Overview
The Royal Devon University Healthcare NHS Foundation Trust (RDUH), in partnership with the Probation Service, is leading a six-month NHS England-funded Health & Justice pilot in Ilfracombe to improve health outcomes for people on probation—a group facing significant health inequalities and systemic barriers to care. Running from October 2025 to March 2026, the £40,000 pilot will embed probation delivery within a Neighbourhood Health model, using a “Team Around the Person” approach to provide holistic needs assessments, structured health checks, and multi-agency care planning. The project aims to generate new evidence on healthcare needs and utilisation, test integrated models of care, and develop a scalable blueprint for health–justice collaboration. Evaluation will combine quantitative and qualitative methods to assess feasibility, impact, and system learning, informing future Neighbourhood Health MDT design and national policy on inclusion health.
Read about how the media have picked up on this scheme – HERE
People under supervision of the probation service experience health inequalities linked to complex and inter-related socio-economic disadvantage…
People in contact with the criminal justice system (CJS) are recognised as a priority inclusion health group under the Core20PLUS5 framework….
This pilot aims to create a new partnership between the NHS and the Probation Service to fill national and local knowledge gaps about the healthcare needs….
The pilot comprises seven interconnected elements including Neighbourhood probation delivery – relocating probation meetings to Ilfracombe….
Six-month pilot running from 1st October 2025 – 31st March 2026. Funding of £40,000 has been allocated by NHS England to deliver a six-month pilot….
South West Probation Service, Royal Devon University Healthcare Trust and Operational team are listed as….
The problem we are addressing
Poor health and unmet needs
People under supervision of the probation service experience health inequalities linked to complex and inter-related socio-economic disadvantage. They have significant health and social care needs compared to the general population. Around 50% have a diagnosed mental health condition, and they are more likely to suffer from cardiovascular disease, respiratory illness, and cancer. Despite these complex needs, people on probation (who are serving non-custodial sentences), do not have access to the specialist support services that are available to prisoners and prison-leavers and often fall through gaps in service provision.
Lack of Data Visibility and Integration
People on probation are often invisible to the NHS. Their NHS numbers are not routinely captured, and their probation status (and therefore enhanced risk factors) are not known to public services. There is no shared care planning between agencies, and public services lack the mechanisms to track unmet needs or coordinate responses. This prevents effective population health management and contributes to poor outcomes, including unplanned hospital use and poor continuity of care.
Rising System Pressures
National policies aimed at reducing the use of prison and promoting community sentences are increasing pressure on probation and wider services in the community.
Without joined-up intervention, this will likely result in increased costs across health, housing, and justice systems.
Missed Opportunities at Probation Contact Points
Probation appointments represent a critical touchpoint to engage individuals who are otherwise disconnected from services. Currently, there is no systematic way to use these encounters to assess health and wellbeing, develop coordinated support plans, or enable early intervention. This represents a missed opportunity to improve health and reduce reoffending through timely, holistic support.
Barriers Created by System Complexity
Insights from the Kafka Brigade and Poverty Truth Commission show that fragmented services, rigid processes, poor communication between agencies and lack of local access are key barriers for people trying to access help. These systemic issues reinforce disadvantage and waste public resources. A new model is needed that improves access, reduces wasted contacts, and holds systems to account for addressing identified needs, rather than responding only to crisis escalation.
Problem Summary
National evidence shows that people on probation often come from underprivileged backgrounds shaped by trauma, poverty, and exclusion, and experience some of the poorest health outcomes in the community. Engagement with local partners has highlighted the perception that services too often “set people up to fail” by not ensuring access to basic needs such as housing, healthcare, and income. Needs in this population are frequently invisible in mainstream health planning because NHS numbers are not consistently captured and data is not linked across agencies. Services work hard but operate in silos, leading to duplication, missed opportunities, and gaps in care. Without systematic assessment, shared data, and coordinated responses, individuals are more likely to cycle between crisis and reoffending, while the wider system bears the cost.
The intended beneficiaries
People in contact with the criminal justice system
People in contact with the criminal justice system (CJS) are recognised as a priority inclusion health group under the Core20PLUS5 framework. The population faces multiple, interacting risk factors and in addition, often belong to one or more of the following high-risk groups, multiplying their risk for poor health and chronic disease:
- People living in the most deprived 20% of neighbourhoods
- People with learning disabilities and autistic people
- People experiencing homelessness or rough sleeping
- People with substance dependence
- Sex workers
People on probation
At 240,000, the probation population is approximately three times larger than the prison population (England and Wales as of September 2024). Unlike those in prison, people on probation do not have access to specialist commissioned healthcare and their health needs are often invisible to both the NHS and local authority public health.
