Individual level

Activities

Data and evidence collected from local partners on participants with protected characteristics.

Increased evidence and insight on how people with protected characteristics experience multiple disadvantage.

Areas:

• provide flexible person-centred support to people experiencing multiple disadvantage;
• support people to engage with family/community;
• coordinate care;
• build relationships with people experiencing multiple disadvantage.

Provision of harm reduction pre-treatment support whilst participants await treatment.

There is sustainable holistic keyworker support in local systems.

The local eco-system of support can respond to the longer-term needs of people in recovery.

All services needed by people experiencing multiple disadvantage have sufficient capacity to enable timely, trauma-informed treatment.

Services across the system provide flexible, person-centred, asset-based support.

Pathways of support for people who are stabilised

Sustainable peer support in place as part of step-down support.

Participants who are stabilised receive step-down support (continuing casework or mainstream service as appropriate).

Short-term outcomes

Participants are engaged by the programme

People at key transition points (leaving care, prison) are engaged.

Participants with high levels of needs and poor past engagement with services are engaged.

People with protected characteristics experiencing multiple disadvantage are engaged.

Early outcomes of programme support

Improved financial security.

People engage more positively with family and community and move away from negative relationships.

Individuals feel supported, trusted, valued, safe, and in control.

Improved capability and motivation to access services.

Crisis-prevention reduces need for emergency services or treatment.

Individuals can sustain their engagement with the service and treatment they need and want.

Longer-term outcomes

Stabilisation of health and wellbeing reduces need for intensive caseworker support

Improved connectivity to family/community.

better health, including mental health and addiction.

Improved wellbeing.

Increased ownership of recovery.

Individuals have increased trust in public services.

Impact

Sustained improvements

Sustained greater financial stability.

Progress towards social inclusion is sustained.

Sustained improvements in health.

Sustained improvements in wellbeing.

Reduction in use of emergency services, contact with criminal justice, rough sleeping.

Reduced inequalities in outcomes for people with protected characteristics.

Service level

Activities

Programme activity influences service priorities and targets, putting in place agreements and clear escalation routes.

Programme engages services needed to meet the needs of the cohort, including services not working in a trauma-informed way.

The programme works to improve services based on local priorities, including housing, substance misuse, and other health services.

The programme produces evidence about levers/enablers to improve individual service, system outcomes.

Training and awareness raising activity promoting trauma-informed approaches to other services.

Recruitment of specialist keyworkers/staff with low caseloads, the right skills and knowledge, and personal budgets/resources.

Participation in operational level multi-agency forums and/or colocation of services.

Creation of lived experience roles or teams in Changing Futures areas. Connection of existing lived experience and involvement groups to share learning and collaborate.

Government supports areas to join up different programmes, including frontline caseworker and multidisciplinary team activity and multi-agency governance structures.

Existing interventions and conditions supporting increased service capacity.

Short-term outcomes

Changing Futures projects demonstrate different ways of working including reduced staff burnout.

Flexible, responsive additional support for people experiencing multiple disadvantage.

Staff have the appropriate knowledge of, and contacts across the system.

Improved processes for recruiting and supporting people with lived experience to co-design and deliver services.

Wider system staff have the capabilities and motivation for trauma-informed working.

Longer-term outcomes

Improved facilitation of referrals and joint case working across services. Service coordination.

Lived experience co-design and delivery is embedded.

Impact

Wider service system staff have access to support, feel valued, and have reduced burnout across services.

Wider system service conditions (flexibility, autonomy) and capacity enable staff to respond to multiple disadvantage.

Services across the system provide flexible, person-centred, trauma-informed support that is effective in addressing multiple disadvantage.

Services needed by people experiencing multiple disadvantage have sufficient capacity to enable timely, trauma-informed treatment.

System level

Activities

The programme resources strategic roles with the right skills and position to advocate on multiple disadvantage.

Programme staff build relationships with other services and participate in multi-agency meetings.

Strategic multi-agency forums are established (programme or others) and work effectively.

Skilled strategic Changing Futures leadership communicates evidence of what works to existing owners and fora.

Local leadership (e.g. local strategic commissioners) are engaged by the programme.

Lived experience groups and activity (codesign and delivery).

Strategic workforce activity focussed on multiple disadvantage.

Changing Futures areas identify existing data that enables better responses to multiple disadvantage.

Changing Futures influences data owners to increase the availability and awareness of data relating to multiple disadvantage.

Government supports areas to join up different programmes including funded frontline work and governance (multi-agency structures).

Existing interventions and conditions supporting increased service capacity.

Operational and strategic activity supporting service improvement (see Service level theory).

Short-term outcomes

Clear cross-service referral pathways.

Strategic alignment across local strategies (local policies, processes, funding, delivery).

Better use of data at a strategic level, enabling a better response to multiple disadvantage.

Increased understanding of the impact of multiple disadvantage on demand and the effects of the Changing Futures programme on this.

Wider system staff have the capabilities and motivation for trauma-informed working.

Longer-term outcomes

Early identification of people at risk.

Co-commissioning, pooled budgets and KPIs joined across services.

Lived experience involvement embedded and guiding commissioning.

New services or service specifications

Outcomes driven commissioning to appropriately reflect the needs of the cohort.

Commissioners buy services that work flexibly around individuals rather than within service or activity boundaries.

Impact

The structures, knowledge, skills and expertise needed to meet the needs of the cohort are recognised and strived for.

Wider system staff have access to support, feel valued, and have reduced burnout across services.

Wider system service conditions (flexibility, autonomy) and capacity to enable staff to respond to multiple disadvantage.

Services needed by people experiencing multiple disadvantage have sufficient capacity to enable timely, trauma-informed treatment.

Joined-up system aligned to respond to and prevent multiple disadvantage.

Services across the system provide flexible, person-centred, trauma-informed support that is effective in addressing multiple disadvantage.