Spill the beans...

Evaluators

It is key that the programmes we run are primarily beneficial to the young people they are designed to support. We are confident that our efforts are helping those most in need, and are always seeking new evidence of these benefits for project partners, funders and young people alike.

Liverpool John Moores University (funded by NHS England Midlands)  (2022)

“Service evaluation of Redthread’s Youth Violence Intervention Programme (YVIP) across the Midlands” 

Report link

Summary of key findings: see Twitter thread

University College London / Nuffield Trust (funded by National Institute for Health and Care Research) (2022)

“Youth violence intervention programme for vulnerable young people attending emergency departments in London: a rapid evaluation”

Report link (we are asking for further revisions to this report to address a few errors)

Summary of key findings:

• Review of the published evidence found that young people who present ED following a violent injury are at significant risk of repeat injury. 
• February 2020 – December 2021, 397 eligible referrals were made to Redthread at UCLH. Of these, 169 (43%) received some form of support. 61% of referrals were males. 44% of young people referred to Redthread had presented at hospital due to an assault. 
• Hospital staff felt that Redthread were filling a gap in support and benefitted both young people and clinicians. Staff were wafer to refer young people to Redthread. 

“In terms of the intervention that they’ve been able to provide through our young people, it’s been absolutely invaluable. I think they essentially deliver a very assertive youth working intervention. They will meet young people on the ward, they will follow them up into the community… They tend to be very good at engaging young people who, which traditional services such as CAMHS or social care, often find it quite hard to reach.” (Consultant, UCLH)

“It’s massively strengthened our offer of holistic care to young people …. I think it has been a really instrumental part of facilitating that care. Particularly in those presenting in the greatest distress.” (Consultant, UCLH)

“I would quite happily have a youth worker for every young person we saw in the Trust, quite frankly” (Clinician, UCLH)

Case study vignette: A young person presents at UCLH with suicidal ideation. Staff become aware, through clinical assessment, that the young person is vulnerable because the family is “in crisis” with aggression occurring in the home which is affecting the young person’s mental health. The young person is however “very suspicious” of mental health services (i.e. CAMHS). Redthread youth workers visit the young person on the ward and interact with the family, and then continue to support the young person in the community by engaging with other public agencies. UCLH staff perspective on the case: “So they [Redthread] are incredibly valuable, incredibly useful in reaching out and engaging that young person to make sure they got the right support they need to keep them safe.”

• The overall level of assessed risks of ‘experiencing further harm’ and ‘not maintaining positive relationships with family’ were significantly lower at the end of the programme compared to at the beginning, among young people who engaged with the Redthread YVIP. 
• The Redthread YVIP has the potential to reduce healthcare costs – if for every three young people engaging with the service at least one emergency inpatient admission was avoided, the service would ‘break even’ economically.

Nottingham University Hospitals NHS Trust (funded by The Health Foundation)

“Redthread YVIP Adoption and Spread” (2020)

Report link

Summary of key findings:

• Evaluation conducted in the Midlands
• NHS staff are very willing to engage with the Redthread YVIP and support it. The YVIP was seen to meet a gap in NHS services.
• NHS frontline staff felt that there was a high level of unmet needs which were not addressed by clinical care alone – Redthread filling a gap. Also identified a need for help with communicating effectively with young people in some cases. 

“[ED] we’re not specialists in dealing with these things. So we don’t have the knowledge or the awareness. So that is the biggest gap which they are filling, is basically the support...”  (ED Clinician)

• Embedding youth workers in ED can improve communication between patients, friends and family, and professionals.

“It works both ways because the patients are happier patients, the parents are happier parents, they communicate more effectively with all staff, including the healthcare staff, we care for them better” (ED Clinician)

“The group of patients which the Redthread team are involved with are a group which previously would have been discharged from ED, without any social input. As a result of this, we were unable to help this group of

patients address the factors which commonly led to their ED admissions, often leaving staff feeling as though we were failing our patients to a certain extent” (Senior ED Clinician)

• The perception of young people that Redthread are independent from NHS staff, police or other agencies was important – youth workers were perceived as more relatable and approachable than some other professionals. 

“We’re a barrier. The uniform, the name of the organisation, it’s that automatic barrier and in some respects the NHS probably is as well because people see ‘well, they’re going to ring social care, they’re going to do this, they’re

going to do that’, but actually having that individual person who’s a youth worker, who specialises in working with young people, it’s going to have a positive impact and it would hopefully help a number of young people on

their future pathway and the decisions that they’re going to then make from then on.” (Senior Police Officer)

• Anecdotal examples of benefits from youth workers’ presence in hospital settings (from interviews with Redthread staff and other professionals):
  • Greater likelihood of young people cooperating with the police and helping with investigations.
  • Giving a young person a greater understanding of Police investigatory processes and providing support with steps in this process.
  • Reducing the risk of self-discharge from ED or wards prior to receiving treatment.
  • Directly receiving comfort and support during treatment,
  • Assisting in the management of tensions amongst friends and family in distressing circumstances.

Nottingham University Hospitals NHS Trust (funded by The Health Foundation)

“Evaluation of the Redthread Youth Violence Intervention Programme at the East Midlands Major Trauma Centre: An Analysis of Impact on Re-injury and Re-attendance Rates (2021)

Report link

Summary of the report

Summary of key findings:

• Study at the East Midlands Major Trauma Centre from March 2018-March 2020.
• 77% of eligible referrals were male, 23% were female, 66% were White British, the majority were 15-21.
• Among those who engaged with the full Redthread programme, 29.9% had attended ED in the prior 2 years for violence, mental health or exploitation (compared to 16.4% of those who did not engage in the full programme). 
• The most common reasons for ED attendance among engaged young people were 1) assault, 2) mental health, 3) substance, 4) accident.
• Overall, young people who engaged in the full Redthread programme saw a relative reduction of 51% in the rate of subsequent ED attendance compared to those who chose not to engage.

Outcomes UK (funded by The Health Foundation)

“Redthread’s Youth Violence Intervention Programme: A Cost Benefit Analysis and case for scaling across hospital Emergency Department location” (2020)

Report link

Summary of the report

Summary of key findings:

• The cost benefit analysis concluded that the outcomes achieved and cost avoidance result in a economic and social benefit of £4.90 for every £1 spent on Redthread’s YVIP. 
• The areas of greatest benefit were found to be: 1) ‘Quality-adjusted life year’ (a measure of the state of health of a person), 2) Lost output – time off work and lower productivity, 3) Health services, 4) Victim support, 5) Police costs in response to violence/crime, 6) Other CJS costs in response to violence/crime, 7) NEET costs.
• Stakeholder interviews also showed that although historically a substantial proportion of young people engaging in the YVIP have been affected by knife-related injuries, the intervention is equally relevant to other forms of violence prevention.

NPC Associates 

Report link

Summary of the report

Summary of key findings:

• Hospital re-attendance rates fell from 5.3% to 2.9% in the three years after the programme was launched.
• 59% of young people who completed beginning and end risk-assessments with youth workers reduced their personal associated involvement with violence.
• The YVIP has helped at risk young people who attended St Mary’s to reduce the risks in their lives including reduced involvement in crime and violence.
• The YVIP has supported at-risk young people to access appropriate supporting services in a planned way.
• There has been an increased awareness, understanding and engagement by St Mary’s ED staff with young people attending with violence related injuries including those related to sexual exploitation.
• Hospital staff reported improved self-efficacy and confidence in dealing with young victims of trauma.
• Collaborative working and sharing of data between relevant agencies has improved.
• Intuitively, the service appears cost-effective.