Kate Morrissey works for NHS England and NHS Improvement's Health and Justice team as the National Implementation Lead for RECONNECT, which is NHS England’s care after custody service. In this blog she introduces the RECONNECT service and explains how it was developed in consultation with people with lived experience and voluntary sector organisations.
RECONNECT starts working with people before they leave prison, where they will have access to a RECONNECT worker, and helps them to make the transition to community-based services that will provide the health and care support that they need. The RECONNECT service was first announced in the NHS Long Term Plan (LTP) and is the biggest new investment in Health and Justice services for the past six years. The LTP committed to £20 million in investment for these new services by 2023/24.
Getting the commitment to deliver the RECONNECT service was the start of what has been an exciting journey for those of us working within health and justice settings. For a number of years there has been a growing body of evidence identifying the need for better continuity of health care after prison custody. Without robust continuity of care from prison to community, we risk losing the health gains and significant health investment made in custody.
For many people, release from prison is a crisis point. They are leaving a secure environment where their needs (such as health and housing) are met, and moving to an environment where, not only are they responsible for themselves, but they may have interrupted care pathways and are often without accommodation. They move from a supported and regimented environment to one with little or no support and uncertainties. Providing support for people at this point of transition is imperative.
As long ago as the 2009 Bradley Report it was recognised that, where people have been accessing treatment in prison, it is important to ensure that we continue to engage with them after they have left.
Once we were given the go ahead to develop the RECONNECT service offer, we immediately realised that we needed to do this in consultation. It is all very well deciding a policy direction on paper, but to really deliver the success in the RECONNECT service, we knew we had to listen and learn from those who might access the service and those who might deliver it, including both voluntary sector organisations and NHS trusts. As a result, we set about a year of learning and consultation.
Using a number of different routes, we visited sites already undertaking work similar to this, building an understanding of what worked, the barriers, challenges and successes. We heard from substance misuse services, people with lived experience and those who provided services. We used this learning to develop the scope of the service and to design pathfinder sites to test these service models. We commissioned the Revolving Doors Agency Lived Experience Team (LET) to be our “critical friends” testing theories and ideas and seeking advice from them to break down barriers and stigmas.
The first RECONNECT services went live in January 2020, and we currently have 11 live pathfinder sites. We have plans to bring more services online in the next year, aiming to have 100% geographical coverage by April 2024.
One of the key things that has come out strongly through our work is the need for services to be joined up and aware of each other. It is also important to have links with more informal services – such as wellbeing and social activities – often delivered by the voluntary sector, who have vast networks of services that can support people leaving detained settings. As a result, we are looking to see how we can embed this into the National Minimum Specification to ensure that all RECONNECT services formally have these links.
The pathfinder sites have so far done some amazing work supporting those who are leaving prison, particularly given that they rolled out their service in the middle of the pandemic. One case study from a site talked about a man, Mr B, who was released and initially did well. However, his engagement began to falter and the RECONNECT service was able to increase his support to ensure that he remained engaged.
“Having an extended period of time of support in the community has allowed Mr B to go through his blips and come out the other end. Everyone’s journey is different and when there is no support available it is very easy to live as one is used to. Having a support network to listen, understand and guide means the world to individuals and to overcome barriers and hurdles and see a light at the end of the tunnel is all some individuals need”.
As we roll out further services, we know that we will need to adapt and change how we deliver services for those most vulnerable people who are leaving detained settings. Working with people with lived experience, the third sector and NHS trusts to share learning and best practice gives us the best possible chance of helping to support those who need it.
I am proud of the work that has gone into making RECONNECT the service that it is. Whilst RECONNECT is not a panacea that will solve all the issues that impact on continuity of care, I am excited to see how the roll out of services nationally provides opportunities to improve on our pathways of care for those who need it most. More information will be published here as it becomes available.
Clinks are a member of the RECONNECT project board. If you want to find out more information on RECONNECT and Clinks’ wider work on health and justice, please contact Zahra Wynne