Sensitivity results (LA/NHS perspective).

ContextFamily 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.ObjectiveThis paper aims to identify resource use and associated monetary costs associated with FGC services in English adult social care and mental health settings.MethodsFramework 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.ResultsEstimated 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.DiscussionHigher staff costs account for slightly higher intervention costs in an NHS mental health setting, compared to adult social care settings.ConclusionReallocating 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).研究背景：家庭与团体会议（Family and Group Conferencing，FGC）是一种基于优势视角的社会工作实务模式，发源于新西兰，目前已在全球范围内得到应用。既往针对FGC的研究大多聚焦于儿童服务场景，但FGC同时契合英格兰《护理法》的相关原则，能够预防、减少或推迟长期（且可能成本高昂的）成人护理服务需求。现有相关研究较为有限，且多仅探讨FGC可能带来的成本节约，却未考量干预措施本身的成本，存在研究结果出现偏倚的风险。**研究目的**：本文旨在明确英格兰成人社会护理与精神卫生场景下，FGC服务的资源使用情况及其对应的货币成本。**研究方法**：本研究的分析框架参考了既往已发表的FGC项目理论研究成果，并结合专家意见与公开的货币成本数据源进行拓展；分析框架采用基于场景的分析方法与自下而上的成本核算方式，并辅以敏感性分析。**研究结果**：从地方政府与英国国家医疗服务体系（National Health Service, NHS）的视角出发，标准完整FGC服务（不含转介环节）的预估成本区间为1455英镑至2043英镑（已按2022-2023至2025年的物价水平进行调整）。服务成本会因是否有倡导者或译员参与、服务网络规模以及待解决问题的复杂程度而有所差异。本研究同时报告了包含与不包含转介相关专属资源使用的总成本。**讨论**：相较于成人社会护理场景，英国NHS精神卫生场景下的人员成本更高，导致干预成本略有上升。**结论**：随着满足急症护理需求的压力不断增大，为预防、减少或推迟未来高额护理服务使用而开展的稀缺公共资源再分配工作，必须以实证为依据。精准核算FGC的单例服务成本，是探索FGC成本效益的必要前置步骤。完整的经济学评估需涵盖成本、服务效果以及有限资源的替代使用方案等维度。