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General overview

Stage of development: Implementation

Policy sector: Health

Date outcomes contract signed: Aug 2018

Start date of service provision: Nov 2018

Anticipated completion date: Sep 2024

Capital raised (minimum): GBP 407k (USD 543.01k)

Max potential outcome payment: GBP 2.23m

Service users: 705 individuals


The intervention includes very regular key worker outreach, home visits, drop in sessions and at community services, crisis management to address immediate problems (e.g. lack of accommodation), SMART goal planning alongside motivational interviewing and other therapeutic techniques to address substance misuse, reduce chaotic behaviour, improve coping skills and facilitate stabilisation.

Target population

The target cohort is Cornwall residents aged 18+ with a substance misuse issue who have had eight A&E attendances/two hospital admissions in a year.



  • United Kingdom

Service delivery locations

  • Cornwall County Council

Involved organisations

Configuration of contracting parties:

  • Direct contract between outcome payer and provider

Commissioners/outcome payers

Service Providers


Intermediary organisations

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Outcome metrics

  • Outcomes for this project are: a) To decrease the chaotic and avaoidable use of A&E by drug and alcohol 'frequent attenders' and b) To increase their ability to engage with support services in an effective way. Payment triggers include: 1) Sustained engagement (achieved after 12 weeks)
  • 2) 60% reduction in A&E attendance (achieved after 6, 9 and 12 months)
  • 3) Sustained reduction of use of A&E services (achieved after 18 months)
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