Changing Futures: Transforming services for vulnerable adults

Currently, people experiencing multiple disadvantage are supported through separate public and voluntary services but this system is not working and can often make things worse.

Changing Futures is a £64m three-year programme funded by the government and the National Lottery Community Fund. Our role is to help the 15 local areas to establish new, innovative and co-ordinated ways to support vulnerable adults. We’re supporting services to work together, learn together and move towards a ​‘whole person’ approach where people are treated as individuals, and where accountability and ownership of support is shared across the system.

People experiencing multiple disadvantage are among the most vulnerable in our communities but often face difficulties getting the coordinated support they need from local services.

One of the reasons is that services are commissioned and operated separately and staff do not have access to shared data and people’s case histories.

To get support, people must tell their story to each of the different services they interact with, often in a crisis when they may not be in a position to recount their history in detail. This leads to them missing out key information that staff need in order to direct them to the right support when they need it the most. Having to frequently retell their story can also be retraumatising.

Without the right support, cycles of disadvantage continue and worsen, impacting the individuals, their families and communities and creating higher demand and costs for local frontline services and systems.

We know from our extensive experience that, for big, complex social issues like this which require lasting service and system change, there isn’t one solution that will work everywhere. Each of the 15 areas has established their own partnership bringing together services such as their local voluntary and community sector, the NHS, the police and others.

We are working closely with each area as a learning partner. We provide one-to-one area support leaders to help understand each partnership’s needs and challenges, define and map their goals, review and reflect on progress and learnings and provide tailored guidance on next steps or how to overcome hurdles they may be facing. This could be around big long-term goals such as how services are commissioned, measured and improved or how data can be shared. It could also be around day-to-day activities of making a systems change partnership work such as designing effective workshops that bring together all the stakeholders.

Alongside our partner, Revolving Doors, we’re championing co-production, involving experts – people with lived experience of multiple disadvantage – in designing, delivering and evaluating services as well as governance and decision making. This is vital to really understand what isn’t working and how to change it in a trauma-informed way.

We’re able to apply what we learn in one partnership to help others and offer additional expert skills and resources in our wider team. We help with:

• Deep research
• Building partnerships
• Designing and implementing learning systems
• Problem solving
• Project management
• Developing training
• Developing theories of change
• Analysing and synthesising qualitative and quantitative data
• Implementing data and digital solutions

This is a long-term project and its impact will develop over time but by the end of the three years we expect each area to have:

• Identified very clear goals and theories of change around how they’re going to achieve these goals.
• Set up the infrastructure to help them sustain changes to services and systems for the future.
• Supported a cohort of vulnerable adults in new ways and evaluated the impact on their life situations.

The following blogs dive deeper into some of the things we’ve learned during the project.

What is meaningful data for people experiencing multiple disadvantage?

Leading systems change: Three key lessons

Understanding systemic constraints using communities of practice