Research and analysis

Changing Futures infographics: text version

Updated 11 December 2025

Applies to England

The content from 4 infographics presenting insights from the Changing Futures programme evaluation are presented. The 4 infographics include:

Content from the infographic ‘Understanding multiple disadvantage’

There are an estimated 363,000 people affected by multiple disadvantage in England. The Changing Futures programme aims to test innovative approaches to improving outcomes for this group. This infographic provides information about the characteristics, needs and experiences of over 3,000 people who have received support from the programme.

The infographic draws on questionnaires completed up to February 2024. Questionnaires are completed, on average, two and a half months after participants begin to get support from the programme. Bases for the statistics differ depending on how many people answered a particular question.

Disadvantage is interconnected and mutually reinforcing

The Changing Futures programme targets those for whom current systems of support are not working. The following percentages outline the proportion of Changing Futures participants who had experienced different forms of disadvantage prior to joining the programme:

• 95% homelessness
• 99% mental health issues
• 95% drug/alcohol problems
• 88% contact with the criminal justice system
• 70% domestic abuse - this differs significantly by gender: 93% of women participants have ever experienced domestic abuse compared to 46% of men

83% experienced 4 or more of these disadvantages. It highlights the overlap of disadvantage, making the case for more joined-up support.

People experiencing multiple disadvantage are vulnerable to abuse and exploitation

Of the 88% of Changing Futures participants with experience of the criminal justice system, almost half (49%) had experience of offending and been a recent victim of crime. This highlights the importance of seeing the full range of people’s experiences and understanding how offending and victimisation are linked. 33% had contact with the criminal justice system due to offending only. 18% had been a recent victim of crime only.

Many participants are extremely vulnerable. In the three months around when they joined the Changing Futures programme:

• 43% had been a recent victim of violent crime
• 35% had been a recent victim of other crime e.g. theft
• 32% had probably or definitely experienced recent abuse or exploitation

Drug and/or alcohol problems are often linked to mental health issues

Most (94%) of Changing Futures participants with experience of drug and/or alcohol problems had also experienced mental health issues. 5% participants had experience of mental health issues only. 1% of participants had experience of drug/alcohol problems only. This underlines the importance of services addressing these problems together.

Disability and physical ill health are common

There is also substantial need for health and social care support. On joining Changing Futures:

• 86% were disabled
• 30% had a form of neurodiversity or cognitive disability
• 23% were experiencing severe or very severe physical health problems

People are not getting timely treatment and support and are therefore accessing help in crisis

High thresholds for some specialist services, long waiting lists, and people being excluded due to behaviour can drive up use of emergency services. In the three months around when participants joined Changing Futures:

• 29% had called an ambulance
• 37% had gone to A&E

Targeted approaches are needed to reach under-represented groups

Overall, women appear to be under-represented among Changing Futures participants. 64% of participants are male and 36% are female.

Women’s experience of multiple disadvantage can mean they are less visible to services. Outreach work is therefore particularly important. Women are more likely to experience domestic abuse. Support needs to be flexible so they can meet workers without abuse perpetrators finding out. Single sex spaces and accommodation where women feel safe are important but can be lacking.

Changing Futures staff and stakeholders agree that more could be done to reach ethnic minorities. 11% of Changing Futures participants are from ethnic minority backgrounds.

Collaboration with trusted community and faith groups can help raise awareness and reach under-represented groups. Dedicated specialist workers have also been successful in reaching target groups. Diverse support teams, including people with lived experience of multiple disadvantage, can help to build trust.

People want services that are easy to access, flexible and understand their needs

People experiencing multiple disadvantage often say they feel stigmatised by services as well as the public. Disconnected services make it hard for people to find and get the help they want. Rigid policies and procedures mean support is not tailored to people’s needs. People need time to re-build trust in services and want a say in the help they get. Quotes from the evaluation research are below:

They weren’t listening

It takes a lot of time to build up a relationship; it’s hard to do this in a 10-minute appointment

They would just pass us pillar to post

The Changing Futures programme demonstrates a more joined-up, ‘whole person’ approach to support. Quotes from the evaluation research are below:

Every interaction I’ve had with the Changing Futures staff, I’ve felt at ease

What Changing Futures has done is connect all the services together for me

You can read more about the evaluation findings, including what participants think.

Content from the infographic ‘Achievements of the Changing Futures programme’

The Changing Futures programme is a £92 million initiative between Government and The National Lottery Community Fund. It seeks to test innovative approaches to improving outcomes for people experiencing multiple disadvantage, including homelessness, drug and/or alcohol problems, mental health problems, domestic abuse and contact with the criminal justice system. Up to September 2024 the programme had provided direct support to almost 5,000 people.

