Conclusion VOICES has had a substantial impact on the system of support for people in Stoke-on-Trent who are experiencing multiple disadvantage. During the eight years of VOICES, there has been progress against all three priority areas for systems change, which should now be built on through the Changing Futures funding (2-3 years funding to deliver improvements for adults experiencing multiple disadvantage at the individual, service, and system level). Learning from VOICES has shaped the Changing Futures approach; successful components are included e.g. Case coordination Multi-Agency Resolution Group (MARG) CRM Welfare Benefits Leading and Learning (WBLL) Centre of Excellence (Citywide Learning Programme) Where VOICES was unable to effect change the learning from VOICES commitment to research and evaluation has informed alternative approaches.
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Introduction
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Multiple disadvantage
This report presents a summative evaluation of the VOICES programme, which was the Stokeon-Trent implementation of the national Fulfilling Lives: supporting people experiencing multiple disadvantage. Fulfilling Lives was established by the National Lottery Community Fund (formerly Big Lottery), investing £112 million across 12 areas of England that had high concentrations of people experiencing multiple disadvantage. The aim was that each area develop partnerships with local people with lived experiences, service providers and commissioners, to design, test and implement different approaches to improving the lives of people experiencing multiple disadvantage. Despite variation in terms used to describe those who would be target beneficiaries of the programme, including multiple needs and complex needs, we will use the term ‘multiple disadvantage’, which has been defined as: “
Experience of two or more of homelessness, offending, substance misuse and mental ill health” [1,pg 5]
Common to the concept of severe and multiple disadvantage (SMD) offered by Lankelly Chase, we use this to refer to those at the ‘extreme margins of social disadvantage’ [2, p11] who tend to have much worse health and quality of life compared to many other low income and vulnerable people, and can create a substantial cost for the rest of society, particularly with respect to disproportionate use of certain public services (e.g., emergency health care, criminal justice system). Fulfilling Lives aimed to improve the lives of this group by: Providing learning which can be used to create system change Addressing the combination of factors that can affect the person, in a way that is simple and straightforward for individuals to navigate, with a single access point Assuming that people can improve their own circumstances and life chances with the right support Engaging people with lived experience of multiple disadvantage in the design and delivery of services.
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