1. Executive summary

This report details the responses to consultation on the proposed changes to domestic abuse service commissioning from 2017/18. The public consultation was open between 8 June and 15 August 2016.

The consultation was well received by members of the public, service users, stakeholders, partners and service providers. Considerable support was expressed for the proposed integration to achieve an effective level of service across the county and in particular the introduction of a central referral system to better manage initial access by those needing support.

The most significant concern noted within the consultation feedback related to the full centralisation of the service and perceived the loss of local focus and associated risks to smaller service providers.

In response, Kent County Council has adjusted the model to take these concerns into account, with greater flexibility and control of service through the inclusion of smaller, area based contracts. The amendment to the model allowing for area based contracting will operate in line with the integrated service specification, supported through central referral, assessment and triages services. This approach to responding to the consultation feedback is expected to alleviate the risks and concerns raised by respondents.

  1. Introduction:

Domestic Abuse Support Services in Kent are currently funded through a mixture of commissioned services, grant funding and charitable funds. The landscape of service provision is variable with disparities in available support evident.

The three largest commissioned services are Women’s Refuges, Independent Domestic Violence Advisors (IDVA) and Floating Support. Refuges and Floating Support are commissioned by Kent County Council. The IDVA service is partnership funded, with the Office of the Police and Crime Commissioner (OPCC) holding the contract.

All three contracts are due to end in 2016/17, presenting an opportunity to review and improve how the services are commissioned and delivered to ensure good levels of access and provision across the county.

The historic trend of commissioning services individually has led to a service landscape which is not joined up, and does not offer clear pathways for clients requiring support. This can result in duplication of effort in some cases, and in others, the absence of a support option, dependant on the location of the client.

This service landscape means that there is not a clear ‘pathway’ for clients to follow to access services, meaning that they have to go through multiple referrals and assessment processes which can delay the time it takes to start receiving support, and means that clients have to repeat their story to a number of professionals.

The repeated movement of clients between services increases the risk of clients ‘slipping through the cracks’ and not accessing support because they aren’t seen quickly enough, and do not know how to get the help they need.

The proposal from KCC is to integrate the three primary areas of commissioning into a holistic model of support, thus improving client pathways and consistency of support.

The proposed model also incorporates a strengthened early intervention and preventative response, based on the premise that by making support available to victims of domestic abuse earlier, there will be a lesser reliance on high risk, crisis interventions.

This commissioning activity will not deliver immediate cost savings but through commissioning a more robust model of support, associated costs to the County Council will be reduced and demand for crisis intervention will fall.

  1. Consultation process:

Consultation for the proposed commissioning of domestic abuse support services from 2017/18 ran from 8 June – 15 August 2016. Consultation took the form of online responses through kent.gov.uk as well as a number of focus groups with service users, members of the public, service providers and stakeholders. 271 responses were recorded in total across all feedback channels.

Approximately 80 people attended 11 focus groups to discuss the proposed offer, and complete questionnaires. This was a mix of professionals, and current and former users of existing services.

The consultation was publicised through a variety of channels including social media outlets, direct emailing to stakeholder groups and the Kent & Medway Domestic Abuse Strategy Group. Publicity material was circulated to a range of locations including Gateways, libraries, Police Stations and ‘One Stop Shops’ to promote the consultation.

Focus groups were held across the County and timed to run during school hours to mitigate against barriers to attendance from those with school aged children.

The timetable of focus groups was as follows:

Location / Date
Hawkinge / 23 June 2016
Aylesford / 28 June 2016
Dartford / 30 June 2016
Barham / 6 July 2016

These events were structured in such a way that an officer was on site all day, with structured discussions held in the morning for service users and members of the community, and afternoon sessions for professionals and service providers.

In addition to these programmed events, 3 additional events were held in specific locations as requested by partners and service providers. These were a client based group on 29 June at a women’s refuge in East Kent, a client based group on 13 July at a women’s refuge in West Kent and a session for professionals on 21 June in Sittingbourne.

The consultation was due to end on 15 July 2016 but due to a number of requests from key partners and a consistently good response level from the public and professionals, the deadline was extended to the 15th of August. This extension allowed many local organisations and authorities to consider the consultation as part of their formal committee or meeting schedule and provide approved organisational responses.

The consultation document is attached at appendix 1.

  1. Respondents

There were 276 response questionnaires received through the website, the post and from focus group attendees.

