Health Serious Violence Needs Analysis Workshop – July
Voluntary sector perspective
Before we develop new projects that often have externally imposed deadlines, it is important to find out what is already happening and to hear the voices of the individuals and communities that may be impacted by the work, and at the same time, take time to familiarise yourself with what other organisations are doing in that area of work.
Introduction
This blog has been written to share the experience of attending the first ‘Health Serious Violence Needs Analysis Workshop’. CCVS attended on behalf of Support Cambridgeshire but also as a member of both the Cambridge Community Safety Partnership and the Souths Cambs Community Safety Partnership. The workshop was held in July 2023.
Serious violence duty
This meeting was set up to look at the health response to serious violence duty. More info can be found on this on the government website
In essence, this duty makes councils and local services work together to share information and target interventions to prevent and reduce serious violence. The Secretary of State issues it as statutory guidance under Chapter 1 of Part 2 of the Police, Crime, Sentencing and Courts Act 2022. As a significant statutory organisation, this applies to the Cambs and Peterborough ICS who have to have a strategy in place that addresses their actions against the duty.
The meeting
There were a lot of health people at the meeting who had different roles around safeguarding and a scattering of attendees from other statutory partners. My feeling was that there were far too many gaps in the wider attendance, possibly due to a mixture of who was invited and who prioritised and attended the meeting.
It was unclear what the Integrated Care System[1] (ICS) was trying to achieve and the impact they wanted to come from the meeting. There was a commitment to a ‘public health’ approach to reducing serious violence that I believe means that it is about looking at the causes and how we can prevent the violence from occurring. Despite this the solutions presented did not reflect this and were very much more reactive after the incident.
The meeting presentation was excellent and did cover a lot of ground around the causes of serious violence and also included some case studies, both national and local, that looked at real-life stories of people who had been impacted by violence. There was also some good discussion during the meeting, especially in the Teams chat.
At the end of the meeting, there was a chance to move into breakout rooms to look at specific project ideas. This gave the opportunity to suggest and discuss options other than the ones presented, and the room I was in was productive.
My impressions
My overriding impression was that the ICS need to spend some time getting up to speed with what others are doing around serious violence before they commit to anything. There seemed to be little understanding at this stage of the work that Community Safety Partnerships (CSP) were doing and especially since the Cambridge CSP has serious violence as a continuing priority and has been working on this for a number of years. More info on the council website
The ICS were keen to do more research to get the figures and data that helped to understand serious crime, and it was pointed out this would be a waste of time and money given the work of the county council research team and the excellent reports they provide on this for the different CSPs. Other attendees pointed out that the ICS could best contribute to the research by encouraging the sharing of data from the bits of the health system that have traditionally not been shared. In this area, this would mean getting appropriate data from the East of England ambulance service and data on serious violence from Hinchingbrooke Hospital.
We spent a good deal of time looking at violence and young people, and again the importance of youth work and the first 1000 days of life were pointed out. I pointed out that we have seen statutory youth services slashed over the years and that the excellent work of charities such as Romsey Mill or Connections Bus Project can not replace this.
We spoke of the wider impact of serious violence on mental health etc and again there was talk of the difficulty of getting support, in one case study used the only totally positive experience of the victim was the service they received from a charity – Victim Support. At all other points of contact whist there were good parts there were negative experiences as well. It is essential that we recognise the work of local charities working with younger people to support them with wider impacts of serious violence and when I mentioned Centre 33 and the wider Fullscope partnership it appeared that too few in the ICS knew of these essential services.
My over riding fear from attending this meeting was that.
- There was insufficient understanding on the part of the ICS on what impact they wanted.
- There was no understanding of what the wider system was doing and had been doing for a long time.
- There was a danger of reinventing the wheel and duplicating work around research.
- There was a preferred set of outputs that were an easy win but that I, and other professionals in the meeting, believe would have little impact even if they could be implemented.
I think that the ICS had been backed into a corner on this due to ridiculous timetables imposed on them. I believe that they would be interested in a more radical approach that had a greater impact if they could have more time. I also believe that time constraints withstanding the ICS and the staff leading on this were totally aware that they need to find out more and were more than willing to work in partnership across the wider system and with the voluntary sector.
What I would like to see happen
These are the author’s thoughts and ideas and have not been discussed with the wider sector or partners.
There is a lot being done to address all aspects of severe violence by statutory partners and local charities, but we are not seeing any real decrease in number of incidents in many areas. It is vitally important that we all work together to address all forms of serious violence, but I think we have to embrace the public health approach and look to some more innovative solutions that start to address some of the causes and triggers to the violence. We have to understand that these solutions may not have the same ability to measure the impact and savings that many funders and organisations crave. We also have to recognise that not everything tried will be a success and that projects will need to be able to adapt or even end and that there is learning in that. Finally there has to be a commitment to be in this for the long term, a one-year or two-year project or programme is not going to be enough, we need to invest in the long term and to embed these innovative ideas into business as usual.
I think that given the time frame of this funding, the ICS would be setting itself up to fail if it introduced a project that had no sustainable future. Instead I think it could best use the funds and the time in two ways.
- Help the system to understand.
This would be about research and information. It should include making sure all parts of the health system are supplying the data to a central place (I think the county council research team) and that there are funds to help enhance the analysis and reporting of this data so that it can be used by all partners. In other words, build on the reports that the CSPs already get and use.
I also think that there is an opportunity to do more work with those impacted by serious violence. This is about real listening and understanding and about building trust and relationships that help to examine what are the causes and what those impacted think needs to change for them and their communities to address the issue.
- Design a new approach to solving the problem.
This is potentially a risk if continuation funding can’t be found or if the approach can’t become business as usual. I think that this approach should build on listening, should be about that preventative public health approach and should be truly multidisciplinary. They must do the work with individuals, families, and communities with support from the team. It has to be based on real relationships and trust, it has to be non-judgemental, and it has to work in a voluntary and not mandatory way.
I don’t think that the approach has to be developed from scratch as there are undoubtedly examples to learn from, but it has to be something that local partners can sign up to and that is tailored to and appropriate for Cambridgeshire.
Conclusion
Once again there are issues of unfeasible timeframes, short-term funding leading to short-term ideas, and a complex system which has seen unprecedented change and broken relationships. These lead to a lack of opportunity to radically innovate and a missed opportunity to start to do things differently.
We know that more of the same won’t work. We know that throwing good money after bad is not sustainable. We know siloes only make problems worse and positive outcomes less likely.
We also know the power that communities and individuals have to make changes if they are supported and resourced. We know the difference that working together can make in sharing expertise and understanding. We know that relationships are essential both across services but more importantly, with those that the services are working with.
There is an opportunity here to take a bit of a risk and to do things differently, and if we don’t things will get worse and not better.
