How information sharing is improving help for troubled families
Download our most recent reports from the troubled families health information sharing project:
- Troubled families - Staffordshire case study
- Troubled families - Oldham case study
- Troubled families - summary report
The troubled families programme was set up by government in 2012 to support families with multiple and complex problems. In the past, these families have often been failed by services which have tried to respond to the one problem that presented itself to that service at that particular time – whether it was truancy, domestic abuse, anti-social behaviour or unemployment – but failed because they have been incapable of dealing with the many interrelated problems the family is facing.
Information sharing has been at the heart of the troubled families programme since it first began. Not only does information sharing allow the most complex and costly families to be identified (by using data to cross reference the demand they are placing on different services), information sharing also means problems can be tackled more effectively.
With the support of the Ministry of Housing, Communities and Local Government, the Department of Health and Social Care, and Public Health England, the troubled families’ health information sharing project was established to identify the cultural barriers and enablers to sharing health data and provide case studies to help those who are trying to share health information better.
To capture these case studies, engagement managers from the Centre carried out a series of semi-structured interviews with key professionals involved in the management and the delivery of both the Staffordshire and Oldham troubled families programmes, looking at the approaches taken in each place to sharing information with health partners, in order to share the learning and encourage others by showing what can be done.
Staffordshire case study:
The Troubled Families Programme in Staffordshire is known locally as ‘Building Resilient Families and Communities’ (BRFC). Key health, council and other public services work to a shared local vision - enabling families to be ‘safe, healthy, self-reliant, educated, responsible and informed’ by coordinating support across local services. It is delivered through a partnership approach to workforce development, joint commissioning, and improved information sharing. Phase one of the programme revealed local need around ‘hidden harm’ (domestic abuse, mental health, and substance abuse), which strengthened the case for sharing information between health partners and the BRFC programme. The Staffordshire case study therefore focuses on the local priority of information sharing with mental health partners and highlights the role commissioning can play as an enabler of information sharing.
Download the Troubled families - Staffordshire case study
Oldham case study:
Within Oldham, the Troubled Families Programme sits within a universal age ‘early help’ service. Delivered by council-based teams and through contractual arrangements with third party suppliers, Oldham’s early help service is targeted at residents who experience multiple and often complex issues in their lives. The different strands of the service are designed to identify these residents, and provide short but often intensive services, with the aim of resolving complex issues before the need for escalation to more specialist services such as social care, mental health and drug and alcohol services.
The Oldham case study focuses on looking at two ways of using health information. Firstly, as part of a pilot with a local GP practice where direct information sharing enables early identification of families with significant levels of need (including health needs) before they reach crisis. And secondly, working with public health services and a Clinical Commissioning Group to better understand the level of use and the level of demand on local health services by families with complex needs.
Download the Troubled families - Oldham case study
From the two case studies mentioned above, a summary report was also produced. This summary report is an overview from both case studies and it identified eight common barriers to sharing. These were:
1) Varying levels of information sharing maturity;
2) Concerns about security, confidentiality and interpretation of data;
3) Concerns about legal gateways for sharing health data to support troubled families;
4) Different approaches to consent;
5) Addressing a lack of trust and shared vision;
6) Poor engagement due to lack of explicit joint benefits;
7) Partners can have complex systems; and
8) Not everyone is used to ‘thinking family’.
If you'd like to read more about these barriers and approaches to overcoming these, please download the summary report:
These case studies and the resulting summary report would not have been possible without the time and support from both the Staffordshire and Oldham troubled families team and their partners, and we would like to thank everyone involved for sharing their views and experiences with us for others to learn from.
Through our work with the Staffordshire BRFC team, it was identified as a priority that the team should develop their strategic relationship with health partners in order to build on and extend the successful information sharing that BRFC has developed with mental health providers. To support this, the Centre developed a workshop with Staffordshire which focused on exploring a proposal to develop a local GP mental health information sharing pilot.
The objectives of the workshop were to:
1. Bring together local health partners to consider and inform the development of the GP mental health sharing pilot.
2. Provide an opportunity to discuss and identify cultural, people and behavioural information sharing challenges in relation to the proposed pilot and develop solutions to these.
You can download a copy of the Staffordshire troubled families workshop report
Background to the wider troubled families programme:
For those not familiar with the troubled families programme overall, we have included a brief overview below which outlines the background to the programme – adapted from the Ministry of Housing, Communities and Local Government website.
Phase one (2011-2015)
Troubled families are those families that have multiple and complex problems which both disadvantage themselves and the wider community, putting high costs on the public sector. The government aim was to commit to working with local authorities and their partners to help 120,000 troubled families in England turn their lives around by 2015. They wanted to ensure the children in these families have the chance of a better life, and at the same time bring down the cost to the taxpayer.
As part of the troubled families programme, the government committed to work alongside local authorities to:
- get children back into school;
- reduce youth crime and anti-social behaviour;
- put adults on a path back to work; and
- reduce the high costs these families place on the public sector each year.
Government encouraged local authorities to work with families in ways the evidence shows is more effective, such as:
- joining up local services;
- dealing with each family’s problems as a whole rather than responding to each problem, or person, separately;
- appointing a single key worker to get to grips with the family’s problems and work intensively with them to change their lives for the better for the long term; and
- using a mix of methods that support families and challenge poor behaviour.
To read more about phase one of the troubled families programme, see:
- The first Troubled Families Programme 2012 to 2015 - an overview
- Policy paper, 2010 to 2015 government policy: support for families
- National evaluation of the Troubled Families programme. Final Report on the Process Evaluation - White, C., and Day, L. (2016)
Phase two (2015-2020)
In August 2014, Eric Pickles announced details of an expansion of the government’s troubled families programme. ‘As well as expanding from working with school-age children to those under 5, the wider programme will also have a particular focus on improving poor health…which is a particular problem in troubled families, with 71% having a physical health problem and 46% a mental health concern.’ The full detail can be read in the DCLG press release for the announcement.
The second phase of the troubled families programme aims to achieve significant and sustained improvement for up to 400,000 families with multiple, high-cost problems. Whilst it retains its focus on families with multiple high cost problems, the criteria has been broadened out (to include, for example, domestic abuse and mental health) so that local areas get to families of most concern to them.
Useful links and resources
- Interim guidance for troubled families programme early starter areas - sharing health information about patients and service users with troubled families’. (This document was produced in 2014 by the Department of Health and Social Care in collaboration with the Ministry of Housing, Communities and Local Government, and Public Health England).
- Note on information sharing in context of the Troubled Families initiative, produced by the Information Commissioner’s Office (ICO): ICO view of troubled families data sharing
- Guidance note on the use of police data for the purposes of the Troubled Families initiative, produced by Association of Chief Police Officers (ACPO) and Troubled Families Unit at DCLG: ACPO/DCLG guidance note
Our previous work
- Bath and North East Somerset troubled families information sharing workshop
- Bath and North East Somerset connecting families case study
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