By moving from a prescriptive and uncoordinated approach to commissioning services across various departments to one based on outcomes, integration and collaboration, Southwark has transformed the provision of its domestic abuse services. This has enabled services to move beyond simply ‘managing risk’, to truly help survivors of Domestic Abuse and challenge the cultural norms, myths, perceptions and behaviours that perpetuate it.
Southwark is one of the London boroughs with the highest levels of reported domestic abuse. It could be argued as to whether this is a good or a bad thing (reflecting either a higher incidence or a higher degree of reporting) but Domestic Abuse (DA) is massively underreported, so the more people report it and access the help and support they need, the better. However this doesn’t mean there should be complacency regarding the issue, or that prevention and addressing its root causes should be ignored.
Southwark Council takes Domestic Abuse very seriously, and it is a political priority. The council has set out a number of key priorities known as the Fairer Future Promises, one of which was agreeing a Domestic Abuse Strategy. In March 2015, after extensive consultation, the council achieved this pledge, approving Southwark’s five-year ‘Domestic Abuse Strategy’. Southwark has also adopted a community response model for commissioning its VAWG (Violence Against Women and Girls) services. The community response is the result of a collaborative outcomes-focused commissioning approach and owes much of its development to Southwark’s service provider Solace.
In the past, sporadic and uncoordinated commissioning by separate council departments had meant that there were varying DA services within the borough which were not fully integrated and used differing service standards. There was no clear picture of the range of provision and no shared agreement of the desired outcomes Southwark wanted its commissioned services to deliver. Services also focused exclusively on managing risk of harm.
Traditional commissioning models had often focused on providers’ compliance with procedures, activity and completion of inputs. The focus was usually on provider activity i.e. how many clients were seen, how many assessed, how many workshops held etc.; however, this did not guarantee that desired outcomes for the service users were achieved or provide a real sense of how the service had a positive impact on the lives of the service users.
Borough officers undertook a consultation exercise with survivors, practitioners and colleagues in different departments to clarify what outcomes they wanted DA services in Southwark to deliver. This exercise identified a need to look beyond managing risk in order to truly help survivors of DA and change the cultural norms, myths, perceptions and behaviours which perpetuate it. This highlighted:
- A need to tackle the root causes of DA and address perpetrator behaviour. It was agreed that the new DA service would have to provide perpetrator outcomes.
- A truly-coordinated response to support survivors of DA across the system is only possible if the very people at the front line are fully aware of what DA is and its impact. So it was decided that professionals and practitioners training outcomes should also be a must.
- • Consultation with survivors also highlighted the importance of ensuring that health professionals in the borough, particularly GPs, were equipped with the skills to recognise domestic abuse and to signpost people for specialist support so it was agreed that outcomes were needed on this front too.
- Children are often the unheard victims in abusive relationships. Growing up in this environment means they themselves might become abusive or abused in their own relationships as well as affecting their emotional, psychological and behavioural development, making the effects of DA last for generations. So it was clear that the service delivered outcomes for children.
- Speaking to survivors and reflecting long and hard on what they said ensured that when commissioning for outcomes, results had to be defined by changes in the quality of life of service users. For the council this would mean far less concentration on outputs and far more emphasis on how many people would improve their quality of life as a result of their interaction with the service.
Southwark therefore agreed that the service specification would focus on desired outcomes rather than being a prescriptive list of what the service should look like.
Taking an outcomes-focused and collaborative approach allowed providers to be innovative in their bids, and create a real and sustainable change in attitudes at a community level. This work was supported by the
domestic abuse charity Solace.
The end result is the most comprehensive and innovative DA service offer that Southwark Council has ever had.
It is viewed by the council as a flagship service in the borough and across London. This service includes:
- Sanctuary scheme
- Comprehensive offer of awareness and resilience building programmes for survivors of DA
- Specialist counselling
- Legal surgery
- Comprehensive training for professionals, community organisations and community volunteers
- Children’s therapeutic intervention
- A new perpetrator intervention
- A GP based intervention
- A new peer supporters programme
- Women’s Voices groups to shape service development.
This service sits within the context of the five-year ‘Southwark Domestic Abuse Strategy’, which includes a focus on expanding prevention work which promotes healthy relationships. Southwark wants potential victims, perpetrators and their family and friends to be able spot early warning signs of abusive behaviours and seek support before it escalates. There is also a strand around perpetrators, talking about their behaviour – its impact on others and the consequences, and how they sought help.
There are a number of separate, complementary projects working with and alongside Southwark’s DA service.
- A wider DA awareness campaign #oktotalk. This recognises the fact that psychological and emotional abuse, as well as controlling and coercive behaviours, are more prevalent than and usually precede physical violence. This campaign taps into the idea that most people have experienced difficult relationships either directly or through a friend or family member. It is by talking to people they trust that they can find the strength and support they need to identify potentially damaging relationships before the risk escalates. It also emphasises that DA can happen to anyone and that it is not necessarily physical. The campaign uses a combination of social media, council media and face to face community engagement to get these messages across, engaging with community leaders to spread these messages and advocate them as their own within their communities.
- A new DA community champions programme. The programme aims to help champions recognise members of their community experiencing or perpetrating abuse, give the right advice and signpost to specialist services for those who disclose experiencing or perpetrating abuse and challenge cultural norms in their communities which may condone abusive behaviours.
- The forthcoming DA peer supporters programme. This matches trained ex-service users who are no longer experiencing abuse with victims to offer emotional and practical support. Candidates will be be given the option to enrol on a recognised DA qualification.
Outcomes-focused commissioning allows Southwark to take a more collaborative approach to service design and to continuously develop and improve the service, being attuned to changes in levels of need and service
Southwark now has a very comprehensive outcomes focused performance management framework in place which allows commissioner and provider to track how the service is making a difference to service users’ lives.
The council considered how a more collaborative commissioning model could be facilitated and whether this could help to address the issues of consistency of quality and evidence of outcomes.
The council decided to pool commission budgets for VAWG services and take an outcome focused and collaborative commissioning approach. The council became an “investor”, acting in partnership with providers rather than being just a funder.
Community Safety Manager – Children’s and Adults Services
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