An exploration of the costs of family and group conferencing pathways in adult social care and mental health: A scenario-based cost analysis

Context: Family and Group Conferencing (FGC) is a strengths-based approach to social work, originating from New Zealand and now used internationally. Previous research on FGC has focused largely on the context of children’s services but, FGC also aligns with the principle of the Care Act in England to prevent, reduce or delay the need for long-term (and potentially costly) adult care services. Limited previous research has tended to explore potential cost savings associated with FGC, without accounting for the cost of the intervention itself, risking biased results. Objective: This paper aims to identify resource use and associated monetary costs associated with FGC services in English adult social care and mental health settings. Methods: Framework development was informed by previously published work establishing programme theory for FGC, extended by expert opinion and published sources of monetary costs. The framework used scenario-based analysis and a bottom-up costing approach, with sensitivity analysis. Results: Estimated costs of conducting a standard full FGC (excluding referral) range from £1,455 to £2,043 (adjusted from 2022–2023–2025 prices) from a local authority and National Health Service (NHS) perspective. Costs can vary depending on the involvement of an advocate or interpreter, network size and the complexity of issues being addressed. We report overall costs with and without resource use specifically related to referral. Discussion: Higher staff costs account for slightly higher intervention costs in an NHS mental health setting, compared to adult social care settings. Conclusion: Reallocating scarce public resources with the intention of preventing, reducing or delaying use of costly future care must be evidence-based as pressures build to meet acute needs. Accurate per-case costing of FGC is a necessary preliminary step towards exploring the cost-effectiveness of FGC. A full economic evaluation will account for costs, outcomes, and alternative options (uses of limited resources).