Poverty proofing report Doncaster forensic outreach liaison 2024

1 Poverty proofing delivery partner model

Children North East are working in partnership with Rotherham, Doncaster and South Humber (RDaSH) NHS Foundation Trust to fulfil its ambitious promise to “poverty proof” all of its services by September 2026. The trust has committed to piloting a bespoke Delivery Partner Model developed in partnership with Children North East (CNE).

Poverty Proofing is a nationally recognised tool, designed to educate and enable health care professionals to identify, acknowledge, and reduce the impact of poverty. Advocating for equality of access to healthcare services and technologies will positively impact the overall health outcomes of everyone.

A locally trained team (LTT) of people have been trained and are being supported by CNE to carry out this work in line with the ethos and principles of Poverty Proofing.

• Phase 1: 3 model audits carried out by Children North East.
• Phase 2: a further 6 audits carried out by the locally trained team with support from Children North East.
• Phase 3: all other trust services will engage in the Poverty Proofing process during 2025 and 2026. Children North East will deliver training to all staff; the locally trained team will carry out scoping of services and engage patients and staff in consultations; and the trust strategy team members will deliver feedback and write reports for each service. Moving forward, services will become more poverty informed, learning how to work with their patients to identify barriers, so that poverty becomes everyone’s business, and no-one is left out or left behind.

This whole system approach is unique and has accountability at every level and a commitment to alleviate barriers that apply across the whole system.

2 Poverty proofing Doncaster forensic outreach liaison

The forensic outreach liaison service for learning disability and autism (FOLS LDA) provides intensive care and treatment within the community, aiming to prevent individuals from being placed in secure hospitals or prisons, by mitigating their risk of encountering the criminal justice system.

We offer support to men and women aged 18 and above with learning disabilities and, or autism who have interacted with the criminal justice system or secure hospitals or are at risk of doing so.
Our team directly assists individuals with complex needs in both inpatient and community settings. We collaborate with you to ensure appropriate care and support are provided.

For individuals in hospitals, we offer in-reach support and ensure safe and coordinated discharge planning. Additionally, we provide consultation, support, and collaboration with partner agencies. In the community, we offer advice on available options, risk management strategies, and reasonable adjustments.

We contribute to care and treatment reviews and offer offence-specific interventions and training. Each team member possesses specialised experience in working with individuals exhibiting a high risk of concerning or offending behaviours, as well as extensive knowledge of the forensic and criminal justice system.

The forensic outreach liaison service collaborates with local community learning disability teams, including intensive support and mental health teams, to effectively support individuals displaying offending behaviour within the community, aiming to manage risks and avoid involvement with the criminal justice system or secure hospital admission where possible.

The forensic outreach liaison service (FOLS) aims to reduce or safely manage behaviours of people with a learning disability and, or autism that may lead to them having contact with the criminal justice system. The forensic outreach liaison service also aims to reduce the number of people with a learning disability and, or autism who require inpatient facilities. This is achieved through six core functions of support:

• forensic risk assessment and management
• offence specific therapeutic interventions and treatments
• case management
• training to internal and external agencies
• consultation
• in-reach support, to ensure safe and timely discharge

The forensic outreach liaison service aim to support service users to live safely within local communities. We aim to support individuals with learning disabilities and, or autism to obtain good and meaningful lives in their communities, something which is important for those individuals who may be at risk of engaging in offending behaviours. We have a strong focus on prevention and early intervention, ensuring that service users are protected from potential harm, and the community is kept safe.

3 Poverty proofing ethos

No activity or planned activity should identify, exclude, treat differently or make assumptions about those whose household income or resources are lower than others.

3.1 Voice

The voice of those affected by poverty is central to understanding and overcoming the barriers that they face.

3.2 Place

We recognise that poverty impacts places differently, and so understanding place is vital in our response. Organisationally we also need to be clear about why and how decisions are made. This understanding of context is essential.

3.3 Structural inequalities

The root causes of poverty are structural. What structural changes can we make at an organisational level to eliminate the barriers that those in poverty may face?

4 Poverty proofing process

4.1 Stage 1: training and consultation with staff

6 staff completed a three-hour training session.

4.2 Stage 2: scoping

Time was spent gathering information about the setting and how it works. This stage included conversations with staff and management, observing interactions and reviewing key areas such as the website and communications.

