Exploring voluntary sector specialist services for victim-survivors of sexual violence in England: the PROSPER co-production study.

Background: There is increasing recognition in England that voluntary sector specialist sexual violence services are essential in providing crisis and longer-term support to victim-survivors. However, there is limited empirical evidence about the scope, range and effectiveness of voluntary sector specialist provision and commissioning, or what victim-survivors want from services.

Objectives: Explore victim-survivors' experiences of accessing and using voluntary sector specialist services. Analyse the range, scope and funding of voluntary sector specialist services and how demand is managed. Explore the usefulness of different approaches to service delivery and different therapy models. Explore how different principles underlying service provision influence service delivery. Investigate referral patterns and pathways, and how voluntary sector specialist services fit with each other and link to the wider network of services for victim-survivors. Explore how arrangements for commissioning and funding services for victim-survivors across health, local authorities and criminal justice have evolved. Develop a taxonomy of the voluntary sector specialist services/service models being commissioned and provided. Make recommendations for the commissioning and provision of voluntary sector specialist services at practice and policy levels.

Data sources: Interviews with key stakeholders, focus groups with victim-survivors; a national survey of key stakeholders.

Methods: This multimethod study comprised five sequential work packages: work package 1: exploratory interviews with commissioners and providers and focus groups with victim-survivors; work package 2: national survey of service providers and commissioners; work package 3: in-depth case studies in four areas of England; work package 4: co-research with victim-survivors; work package 5: data integration. Co-production was built into the study from its inception through robust patient and public involvement and engagement activities. These included a co-applicant who is a survivor of sexual violence, plus the appointment of five expert-by-experience co-researchers.

Results: We captured the combined findings conceptually and diagrammatically into a new model comprising six themes: the complex and precarious funding landscape; the challenge of competition for funding and contracts; the importance and success of partnership working with organisations; the pressured environments within which voluntary sector specialist services work; different roles, scope and eligibility of voluntary and statutory services within an area; and the ways services are organised and delivered, underpinned by services' values and philosophies.

Limitations: The COVID-19 pandemic meant that we were unable to use the proposed methods of data collection for the qualitative components. Mitigation was through developing online modes of data collection. Recruitment to the case study phase did not reach intended thresholds, but rich insights were drawn from earlier phases of the study.

Conclusions: The PROSPER study has provided hitherto missing evidence regarding the funding and commissioning of sexual violence services in England. The findings are likely to be useful in informing future commissioning of such services. The PROSPER study has also presented some unexpected opportunities for learning, particularly regarding co-research in the field of sexual violence. We also claim a contribution to theory development through the expansion of a current theoretical framework that may be of use to others working in the specialist voluntary sector.

Future work: The model will require development and testing to assess its usefulness as a resource for training and education or as an aid to communications in any interactions that are concerned with the delivery, funding and commissioning of voluntary sector specialist services.

Study registration: This study is registered as Research Registry researchregistry5144.

Funding: This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: 18/02/27) and is published in full in Health and Social Care Delivery Research; Vol. 13, No. 10. See the NIHR Funding and Awards website for further award information.