Additionally, the Women’s Aid Federation of England, and Swale Borough Council submitted lengthy written responses to the consultation.

There was a particularly good level of response from members of the public, and service users, who made up a combined total of 64% of all responses received. The remaining responses were from Service providers and voluntary sector organisations, district and borough councils.

The respondents who selected ‘other’ were a mix of housing association employees, a primary school, Kent County Council employees and town councillors.

Demography data was collected by respondents voluntarily completing some equalities questions.

The age profile of respondents was extremely varied, which demonstrates the far reaching impacts of domestic abuse, across generations, whilst, in line with the profile of people accessing domestic abuse services and working within the sector, the majority of respondents were female.

However, 20% of the members of the public and service users who responded to the consultation were male, which is a higher than anticipated response. These responses were overwhelmingly in favour of the proposal.

11% of respondents stated that they had a disabilityand a broad range of impairments were reported.

Responses were received from a wide range of ethnicities, broadly in line with the demography of Kent.

37% of respondents that answered the religion or belief question, identified as having a religion or belief. Of these, the vast majority were Christian with a small minority identifying as Muslim. No other religions were represented in the consultation process.

69% of respondents answering the question regarding sexual orientationidentified as heterosexual but some responses were received from LGB individuals.

Commissioners are satisfied that the demography of respondents to this consultation process provides a fair representation.

  1. Consultation responses:

Question 2, Do you agree or disagree with theconcept of 'joining up' services into a single model?

Responses showed significant support for the concept of integrating disparate services into a single model.

Of the 67 respondents (16%) who answered either ‘disagree’, ‘don’t know’ or did not complete this question, 16 gave reasons for this. The key areas of concern were:

  • That a countywide contract may be unwieldy and difficult to manage
  • That local specialist knowledge may be lost, and smaller local organisations may be put at risk
  • That a countywide model would not have the flexibility to respond to the differing needs of local areas
  • Pooling budgets and commissioning services according to locality (Option 2 in the consultation) would work better
  • We have concerns around several issues regarding the joining up of services into a single model. We believe that option two - pooling budgets and commissioning services according to locality will protect your individual services

Question 3, Do you agree or disagree with the introduction of a central referral system for people needing Domestic Abuse support?

88% of all responses agreed with the introduction of a central referral system.

Of the 67 respondents who answered either ‘disagree’, ‘don’t know’ or did not complete this question, 14 gave reasons for this. The key areas of concern were:

  • Whether demand for a central referral system would compromise the speed at which clients would be able to access support
  • That this would result in restricted access points for clients and deter approaches, particularly if the referral system was administered by the local authority
  • That the personal touch may be lost

Question 4: Do you agree or disagree with the outcomes for the service?

Of the 188 respondents who agreed with the outcomes, several made reference to the need to include outcomes for children within this service offer. Currently this model is restricted to direct support to adult victims, with children required to access support through alternative means. Based on the comments and concerns raised around children affected within domestic abuse, further work will now be undertaken by commissioners to ensure that services for adults and those for children articulate well with each to deliver consistency of support.

There was support for the concept of streamlining and aligning outcomes to be measured by commissioners to reduce the administrative burden on providers, and a strong emphasis from respondents around the need to measure meaningful outcomes and to ensure that data collection does not become a priority over service delivery.

11 respondents disagreed with the outcomes, of which 6 gave further information to support their views. These comments were:

  • The actual outcomes will not be known until implemented and evaluated. The objectives and targets for outcomes read well
  • We feel with safe implementation and activation and ensuring that victims are indeed kept as safe as possible that the outcome for the service proposed would have a great social impact.
  • We invite further discussions. Email
  • The current providers should have their contracts renewed.
  • I do not like the sound of phrases such as 'most likely' when referring to the continued quality of support.
  • Not enough focus on emotional abuse and helping people to recognise that it is wrong.
  • The intention to keep all information on file to be passed to different services could be done at present, without the need for all the funds to go to one body.

Question 5: Are there any other outcomes you would like included?

There were a significant number of responses requesting specific outcomes around children and young people. This information will be shared with colleagues in Children’s Commissioning to inform commissioning decisions.

Specifically, WAFE (Women’s Aid Federation England) identified that they would like to see support to engage and maintain education and better attainment for children who have experienced and lived with domestic abuse.