4.3 Stage 3: patient and community consultations

We consulted with 8 people who use the service. We also surveyed 5 staff who work in the service.

4.4 Stage 4: feedback session

A feedback session will be held with Tracy Rossall where we will discuss our findings and collaboratively consider various changes that could be implemented.

4.5 Stage 5: review

Around 12 months after completion, the trust will complete a review, identifying impact, good practice and potential considerations moving forward.

5 Common themes

The next sections of this report highlight the most common themes to come out of the Poverty Proofing consultations. For each theme the report covers:

• what works, what you do now that supports those experiencing poverty
• the barriers and challenges faced by those experiencing poverty
• recommendations, each recommendation comes with a set of considerations for “poverty proofing” the service

The themes are presented alphabetically, and this does not imply any hierarchy of importance. The themes for Doncaster forensic outreach liaison were:

• communication
• navigating and negotiating appointments
• patient empowerment
• staff awareness and guidance
• travel

5.1 Communication

Communication is important to consider in Poverty Proofing both from a health literacy perspective of how information is communicated and understood and in ensuring there are reciprocal lines of communication between services and service users. O’Dowd (2020) reported that availability of care was a particular concern for those on a low income and there were significant inequalities in care availability for the most deprived areas. Communication is a key factor in ensuring availability of care.

5.1.1 What works

5.1.1.1 The service is positive

When considering the patient consultations, there is really strong evidence in favour of the positive atmosphere staff strive to create. Patients feel supported by the service.

“I feel very supported by the service.”

“Calm and everything seems fine.”

5.1.1.2 Accessible communication

Staff make a very conscious effort to ensure that all important information is available in multiple formats, including easy read. This is in support of the patient.

“Where information needs to be shared, we try and provide easy-read form or leaflets. As a service we try and make this as adaptable for the patient as possible.”

5.1.2 Barriers and challenges

5.1.2.1 Minimal communication about financial assistance

Patients have expressed that while communication with the service is typically good, they don’t tend to receive any communications about financial assistance. Every patient surveyed suggested they would appreciate more information about what support is available to them. Staff did say that they use Dialog+ to initiate conversations about financial concerns, but the impact is possibly not being felt amongst patients.

“Give clear communication about available support.”

5.1.3 Recommendations for communication

5.1.3.1 Make information about financial assistance available to everyone

• Create a leaflet of all financial assistance available to patients and offer it to all patients.
• Staff to keep an electronic version of this leaflet for use when needed.
• Direct patients to the Benefits Advice sessions which are now available on-site with Citizens Advice.

5.2 Navigating and negotiating appointment

Life can be particularly unpredictable when living on a low income. The challenges, for example around childcare or zero hours’ contracts can make attending appointments very difficult. Pressures on the NHS around waiting times and stretched services can mean there is little scope for flexibility and strict discharge policies are applied for those who miss appointments, effectively severing access for those with changeable circumstances. Furthermore, social problems often accompany poverty, and sometimes life can be chaotic, which makes consistent appointment attendance difficult. Availability and flexibility of care are important for improving access to health care for those on a low income.

The King’s Fund (2021) report states that:

“Services need to be flexible, accessible, responsive and offer continuity of care.”

Doncaster forensic outreach liaison service are typically very good at supporting patients to navigate and negotiate appointments. This includes offering community venues, online or telephone appointments and rearranging where necessary.

5.2.1 What works

5.2.1.1 Most people have not missed appointments due to financial reasons

The vast majority of people who responded had never missed an appointment due to financial circumstances. This is a testament to the staff who go out of their way to make sure patients can make their appointments.

5.2.1.2 Appointments in community venues or at home

During consultations, staff demonstrated good awareness of the need to meet patients closer to home, and strive to make this happen when appropriate.

“We travel to see the patients more than we get them to come to us and this is something we do so that we don’t have people not turning up for appointments.”

5.2.1.3 Offering online or telephone appointments

Staff will offer telephone and online appointments where a patient has expressed an interest or need in doing so; however, this is done on a case by case basis as the need for in-person contact is important in this service.

“The preference for us as a service is to see patients face to face but we are flexible we do offer telephone and virtual appointments if this is appropriate.”

Page last reviewed: August 13, 2025
Next review due: August 13, 2026

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