This infographic summarises the achievements of the Changing Futures programme at the individual, service and system levels. It draws on information provided by people who had received support from the programme and views from programme staff and stakeholders in areas that received funding. Bases for statistics differ depending on how many people provided data on a particular topic. Change over time for participants is based on surveys completed shortly after they joined the programme and then again after approximately 12 months’ of support. As participants joined the programme on a rolling basis, these 12 months are not the same 12 months for all participants and span the period from September 2021 to September 2024.

Positive outcomes for people experiencing multiple disadvantage

There were statistically significant improvements in key outcomes for people receiving support from the programme, which are outlined below.

Reduction in homelessness and rough sleeping:

• Recent experience of homelessness reduced from 62% to 49%
• Recent experience of rough sleeping reduced from 30% to 16%

Improved heath:

• 29% reported improved physical health
• 37% reported an increased ability to manage mental health problems
• 37% reported an increased ability to cope with their problems without misusing drugs or alcohol

There were significant reductions in average attendance at accident and emergency (A&E) and ambulance call outs. Reduction in use of emergency services:

• Participants reporting any recent attendances at A&E reduced from 45% to 29%
• Participants reporting any recent ambulance call outs reduced from 37% to 22%

Reductions in victimisation:

• Participants who were recent victims of violent crime reduced from 46% to 30%
• Participants who were recent victims of other types of crime reduced from 40% to 23%
• Participants with recent experience of domestic abuse reduced from 24% to 17%

Interviews with programme participants, staff and stakeholders indicate that Changing Futures caseworker support is instrumental in supporting participants to get the help they need. This includes linking people to services, advocacy and providing practical and emotional support. See the Caseworker infographic in this series for more information on their role.

For some people, the support provided by Changing Futures has been life-changing. 

I owe [Changing Futures] my life… I was very, very ill. Without this support, I could’ve been gone. I’m nearly 13 months now, with no drink, no drugs. My life is just so different from how it was 18 months ago. I’ve always been an addict, I’ve always had drink, it has always been part of my life. But now, to go over a year without it, day-by-by, I love it.

Improving local services

Changing Futures has provided a wide range of workforce development activities to increase awareness of multiple disadvantage and trauma-informed practice. People taking part in the evaluation said this had helped to reduce the stigma surrounding multiple disadvantage among professionals.

84% of Changing Futures stakeholders responding to a survey agreed the programme had improved trauma-informed practice locally.

The evaluation evidence indicates the following are effective ways to support people experiencing multiple disadvantage:

• teams of caseworkers with small caseloads
• employment of staff with lived experience of multiple disadvantage
• flexible, personalised support built on trusting relationships
• multi-disciplinary teams and forums
• Changing Futures team members embedded or co-located with other services

These approaches have also helped to:

• join-up services so people can get holistic support
• facilitate information sharing so services are more co-ordinated
• share risk between services so they are more willing to help people
• develop understanding and positive relationships between service staff

78% of Changing Futures stakeholders responding to a survey agreed the programme had improved access to services for people experiencing multiple disadvantage.

Trauma-informed practice is an approach to health and care that is grounded in understanding that exposure to trauma can affect an individual’s neurological, biological, psychological and social development.

Changing the system

The Changing Futures programme was about more than providing support to people experiencing multiple disadvantage. It aimed to change the way the wider system of public services works to make it easier for people to get the help they need. The evidence indicates the programme overall has made progress towards some short- to medium-term systems change goals. But more work is needed to extend change beyond the programme partners and to transform the way services are commissioned.

79% of Changing Futures stakeholders responding to a survey agreed the programme had improved strategic alignment and collaboration between organisations to benefit people experiencing multiple disadvantage.

The evaluation evidence indicates that in Changing Futures areas there is now:

• greater commitment to addressing multiple disadvantage
• improved relationships and dialogue between stakeholders
• better use of data and research to assess and understand local needs and how to meet them
• more involvement of people with lived experience in service-design and decision-making

Changing Futures has contributed to these changes by:

• funding strategic leadership roles that have advocated for change
• helping to convene strategic boards and multi-agency forums that have brought people together
• supporting people with lived experience and creating opportunities for them to contribute to improving services
• demonstrating how the approaches used by the programme can help different services achieve their aims

This infographic has highlighted the key achievements of the Changing Futures programme. To find out more, read the full evaluation reports at

Content from the infographic ‘The role of caseworkers’

This infographic describes the role of caseworkers within the Changing Futures programme. It summarises the challenges workers face, the trade-offs and choices they make when supporting people experiencing multiple disadvantage, and their contribution to systems change. Caseworker support is central to Changing Futures. Evaluation evidence demonstrates the crucial role caseworkers play in supporting participants towards healthier, safer, more stable and fulfilled lives.