One respondent pointed to the value of measuring outcomes for those who speak English as an additional language and have specific cultural needs.The first year of service delivery will be used as a period of benchmarking performance, and working collaboratively with service providers to develop a meaningful suite of performance indicators to measure the effectiveness and impact of service provision. Commissioners and Service Providers will ensure that measurement of outcomes for those with language and cultural needs are included within these outcome measures.

Question 6: Do you agree or disagree with the interventions provided by the service?

192 respondents agreed with the proposed interventions of the service and 8 respondents disagreed. The remaining respondents did not answer this question.

Some respondents statedthat the interventions were not described clearly in the consultation document. This is largely because the new service will be commissioned on an ‘outcome based’ basis, meaning that it is difficult at this stage to describe interventions specifically, as providers will have scope during the tender process to bring innovation to their delivery models in order to achieve required outcomes.

Some respondents raised concerns that the commissioning proposal has been designed to deliver cost savings. Kent County Council is not reducing the budget to domestic abuse support services, but is looking to achieve greater efficiency in service delivery through different means of delivery.

Question 8: Do you have any other comments on our proposal?

The full range of comments made on the proposal has been included at appendix 2.

Within the comments, there was a significant body of support for the concept integration but some ongoing concerns regarding the loss of ‘specialist’ providers from the market, and the risks of commissioning a single, large provider to deliver support services.

There were also some financial concerns raised, particularly around how budgets will be set, and whether the changes to domestic abuse support provision in Kent is driven by potential cost savings. This proposal is not designed to deliver immediate direct cost savings to commissioners but consistent, good quality, holistic domestic abuse support is expected to deliver benefits to the users of services, as well as indirect efficiencies to the County Council and other funding partners through a decreased reliance on other public services such as social care and Housing.

Ranking of Interventions:

As part of the consultation process, respondents were asked to rank the interventions to be included within the model of support in order of importance.

Most respondents indicated that safe accommodation such as refuge was the most important intervention, which coalesces with the views of commissioners that safe accommodation is paramount in the delivery of effective domestic abuse support. Through delivery of the proposed model, however, service providers will work alongside commissioners and partners to explore innovative means by which to ensure the safety of those suffering domestic abuse, outside of traditional refuge settings.

  1. Equality Analysis

The consultation responses did not raise any points which contradicted the existing Equality Impact Assessment.

A number of respondents suggested that services for children and young people should be included within the model, and are essential to the provision of domestic abuse support services. This impacts the ‘age’ protected characteristic, but currently the provision of children’s support services sits within the 0-25 portfolio and is out of scope for this project.

Respondents also highlighted the need for suitable support for male victims (gender protected characteristic) and Asian victims (race protected characteristic). Both of these areas have been addressed in the current EIA and these groups will not be adversely affected by the introduction of the new model. The proposed model has a greater emphasis on access for those groups recognised as ‘hard to reach’ (including male victims and those from minority communities), and will deliver a better standard of service than is currently available.

  1. Post consultation:

The proposed redesign of domestic abuse support services was largely well received during consultation, leading to the decision to proceed with integration of the three key areas of delivery (refuges, IDVA, floating support).

The overriding concerns raised during consultation were that;

  • A single, countywide contract would be unwieldy and may exclude the voluntary sector, resulting in an undesirable, unworkable service; and
  • That the contribution to domestic abuse provision from the voluntary sector is valuable and the risk of these organisations exiting the market is significant.

Following the end of the consultation period, a Market Engagement event was held on 9 September 2016 to discuss any potential changes to the model with possible suppliers. This event was advertised on the Kent Business Portal and attended by over 30 individuals representing 31 organisations from a range of sectors including specialist domestic abuse specialists, criminal justice agencies and childrens’ service specialists.

The market were presented with a number of options for delivery of the proposed model, which included;

  • A single contract to be delivered through partnerships of providers
  • 2 Contract areas (possibly East and West Kent) to deliver the whole contract scope
  • Multiple area contracts, to be delivered following either a group of district council areas, NHS Clinical Commissioning Group areas or police areas.

Attendees of the market engagement event were given the opportunity to explore the proposals and discuss the impact of each of these. The resultant suggestion from the majority of attendees was that a countywide triage and assessment service is commissioned, with the delivery of support broken into smaller area lots. Most attendees supported using district council boundaries as a basis for this, due to ease of recognition for service users.