Pilot Participants
The pilot will focus on the 49 individuals currently on probation in Ilfracombe (dynamic cohort, likely to change over the 6 months as people enter or leave probation). All will be offered participation at their probation meetings. Consent will be sought for holistic needs assessment, health check, data sharing, and inclusion in evaluation activities
What we want to achieve
This pilot aims to create a new partnership between the NHS and the Probation Service to fill national and local knowledge gaps about the healthcare needs and healthcare utilisation of people on probation. By embedding probation delivery within Ilfracombe and strengthening collaboration across neighbourhood health, justice, and community services, the pilot will generate new insights into this population’s health and service use while also testing interventions designed to improve healthcare access, health outcomes, and rehabilitation. Learning will inform improvements, test Neighbourhood Health ways of working, and provide a scalable blueprint for wider system change.
Objectives
- To generate new evidence on the healthcare needs and healthcare utilisation of people on probation in Ilfracombe, addressing gaps in local and national knowledge.
- To test the feasibility and effectiveness of embedding probation delivery within a Neighbourhood Health model and using a TAP Proof-of-Concept (NH MDT precursors) to design future NH MDTs, strengthening collaboration across neighbourhood health, justice, and community services.
- To evaluate specific interventions – including holistic needs assessments, structured health checks, NHS number capture, multi-sector data linkage, and the Team Around the Person (TAP) model – in improving access to healthcare, health outcomes, and rehabilitation.
- To identify system enablers and barriers to neighbourhood-based collaboration and cross-sector integration, and assess their implications for wider service design and delivery.
- To use the Kafka Brigade approach to surface systemic failure points through lived experience, test collective accountability, and catalyse partner-led system changes that improve outcomes for individuals and reduce future demand on health, justice, and social care systems.
- To produce a scalable Neighbourhood Health & Justice blueprint – capturing adoptable pathways, data-sharing patterns, and workforce practices from the Ilfracombe pilot – to inform local neighbourhood health service development, strengthen health–justice integration, and contribute to rollout.
The Opportunity
This pilot will generate local evidence and learning to complement national understanding of how health and justice partners can better support people on probation. By systematically capturing NHS numbers, linking data across sectors, and introducing holistic needs assessments, structured health checks, and a Team Around the Person (TAP) model, it will provide real-time insights into health and social needs in Ilfracombe. The pilot will also test feasibility and identify enablers and barriers, creating evidence that can improve outcomes locally and provide a scalable blueprint for wider system change.
How we want to achieve it
Key components
Probation + Health: system thinking, NHS number capture and multi-sector data linkage and governance, neighbourhood probation delivery, health checks and holistic needs assessments, TAP/MDT + action planning, shared tracking and feedback (7 interconnected elements described below)
Kafka Brigade (System Learning & Change Mechanism)
A facilitated process using lived experience and system timelines to:
- Expose where system gaps or pressure points affect people with complex needs
- Identify missed prevention opportunities
- Generate partner commitments to concrete system changes
- Track whether those changes are acted on, sustained, and scalable
The pilot comprises seven interconnected elements:
- Neighbourhood probation delivery– relocating probation meetings to Ilfracombe as part of the Neighbourhood Health model to reduce barriers, improve engagement, and strengthen integration with local health and community services.
- Systemic NHS-number capture– ensuring consistent identification of participants across health and justice datasets.
- Multi-sector data linkage and analysis– probation and NHS data linked for care coordination and planning; feasibility of using the Shared Care Record (direct care) and One Devon Dataset (PHM and utilisation mapping) will be tested.
- Holistic needs assessment– structured assessment covering health and criminogenic needs (such as housing, substance use, mental health, and wider determinants which make reoffending more likely) aligned to probation tools (Oasis record system, sentence plans) used to generate multi-agency action plan.
- Structured health check– screening (e.g. blood pressure, BMI, HbA1c, lipids etc), continuity of medication, and vaccination status, with immediate referral as required.
- Multi-agency plan– personalised plan created from the holistic needs assessment:
- Agreed across NHS, probation, and partners.
- Identifies priorities, assigns responsibilities, and sets review points.
- Forms the basis for a TAP Proof-of-Concept (NH MDT precursor) that coordinates actions during the pilot, generates learning to design future Neighbourhood Health MDTs, and can be incorporated once those MDTs are established; progress tracked via the Needs Met Tracker.
- Aligning TAPs with Neighbourhood Health MDT
- Team Around the Person (TAP) Proof of Concept – multi-agency coordination to ensure tailored, joined-up responses for each participant.
Timescales & Funding
The initial six month pilot from 1st October 2025 – 31st March 2026 with funding of £40,000 allocated by NHS England was extended to 30th September 2026 with a further £26,873 from South West Probation Service.
