Complex Needs Social Impact Bond

The Adults with Complex Needs service targets two separate but linked cohorts – adults with Severe and Multiple Disadvantage (SMD), and adults with SMD and a particular alcohol need.

The first cohort, Adults with SMD, is comprised of people who have three or more of the following disadvantages:
- Substance misuse
- Homelessness or accommodation instability
- Offending or ASB needs
- Mental health difficulties

The second cohort, adults with SMD and a particular alcohol need, is made up of individuals who repeatedly present at the Northern General Hospital with alcohol related conditions and support needs, and receive unplanned medical alcohol detoxification packages.

A draft specification for each strand of the service is attached.

Outcomes-based contracting and Social Impact Bond

Sheffield City Council has been awarded a grant in principle by the Life Chances Fund to make a partial contribution to the outcome payments of an outcomes-based contract to deliver the Adults with Complex Needs service. The proposed arrangement is that services for both cohorts will be commissioned through a single Social Impact Bond (SIB).

In a SIB, a socially-motivated investor or investors will lend money for a project, which is then used to commission a service from a provider or providers. The commissioner, provider and investor sign up to a contract that includes a set of targeted outcomes and a financial reward for achieving them. The commissioner pays the loan back to the investor as the outcomes of the service are achieved.

In this case, there may be different providers best placed to deliver the different strands of the service. There are various ways in which they could come together within a single Social Impact Bond, and there is more information on this in the attached documentation.

The Adults with Complex Needs service is targeting the following outcomes for the adults with SMD strand:
• Increase in the number of individuals living in safe, secure and appropriate accommodation;
• Reduction in the number of unplanned hospital admissions;
• Reduction in involvement in crime and anti-social behaviour;
• Improvement in wellbeing;

And the following outcomes for the particular alcohol need strand:
• Reduce the number of unplanned inpatient alcohol related admissions for a defined cohort of individuals who have frequent admissions to Sheffield Teaching Hospitals;
• Reduce the number of unplanned readmissions within 30 days of discharge for this cohort (all readmissions – not solely alcohol related admissions)

More information about the indicative cohort size and range of outcomes expected to be achieved by each strand of the service is available in the tender documentation.