
6.1 The process of assessing the costs and benefits of SP has been challenging. The data on the cost of the SP programme have their limitations - particularly in terms of matching service recipients with programme costs and this has limited the scope for unit cost analysis.
6.2 SP is a diverse programme of activities but at its core is the concept of providing advice and support which enable people to live independently in acceptable conditions and the pursuit of this through 21 tasks or activities.
6.3 We consider that the effects of SP can be considered in terms of three types of effect - assisting people to cope with problems and increasing the probability that they will "move on" to a completely independent life; providing permanent support which maintains the recipient's ability to live in the community indefinitely; and providing support which reduces the risk that a household will become unable to maintain an independent way of life.
6.4 The benefit of any SP intervention is composed of the benefit which will accrue if the intervention is effective, the likelihood that the intervention is effective and the value of the benefit.
6.5 The data available to assess the elements listed above are limited. There is a lack of information on the effects of many programmes and data to value benefits is even more scant. The approach used by Matrix of focussing on "avoided" public spending is not a comprehensive assessment but it is useful and it has been applied here - recognising that it is a partial analysis. The present study has sought to rely on the more robust evidence of impacts and where such evidence is lacking then assessment of benefits has been necessarily limited.
6.6 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.
6.7 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.
6.8 Using these procedures, we have been able to assess the benefit of £402 million of SP spend and have concluded that financial 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. This result is in many respects comparable to the findings of the Matrix study in Wales. It is far below the estimate of financial benefits in the draft report from the Capgemini study in England.
6.9 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.
6.10 What is clear in this study and in the other studies is that the main financial "pay off" to SP arises in situations in which it prevents the admission of people to residential care - we consider this impact to be clearest in relation to services to (some) older people and to people with disabilities. The effect of SP on prevention of homelessness and the financial gain from prevention of homelessness are areas in which there is some uncertainty and scope for debate. The impacts of SP on what may be termed behaviour-related problems - alcohol and drug abuse and offending behaviour - are especially hard to establish, we have adopted conservative assumptions given the lack of evidence.
RECOMMENDATIONS
6.11 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.
6.12 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. The variation in the observed pattern and level of service provision is grater than could be accounted for by variations in need
- Use of SP resources to support "one off" programmes for very small numbers of clients within needs groups should be reconsidered.
6.13 In relation to analysis it is recommended that:
- Collection of data on expenditure and client numbers by the Executive 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. This could be achieved if project beneficiaries were classified by the nature of the project through which they were supported ( i.e. every individual supported by a project to help drug abusers would be so recorded even if the person was also, say, homeless)
- 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 to deepen understanding of the benefits of SP programmes which aim to help people with complex and behavioural problems. This includes programmes supporting ex-offenders, people who abuse drugs and alcohol and some people who are homeless or threatened with homelessness.
- 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.
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