Simple but effective

Finding ways to engage with people who are hard to reach was the aim of the Adults facing Chronic Exclusion (ACE) pilots. The ACE programme was a joint undertaking between healthcare, housing, employment and other agencies. It looked at interventions for people whose lives were "chaotic or isolated" and for whom local services were inaccessible or unaccessed, often because of homelessness prostitution or durg and alcohol misuse. The twelve pilot programmes have now ended and the report on their achievements has been published by the Department for Communities and Local Government: the emphasis is on local solutions, most of which were comparatively inexpensive. The most noticeable healthcare impact was a reduction in use of emergency services, with a shift instead towards primary care. However, the clearest message from the final report is that a key part of any success is "the consistent, trusted adult" who helps clients in accessing existing services in an appropriate way.