Fund beyond the pilot and evidence the benefit that lands right across the system, not just one budget
- June 2026
Adults facing multiple disadvantage are a small population with a system-sized challenge. For local authorities and their partners, a coordinated, trauma-informed response can change lives while reducing the cost that lands right across the system.
What is multiple disadvantage?
Multiple disadvantage describes adults experiencing three or more overlapping issues at once — homelessness, substance use, poor mental health, domestic abuse and contact with the criminal justice system. Their needs don’t fit neat service boundaries, so they cycle through a system built for simplicity and too often fall through the gaps.
Why multiple disadvantage matters: the cost to people and public services
This is a small cohort that draws heavily on crisis services. The case for acting earlier, and together, is both human and financial.
- 4 more likely to attend A&E than the general population
- 8 more likely to need inpatient hospital care
- 28800 public-service cost per person, every year
- 10 of the cohort currently reached by services
Sources: National Framework for Action on Inclusion Health (2023); Darzi review of the NHS (2024); national evaluations of multiple disadvantage.
The Changing Futures programme: a national response
The Changing Futures programme aims to improve outcomes for adults facing multiple disadvantage by promoting greater integration and collaboration across local services and developing strong multi-agency partnerships.
A new phase from April 2026
Some systems already have existing Changing Futures programmes in place since 2021, whilst from April 2026, a new 3-year £55.8 million phase of the programme will target 18 of the most deprived areas of the country, with those areas standing up services and approaches over the coming months.
Six considerations for designing a multiple disadvantage programme
BearingPoint worked alongside a local authority in the South East to develop a sustainable model for multiple disadvantage. Six key learnings emerged from the design of the programme.
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Make the long-term funding case
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Set the evaluation framework first
Agree what good looks like and how it’s measured at the outset, not retrofitted at the end to ensure you are able to evidence benefits
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Design for integration
Overlap with other services is the norm. Plan deliberately for how the model joins up with existing services, not duplicates, and co-design and tailoring to local need is key
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There’s more than one way to meet need
Coordination and relational outreach do different jobs; the strongest models combine both
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Strong LA system leadership is key
A local authority that leads, with system partners aligned, is what we have seen help drive a consistent approach.
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Supporting multiple disadvantage adults is central to neighbourhood health
A small but high-consuming population that must be built into Integrated Neighbourhood Teams from the start
Adults facing multiple disadvantage are few in number but high in need. Designing for them from the start — within Integrated Neighbourhood Teams, with a local authority leading and system partners aligned — is how systems move from crisis response to sustainable support.
How BearingPoint supports local authorities
We worked alongside a local authority in the South East to develop a sustainable model for multiple disadvantage, across three workstreams.
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1
Building a financial model
We modelled the economic opportunity of a system uniting around this cohort. This included the avoided cost, and where the value lands for each partner.
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2
Evaluating impact
We built a unified outcomes framework, looking at housing stability, crisis-service contact, offending and wellbeing, so impact is measured consistently.
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3
The right operating & delivery model
We tested what good looks like. Multi-agency coordination plus relational, trauma-informed outreach, co-design with lived experience, LA-led with VCSE delivery partners.
Talk to us about supporting adults facing multiple disadvantage
We help local authorities and their partners build the financial case, the evaluation framework and the operating model for multiple disadvantage. Contact our UK public sector team to start the conversation.
Contact us
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Alex Goodman Senior ManagerContact me
