It is a shameful truth that people experiencing the worst disadvantage in Scotland today face the biggest hurdles to getting support. This is not down to a failure of individual services or frontline practice. It is a systemic problem in the way that services are designed, funded and delivered to address single issues in an isolated way – in silos.
This fragmentation has profound consequences for people with severe and multiple disadvantages (SMD), including mental ill health, addiction, homelessness, offending and domestic abuse. For those at the hard edges, problems frequently overlap. They reinforce each other and without resolution trigger fresh problems.
But siloed systems do not match this real life complexity. They ask people to unpack their crises one after another, getting help from each service in turn. It’s like trying to put out a forest fire one tree at a time. People with multiple problems cannot recover in sequence.
The result of this mismatch, where an inflexible system meets the fluidity of actual life, is to create a self-reinforcing cycle of disadvantage that no single service can break. This causes deep harm to people and significant financial cost to public finances – a ‘silo tax’.
Those at the hard edges – the 1 in 28 people in Scotland who today experience extreme disadvantage, according to the landmark Hard Edges Scotland research – pay the highest levels of silo tax. And this unfair penalty comes on top of lives that are likely to have been shaped from childhood by exposure to violence, poverty and trauma.
Committing crimes just to get help
People are left to navigate a complex system repeating their story and trauma at every door they go to. They fall through gaps between services or – understandably – disengage. Crisis goes unresolved or escalates. Disadvantage, harm and exclusion deepens.
Hard Edges Scotland highlighted how homelessness and justice services are often left to carry the can when issues haven’t been addressed elsewhere – with many people deliberately offending in the hope of getting support via the justice system.
The silo tax hits public finances through additional spending generated by this mismatch. And there is a wider cost to us all when we consider the contributions to communities, society and the economy that are lost when system failure makes recovery harder.
Over decades, many minds have focused on the need to build preventative, people-focused and connected systems of services, commonly known as the ‘no wrong door’ approach. Everyone agrees that this is the way forward. The problem is making it happen.
System change is not easy. But we can raise The Level.
At Scotland’s National Summit on Severe and Multiple Disadvantage on October 7 we will launch The Level, a new and implementation-focused delivery protocol for providing consistent support for people whose needs cross multiple systems at once.
The Level is not another framework or policy competing for existing resources. It is a practical response drawn from learning during the No Wrong Door Scotland test of change programme, which explored with innovative service delivery partners what is needed – the tools, cultures, resources and policy – to provide joined-up support.
This is the toolkit that will allow Scotland to translate years of commitment into practical implementation, improving outcomes and services and saving money.
The Level provides operational infrastructure that can close the gap between good policy and great delivery, and provide the glue to bring together different strategies, by providing practitioners, policymakers and commissioners with the tools to work differently. It contains changes that can be made now and longer-term shifts that will work.
The Level will also set out the human cost of system failure through a peer research project undertaken to hear people’s real experiences of fragmented service delivery, and a full analysis of the social and economic costs of failing to address SMD – and the savings that can be made by doing so.
A toolkit for leadership and action
The objective of The Level is to prevent system failure where it hurts and costs most. By enabling integrated service delivery for people at the hard edges, we can raise the national minimum standard of support for everyone, while enabling local leadership and action.
The Level brings together insight and leadership from across the public, third, knowledge and funding sectors. It is not a homelessness protocol but has been led by our sector because research exposes how we are left to “carry the can” for missed opportunities to help people earlier. Deep social exclusion tends to precede the loss of housing.
A system that can act early and consistently get alongside people at the hard edges will be more effective, more preventative and more resilient for everyone. When the system works for people with SMD, the floor rises for everyone in Scotland – raising the level. If the system keeps failing the same people in the same ways, nothing else we do will fully work.
Find out more about the National Summit on Severe and Multiple Disadvantage and join us at Perth Concert Hall on 6 and 7 October to be a part of this important work. Raising the Level: from hard edges to whole lives.