INDICATIVE COST ALLOCATION
The grant allocation is fairly modest but that doesn’t stop NHSE expectations being high. The likely number of people on probation that it is possible to support with £40,000 in 6 months is 50.
To enable partners to both engage in the pilot and create a robust evaluation supporting learning and roll-out we have prioritised the funding to data analysis, personalised care support and funds to overcome access barriers.
It is proposed that RDUH manages the grant funding via the One Northern Devon budget and allocates the resources to the partners/personnel as required.
| Pilot finance breakdown | ||||
|---|---|---|---|---|
| Data analysis & evaluation | Data analyst (RDUH)(B6). To ensure alignment to PHM and risk stratification | 0.2 WTE @£200 per day plus evaluation support (as required) | £9,500 | |
| Health needs analysis | Outreach nurse (RDUH) (B6) Already in post and on a flexi contract which can be uplifted for this pilot | 0.2 WTE initially with ability to increase with need (consumable costs included) | £11,000 | |
| Team around the person (TAP) Co-ordinator | Operations Support Manager (RDHU)(B7) Already in post supporting vaccination team and can do the additional day a week | 0.2 WTE initially with ability to increase with need | £8,000 | |
| Kafka Brigade model – case finding, case development, individual support, event preparation and management | Experienced Kafka Brigade Facilitator | Flat rate | £8,500 | |
| Community venue | Venue for shared health & probation appointments in Ilfracombe | 1 day a week | £1,800 | |
| Inclusion support fund / project contingency | Costs involved in supporting the individual to access services or address needs | £1,200 | ||
| TOTAL (pilot budget) | £40,000 |
| Health Checks & Joint Holistic Needs Assessments | Outreach nurse (RDUH) (B7) Plus consumable costs for health checks | 0.2 WTE from 1st July – 30th Sept 2026 | £5,500 |
|---|---|---|---|
| MDT Co-ordinator | Operations Support Manager (RDHU) (B7) | 0.2 WTE from 1st July – 30th Sept 2026 | £4,000 |
| Extra Capacity for Outreach nurse to attend MDT’s and provide check-in’s/follow-up appointments | Outreach nurse (RDUH) (B7) Additional 1/2 day per week from 1st April – 30th Sept | £2,800 | |
| Venue Hire | Ilfracombe Community Hub | £2,800 | |
| Peer Support Evaluation | Encompass – interviews at the start and end of the intervention and an evaluation report by lived experienced facilitators | £3,773 | |
| Team Around the Person Coordinator | £8,000 | ||
| TOTAL | £26,873 |
| In-kind contributions | ||
|---|---|---|
| Project Lead – RDUH | RDUH Partnerships Team | 0.2 WTE |
| Project Manager – RDUH | RDUH Partnerships Team (within workplan) | 0.2 WTE |
| Project Lead – Probation | Probation Service | 0.2 WTE |
| Project Manager – Probation | Probation Service | 0.8 WTE |
| Public Health | Outreach Health Checks (covering costs for those not eligible) | N/A |
Logic Model
a) If probation is delivered in neighbourhood settings and people receive coordinated health and justice support through holistic assessment, health checks, shared data, and a Team Around the Person approach,
b) then unmet needs will be identified earlier and care will be better coordinated,
c) leading to improved health outcomes, reduced crisis and reoffending, and a scalable model for integrated neighbourhood working
Who has been involved?
Project Team
South West Probation Service
SRO – Louise Arscott – Louise.Arscott@justice.gov.uk
Graeme Murray – Project Manager – graeme.murray@justice.gov.uk
Libby Pickles – Elizabeth.Pickles@justice.gov.uk
Amanda Sheriff -Amanda.Sherriff1@justice.gov.uk
Royal Devon University Healthcare Trust
SRO – Chris Tidman – Deputy CEO – c.tidman@nhs.net
Andrea Beacham – Programme Manager – andrea.beacham@Nhs.net
Simon Rapsey – Project Manager – simon.rapsey1@nhs.net
Amy Slater – Programme Support Officer – amy.slater18@nhs.net
Operational Team
Glenda Jones – Outreach Nurse, RDUH – glenda.jones2@nhs.net
Mandi Tydeman – Team Around the Person Co-ordinator, RDUH – amanda.tydeman@nhs.net
Tim Sawyer – Probation Officer – Timothy.Sawyer@justice.gov.uk
Project Meetings & Workshops
Workshops
Multi-sector stakeholder workshop #1 – 06.06.25
Multi-sector stakeholder workshop #2 – 09.09.25
Multi-sector stakeholder workshop #3 – 16.12.25
Meetings
Health & Justice Pilot Leadership Group Meeting – 13th May 2026
Health & Justice Pilot Leadership Group Meeting – 7th Jan 2026
Health & Justice Pilot Operational Steering Group
- Agenda 07.01.26 (to follow)
- Report