This document provides guidance on completing an application for stage 1 of the NIHR Policy Research Programme (PRP) Research Call for the Evaluation of RECONNECT services for adult prison leavers.
Timetable and Budget
| Description | Deadline/Limit |
|---|---|
| Deadline for Stage 1 Applications | 14 June 2022, 1 PM |
| Notification of outcome of Stage 1 Application | August 2022 |
| Deadline for Stage 2 application | 28 September 2022, 1 PM |
| Notification of outcome of Stage 2 Application | January 2023 |
| Project Start | January 2023 |
| Budget | £450,000 for a single project |
Introduction
The NIHR Policy Research Programme (PRP) invites applications for a single project to undertake an evaluation of the RECONNECT programme. This evaluation will be aimed at identifying best practice to inform the wider implementation of the programme.
This research is needed to better understand if the RECONNECT programme improves engagement with community-based healthcare services for prison leavers, how this is affected by different delivery models used in implementation across different RECONNECT sites, and what barriers are affecting the programme’s ability to support access to services.
The research should explore what delivery approaches are most effective across different RECONNECT services in enabling prison leavers to engage with community-based healthcare services, as well as create a better understanding of the barriers prison leavers’ face that might prevent them from attending their healthcare appointments after they get released from prison.
Background
For many people, release from prison is a crisis point. They are leaving a secure environment where their needs, such as health and housing, were met and moving to an environment where, not only are they responsible for themselves, but they may also have interrupted care pathways and are often without accommodation.
RECONNECT is a ‘care after custody’ service, working with individuals who have any single significant health or social care vulnerability. This is defined as an individual who would otherwise struggle to engage with community-based healthcare services. Prison leavers receive support for up to 12 weeks pre-release and up to 6 months post release, regardless of sentence length or index crime, thereby safeguarding health gains made whilst in prison.
RECONNECT services do not deliver any clinical interventions; the services act as care navigation and support (including peer support) to prison leavers as they progress to engaging with community services. It is mainly driven by non-clinicians (including peer support).
The aim of the RECONNECT service is to increase access to and uptake of healthcare or relevant support services for individuals who have health needs upon release from prison or immigration removal centres and ensure a safe transition to community-based healthcare services.
RECONNECT services began to roll out in 2020. At the end of 21/22 there were 19 services live, with 28.44% of prisons having a RECONNECT service. See Annex A for a map of national coverage of RECONNECT services. Full national roll-out is expected by March 2024.
NHS England and NHS Improvement (NHSE/I) commissioned a formative evaluation in the first year of the pilots for RECONNECT, commencing in January 2020. However due to the COVID pandemic, this evaluation could not go ahead and had to be amended to a lessons learned report. The report’s recommendations are being implemented as the service continues to be rolled out and are also included in the new service specification for RECONNECT.
In addition to this, NHSE/I worked with the Lived Experience Team (LET) to develop the original pilots and to amend these pilots to develop the National Minimum Service Specification. The LET are involved with the design and development workstreams for RECONNECT. This group consists of a network of people with lived experience of the criminal justice system; providing advice and guidance as to the barriers and challenges of accessing health care when leaving prison.
NHSE/I also collect a monthly national minimum dataset (NMD). These include demographic data and some limited data on engagement with the RECONNECT service, such as whether the prison leaver had a RECONNECT peer support worker and whether they attended their first healthcare appointments.
For the RECONNECT programme, a successful outcome is defined as a prison leaver who has attended their first healthcare appointment in the community with their healthcare needs being met or a prison leaver who has remained engaged for 6 months after leaving prison.
Research priorities
We would like to know if the RECONNECT programme improves engagement with community-based healthcare services for prison leavers, how this is affected by the differences in delivery across different RECONNECT sites and what barriers are affecting the programme’s ability to support access to services. RECONNECT services are delivered differently across the different NHS regions; for example, some services work within prisons while others work in the community. However, all services follow the national minimum specification for RECONNECT.
We want to see representation across England in the evaluation, ensuring each NHS region and the different delivery models are included.
We welcome a process evaluation to understand how variations across different RECONNECT services affect the outcomes of the service, i.e. engagement with community based healthcare services. In addition, we want to understand prison leavers’ experiences with the service and the barriers they face in engaging with community healthcare services.
The specific research questions we would like answered are:
- What delivery approaches are most effective across different RECONNECT services in enabling prison leavers to engage with community-based healthcare services? We would like to understand variation between sites in engagement with services across different RECONNECT sites. Specifically, we want to address these questions:
- Do prison leavers engage better in some sites and if so, why is that?
- For those discharged early, is it because of disengagement or because their needs have already been met?
- For those not attending an appointment within 6 months post-release, is it because there are no appointments in the area or because they are not engaging, or other reasons?
- What are the barriers that prevent people from attending their first appointment after they get released from prison? We would like people with lived experience to be involved in the research.
- Do prison leavers feel that the RECONNECT service has equipped them with any skills or confidence to access healthcare or other wellbeing support in the community?
