What is Systems Change?

What Is Systems Change?

Systems are formed of the people, organisations, policies, processes, cultures, beliefs and environment that surround us all. The systems that surround people with multiple needs are particularly complex and have often failed to provide individuals with the support they need.

The Fulfilling Lives programme sees a successful system change as a change to any of the elements above that is beneficial to people with multiple needs, sustainable in the long-term (is resilient to future shifts in the environment) and is transformational.

Changes which are tokenistic, doing the same thing under a different name, or which are overly reliant on key individuals are not system changes. The implementation of good practice or flexing the system (making a one-off exception for example) are not system changes in their own right, but may be a good step towards longer-term systemic change.

Systems Change in Fulfilling lives is broken up into 6 Themes (T) and 2 Mechanisms (M), see tabs for an explanation.

Systems Change Team

Systems Change Team

The Systems Change Team coordinates a series of systems change projects alongside partners, those with lived experience of multiple and complex needs, Fulfilling Lives’ volunteers and staff across the six agreed thematic areas.

T1: Inequalities in healthcare 

T2: Domestic Abuse Pathways

T3: Criminal Justice System - Repeat Offending 

T4: Treatment Pathways for Co-existing Conditions

T5: Temporary accommodation

T6: Repeat Removals of children into the care system

We take a ‘stepping stones’ approach to our work, building on projects and growing them over time, and believe how we go about systems change is just as important as the outcomes we achieve. For us, systems change is about making bold decisions to deliver lasting changes in the systems that underpin how services operate.

Our systems change projects are co-produced with people with lived experience of multiple and complex needs. We also work from a strong evidence base, using learning gained both from within the Fulfilling Lives project and external sources.

We feel closely aligned to how Forum for the Future – a leading international sustainability consultancy - view systems change:

 ‘We believe that creating the change we want to see in the world will require a growing number of people to think and act more systemically. So we see system change as both an outcome and a process.

Our Theory of systems change infographic

Systems Change Diagram

M1: Co-Production

M1: Co-Production

Fundamental to the project’s ethos, and a core project principle from the outset, is a belief that the involvement of people with lived experience of complex needs is an essential part of the solution.

The project is actively modelling a variety of ways of involving experts by experience and incorporating their knowledge, assets and skills into all project activities.

All of our systems change projects are co-produced with members of the Service User Engagement Team, comprised of staff and volunteers with lived experience of multiple and complex needs.  Co-production is integral to the planning and delivery of projects, and we believe that this is an approach that other systems and services should aspire to.

M2: Trauma-Informed Practice

M2: Trauma-Informed Practice

Through our casework we have evidenced a strong link between the experience of complex trauma and the manifestation of complex needs and behaviours that many mainstream services are unable to support. Consequently, clients are perceived as disruptive or too high risk to access or remain in accommodation or services and are excluded from the support they need.

We also have case examples of great practice and flexibility, sometimes because the service culture and processes have built in the ability and support for staff to be flexible, and sometimes because individual workers are prepared to ‘go the extra mile’ to find a creative, workable solution.

However, there are stark inconsistencies in practice, and it is evident that some services and teams are significantly more advanced than others in working in a trauma informed way.

We have identified that working in a trauma and psychologically informed way is key to supporting engagement and improving outcomes for those with the most complex presentations.

The key goal of trauma-informed practice is to raise awareness among staff and services about the wide impact of trauma, to prevent re-traumatisation of clients in service settings that are meant to provide support, and to develop policies and practices that assist healing from trauma.

Through offering training and support, incorporating knowledge and insight from those with lived experience and creating opportunities for shared learning and practice development, staff across services will develop a greater understanding of the psychological and emotional issues that sit behind presenting behaviours and will be able to offer a more understanding, empathic and flexible service.