The Changing Futures programme is a £92 million initiative between Government and The National Lottery Community Fund. It seeks to test innovative approaches to improving outcomes for people experiencing multiple disadvantage, including homelessness, substance misuse, mental ill health, domestic abuse and contact with the criminal justice system.

Caseworkers provide person-centred, trauma-informed support

The Changing Futures caseworker role is highly autonomous and flexible and characterised by smaller caseloads (7 to 12 people) compared to other services. This enables them to build trust and confidence in the service and lead the provision of flexible, person-centred support.

Key responsibilities include locating and engaging participants. Caseworkers spend significant time identifying and engaging participants who may be disconnected from services. Building and maintaining trusting relationships is key. Another responsibility includes coordinating support. They ensure that support is well coordinated across services, often acting as a single point of contact. Providing direct support is another responsibility. This includes practical and emotional support, often tailored to individual needs and circumstances. Caseworkers also are responsible for liaising and advocating. Caseworkers advocate on behalf of participants with other services, ensuring their needs are met despite systemic barriers.

Caseworkers face challenges

Inflexible service practices: Services often have rigid practices that do not align with participant needs, such as local connection rules for housing.

Access to services: There are significant barriers to accessing mental health services and other support due to high thresholds and long wait times.

Management of responsibility and risk: Caseworkers perceived that some services deflect responsibilities onto them and are unwilling to work with people they deem to be high risk.

Staff retention and turnover: High turnover rates among caseworkers, driven by low pay and burnout, disrupt the continuity of support.

Data sharing issues: Limited data sharing agreements hinder efficient coordination and support.

What helps caseworkers

What helps caseworkers includes:

• small caseloads
• high autonomy
• clinical supervision
• reflective practice
• personal experience of related fields
• lived experience of multiple disadvantage
• flexible risk management
• supportive environment

The following is a quote from a Changing Futures caseworker: “Our caseload is small compared, for example, to leaving care workers who have higher caseloads and can’t offer such intensive support. We can do assertive outreach.”

Caseworkers and systems change

Caseworkers play a significant role in influencing systems level change by fostering new relationships and working practices. Examples include:

• new service pathways - establishing clearer pathways for accessing services, such as housing support
• problem-solving groups - engaging in multi-agency groups to address systemic barriers and improve service coordination
• advocating for policy changes - highlighting the need for more flexible and inclusive service criteria to better meet participant needs

Sustaining and growing the caseworker model

To sustain and expand the caseworker model beyond the Changing Futures programme, evidence from the evaluation suggests:

• embedding caseworkers in services - placing caseworkers within various services (e.g., A&E, mental health teams) to improve access and support
• maintaining flexibility - ensuring that caseworker roles remain flexible and responsive to participant needs
• enhancing support and supervision - providing ongoing management and clinical supervision to support caseworkers in their emotionally demanding roles

Content from the infographic ‘Housing, homelessness and multiple disadvantage’

The Changing Futures programme is a £92 million initiative between Government and The National Lottery Community Fund. It seeks to test innovative approaches to improving outcomes for people experiencing multiple disadvantage, including homelessness, drug and/or alcohol problems, mental health problems, domestic abuse and contact with the criminal justice system. There are an estimated 363,000 people affected by multiple disadvantage in England. This infographic summarises the role homelessness plays in the experience of multiple disadvantage. It draws on information provided by over 3,000 people who had received support from the programme up to September 2024. Bases for statistics differ depending on how many people provided data on a particular topic.

When people first join the Changing Futures programme, they have a wide variety of housing situations and the majority are homeless.

The proportion of people homeless includes:

• temporarily at a friend’s or family’s house, 19%
• refuge, 1%
• rough Sleeping, 14%
• other temporary accommodation, 8%
• short term hostel, 8%
• emergency accommodation, 6%

The proportion renting includes:

• social rented housing, 23%
• privately rented housing, 8%

The proportion of people in longer term supported housing is 6%.

The proportion in a house owned themselves, or a close family or partner is 3%.

The proportion in other housing situations is 4%, and 1% in hospital.

Homelessness and multiple disadvantage are highly interconnected

Homelessness can be both a cause and consequence of other forms of disadvantage.

Of Changing Futures participants, 89% had experienced homelessness at some point in their life. 65% of those with experience of homelessness first experienced this before the age of 26. Homelessness can encompass rough sleeping, staying temporarily with friends or family (‘sofa surfing’) and staying in a short-term hostel, emergency accommodation, refuge or other temporary accommodation.

