System Change

It is estimated that 58,000 people face problems of homelessness, substance misuse and offending in any one year.* Within this group, a majority will have experienced mental health problems.

People experiencing multiple needs:

• Have ineffective contact with services, as in most cases services are designed to deal with one problem at a time and to support people with single, severe conditions.
• Are likely to live in poverty, experience stigma, discrimination, isolation and loneliness.
• Are known to everyone, perceived to be ‘hard to reach’

*Data from Health and Multiple Needs Presentation (YHNE)

The Whole System Approach

Taking a ‘whole system approach’ means recognising that Multiple and Complex Needs is the product of a complex web of interacting and changing causes and influences and as such requires a cross sector response.

• Combines bringing together all the partners that can have a bearing on Multiple and Complex Needs with using “systems thinking” to identify the most important factors and make sense of changing dynamics – passage of time, multiple levels, complex influence.
• For significant improvements to be made, we need to look at not just the individual contributions of each organisations but also how the whole system works together and can be “more than the sum of its parts”.
• Creates a map of moving and interacting drivers and recognises that tackling a single driver in isolation does not work.
• Acknowledges the need for both individual and organisational action – creating open and trusting dialogue as a foundation for this to happen.
• By moving the interventions upstream, it creates the environment for more effective societal change.

Fulfilling Lives System Change Core Priorities

To improve access to mental health services for people experiencing Multiple & Complex Needs (MCN)

• Adult Social Care (ASC): Fulfilling Lives Newcastle Gateshead will establish current case load and access issues and build relationships with both area safeguarding and ASC teams to help people experiencing MCN to better access support
• Delivering Together: We will support Clinical Commissioning Group Newcastle and Gateshead to ensure MCN issues considered in the development of services.
• NTWNHS: We will continue to build relationships with the Central Business Unit to develop a MCN pilot

To ensure people in transition do not fall through gaps in service

• Prison Release Task and Finish group; work through and identify ideas/actions in plan e.g. VCS Coordinator Role, resolving Universal Credit and accommodation issues in prison, diversion from custody for short term sentences and capturing voice of lived experience in prison/post release
• Universal Credit: continue to build an evidence base from our client group to establish gaps and best practice and work with DWP partners to influence national policy

To assist commissioners across the 4 key areas and health to develop commissioning that better meets the needs of people experiencing MCN

• Strategic group to develop a Commissioning Group with support of Programme Manager and Systems Change lead
• Peer research used to inform new commissioning contracts relating to MCN services e.g. treatment access

The Power of Voice

Within the core priorities, capturing the Experts by Experience voice will be central to effecting system change with co-production at the heart of informing the wider system. We hope to achieve the following:

• The EBE Network will be a key part of our strategy going forward and each priority area will be informed by the service user and EBE voice.
• New Co-Production (Female Engagement) Worker will increase voice of women with MCN
• Peer Research training and the establishment of a peer research network across Newcastle and Gateshead

For more information about our System Change activity, contact our System Change Lead, Claude Cetinoglu.