- Do prison leavers feel that the RECONNECT programme has helped them in other aspects of their lives post-release such as accessing employment or housing?
- Does the RECONNECT programme work just as well for both male and female prison leavers, ethnic minorities and people with other protected characteristics?
Areas out of scope for this programme of work
This research should be focused on the RECONNECT programme in prisons and in the community.
Areas out of scope are the areas that do not have a RECONNECT service.
Some areas have additional projects such as the Prison Leavers Project and Project ADDER (Addiction, Diversion, Disruption, Enforcement and Recovery). These projects also work with prison leavers to support them post-release. We want to ensure that the research is focused only on the RECONNECT service and any effects can be attributed to the RECONNECT service.
Technical requirements / Expertise required
Applicants are asked to consider the timing and nature of deliverables in their proposals. Policymakers will need research evidence to meet key policy decisions and timescales, so resources need to be flexible to meet these needs. The evaluation of the RECONNECT service will be fed into the national rollout – we expect the national rollout to be completed by March 2024.
We are requesting both qualitative and quantitative outputs. Researchers will need to be able to work with both kinds of data.
Outputs
A meeting to discuss policy needs with DHSC officials will be convened as a matter of priority following contracting.
It is important that we learn as we roll out the RECONNECT service and act quickly to ensure that any gaps in the service are plugged so that we are giving those who leave prison the best chance to maintain and safeguard their health upon release from prison.
We would like the RECONNECT evaluation to begin in January 2023 and provide an interim report in October 2023. The proposed evaluation of RECONNECT will be happening at the same time as the roll out of the services. An interim report will allow for amendments to policy and service specifications before the service is rolled out nationally by March 2024.
We would like the data to be presented in a variety of different ways such as slide packs and easy read versions.
Budget and duration
A budget of £450,000 is available for this research over the period of 18-24 months starting no later than January 2023.
The duration of the project should be as short as is consistent with delivering a high quality study.
Costings can include up to 100% full economic costing (FEC) but should exclude output VAT. Applicants are advised that value for money is one of the key criteria that peer reviewers and commissioning panel members will assess applications against.
Management arrangements
A research advisory group including policy colleagues and analytical colleagues from NHS England and NHS Improvement, representatives of DHSC, and the successful applicants for the research should be established. The advisory group will provide guidance, meeting regularly over the lifetime of the research. The successful applicants should be prepared to review research objectives with the advisory group, and to share emerging findings on an ongoing basis. They will be expected to:
- Work with NHSE/I analysts to gain access to existing datasets relevant to the RECONNECT programme
- Provide regular feedback on progress
- Produce timely reports to the advisory group
- Produce a final report for sign off
Research contractors will be expected to work with nominated officials in DHSC, its partners and the NIHR. Key documents including, for example, research protocols, research instruments, reports and publications must be provided to DHSC in draft form allowing sufficient time for review.
NHSE/I would like a workshop to be held with the RECONNECT commissioners to make them aware of the research.
References and key documents
Annex A
| Regions | Areas | Status |
|---|---|---|
| North East and Yorkshire |
Cumbria and the North East | Full coverage |
| West Yorkshire and Harrogate | In development | |
| Humber, Coast and Vale | In development | |
| South Yorkshire and Bassetlaw | In development | |
| North West |
Lancashire and South Cumbria | Full coverage |
| Greater Manchester | Partial coverage | |
| Cheshire and Merseyside | Partial coverage | |
| Midlands | Staffordshire and Stoke on Trent | In development |
| Shropshire and Telford and Wrekin | In development | |
| Derbyshire | Partial coverage | |
| Lincolnshire | Partial coverage | |
| Nottinghamshire | Partial coverage | |
| Leicester, Leicestershire and Rutland | In development | |
| The Black Country | In development | |
| Birmingham and Solihull | In development | |
| Coventry and Warwickshire | In development | |
| Herefordshire and Worcestershire | In development | |
| Northamptonshire | In development | |
| East of England | Cambridgeshire and Peterborough | Full coverage |
| Norfolk and Waveney | Full coverage | |
| Suffolk and North East Essex | Full coverage | |
| Bedfordshire, Luton and Milton Keynes | Full coverage | |
| Hertfordshire and West Essex | In development | |
| Mid and South Essex | In development | |
| London | North West London | In development |
| Central London | In development | |
| East London | In development | |
| South East London | In development | |
| South West London | In development | |
| South East | Kent and Medway | In development |
| Sussex and East Surrey | In development | |
| Frimley Health and Care | Full coverage | |
| Surrey Heartlands | Full coverage | |
| Buckinghamshire, Oxfordshire and Berkshire West | Full coverage | |
| Hampshire and Isle of Wight | In development | |
| South West | Gloucestershire | In development |
| Cornwall and the Isles of Scilly | Full coverage | |
| Devon | Partial coverage | |
| Somerset | Full coverage | |
| Bristol, North Somerset and South Gloucestershire | Full coverage | |
| Bath, Swindon and Wiltshire | Partial coverage | |
| Dorset | In development |