Of Changing Futures participants, 73% had experienced rough sleeping at some point in their life. 62% of those with experience of rough sleeping first experienced this before the age of 26.

Even among those who are not homeless when they first join Changing Futures, over a third are not confident about the stability of their housing situation. 35% of people who are not homeless when they join Changing Futures are not confident they will still be in stable accommodation in six-months’ time.

Addressing homelessness and securing stable accommodation is an important part of addressing multiple disadvantage

Among Changing Futures participants who shared personal goals, the most commonly mentioned theme was accommodation. Goals included remaining in their accommodation, moving to safer, more appropriate or independent accommodation, or just having a home of their own.

The following are three quotes from Changing Futures participants:

To get a roof over my head and get a good night’s sleep

To avoid eviction, to sort out council tax arrears

Moving into independent accommodation away from problem areas

But when they first join the Changing Futures programme, the majority of those who are homeless are not confident about moving into more stable accommodation in the near future. 73% of people who are homeless when they first join Changing Futures are not confident they will be in stable accommodation in six months’ time.

A lack of suitable accommodation can affect people’s ability to engage in other support services. Addressing housing issues often comes early in the journey of support with Changing Futures. Stable accommodation provides the foundations for people to work on other areas of their life.

The following is a quote from a Changing Futures participant: “I’ve got a flat. I’ve done it up lovely. My son comes up and has his tea every other night. It will be a nice Christmas this year, because last Christmas I was on the streets.”

Gender-specific approaches are needed

There are significant differences in the proportion of men and women who had recently experienced homelessness and rough-sleeping when they first joined the Changing Futures programme. 71% of men had recently experienced homelessness. 57% of women had recently experienced homelessness. 42% of men had recently experienced rough sleeping. 24% of women had recently experienced rough sleeping.

Women experiencing homelessness are more likely to be missed by services. Women-only accommodation and spaces where women feel comfortable are particularly important but are not always available. The Changing Futures evaluation fourth interim report explores supporting women experiencing multiple disadvantage in more detail.

Support like Changing Futures helps. But the transition from homeless to housed is rarely straightforward

The Housing, homelessness and multiple disadvantage infographic includes a diagram which illustrates the flow of Changing Futures participants between different accommodation types between their (approximately) first 3, 6, 9 and 12 months on the programme. It represents where Changing Futures participants were staying most of the time in the previous month at baseline and first follow-up, second follow-up, and third follow-up.

For most of the time in the previous month at baseline, 10% of participants were rough sleeping, 40% were another form of homeless, 5% were in supported housing, 39% were in rented or owned accommodation, and 5% were in another accommodation situation. For most of the time in the previous month at third follow-up, 5% of participants were rough sleeping, 31% were another form of homeless, 12% were in supported housing, 43% were in rented or owned accommodation, and 9% were in another accommodation situation.

The overall proportion of people sleeping rough reduces with many moving into other homeless accommodation, such as hostels and emergency housing. Other forms of homelessness also reduce as people move into supported and rented accommodation. Some people move from more stable forms of accommodation back into homelessness. Of the ‘Renting or owned’ category in the diagram, the majority of people are in social housing (renting from the council or housing association). Less than 3% are in housing owned by themselves or a close family member when they first join the programme.

Refer to the infographic ‘Achievements of the Changing Futures programme’ for further information on changes in homelessness and rough-sleeping over time.

People experiencing multiple disadvantage face particular barriers to finding housing

77% of Changing Futures participants had asked their council for help because they were homeless or at risk of being homeless in the year prior to joining the programme. 18% of these had been helped to find settled accommodation. 55% had been helped to find temporary homeless accommodation. 12% said no help had been provided.

Limited housing stock and high demand can result in inflexible eligibility criteria, such as needing to have high levels of social care and/or mental health needs to be considered for supported housing. A conviction for arson, even if it was many decades ago, is often a barrier to getting accommodation. Where housing is offered, it may not be suitable – such as being a long way from support services or mixed gender.

Disabled people getting support from Changing Futures are less likely to experience improvements in homelessness and rough sleeping than those who are not disabled. People interviewed as part of the Changing Futures evaluation highlighted that the needs of disabled people are not always catered for and there is often limited accessible accommodation.

Changing Futures areas have helped overcome some of these barriers, for example, by organising multi-agency responses with housing providers and other services to provide support and share any risks. Although it varies between Changing Futures areas, several have highlighted statutory housing/homeless services as harder to engage in partnership working.