Fulfilling Lives: Supporting People Experiencing Multiple Disadvantage

The Fulfilling Lives programme is a £112 million investment over 8 years supporting people who are experiencing multiple disadvantage. The programme funds local partnerships in 12 areas across England to test new ways of ensuring individuals receive joined up and person centred services which work for them.

Aims & approach

What is Fulfilling Lives doing?

Fulfilling Lives aims to improve the support available for people who experience multiple disadvantage, so that individuals are better able to manage their lives.

Multiple disadvantage is defined in this programme as people who experience two or more of homelessness, a record of current or historical offending, substance misuse, and mental ill health.

By developing effective networks and services, people experiencing multiple disadvantage can be supported to improve their lives, which in turn will result in healthier and more fulfilled individuals, more effective communities and a reduced cost to public services.

Partnerships will work with beneficiaries, service providers and commissioners, and local authorities to design, test and implement different approaches which:

  • Provide learning which can be used to create system change

  • Address 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

  • Assume that people can improve their own circumstances and life chances with the right support

  • Engage people with first-hand experience of multiple disadvantage in the design and delivery of services

  • Provide better co-ordination between those delivering services (both statutory and voluntary sector) and those commissioning services.

People in the lead

To ensure that this programme meets the needs of the people it is designed for, we have established a National Expert Citizens Group to bring together people with first-hand experience of these issues.

These expert citizens will use their knowledge to improve the design and delivery of the services that are available to them, collaborating with local leadership and decision makers across the partnerships to create solutions that work for them.


Evaluation Approach

Evaluation and learning has been integral to the Fulfilling Lives programme. In 2013, we commissioned CFE Research and The University of Sheffield to carry out the national evaluation. The evaluation spanned 9 years and generated useful and insightful evidence about the programme and multiple disadvantage more broadly. Partnership areas also had their own local evaluations. View Fulfilling Lives reports in The Fund’s evidence library.

The national evaluation aimed to:

  • Track and assess the achievements of the programme
  • Calculate the value of benefits to the exchequer and wider society
  • Identify what interventions and approaches work well, for which people and in what circumstances
  • Assess the extent that our principles (e.g. coproduction, partnership working) are incorporated into project design and delivery and the difference they make
  • Explore how projects are delivered, understand problems faced and help identify solutions and lessons learned.

As a long-term test and learn programme, Fulfilling Lives evolved and changed over time and the evaluation adapted in response. Although the aims were maintained, the approach changed in recognition that we were operating in complexity. We moved away from a traditional impact evaluation and explored our system change priorities using qualitative techniques. The evaluation also benefited from a Common Data Framework to understand beneficiary characteristics and track service use, risk, need and other outcomes over time.

CFE Research reflected on some of the learning from delivering such a large and complex evaluation in Evaluating Fulfilling Lives.

Evaluation Findings

The Fulfilling Lives Programme Summative Evaluation report draws on evidence throughout the programme and is a useful resources for anyone who wants to learn more about the programme or multiple disadvantage. The report reflects on the difference the programme made to people and the extent the system has changed and where change is still needed. Some of our key findings are:

Changes for individuals

  • Over 4,000 people were directly supported by the programme
  • Over 1,200 people left the programme for a positive reason (41% who left)
  • Partnerships demonstrated the benefits of a holistic and strengths-based approach. Effective support was trauma-informed, persistent and ongoing.
  • Low caseloads for frontline staff gave the time needed to work in a personalised way. Navigators supported people through what can be a complex and confusing system.
  • Fulfilling Lives has shown that it is possible to engage and support those with the most complex and entrenched needs. There were significant:
    • reductions in time spent homeless and rough sleeping
    • improvements in people’s self-reliance
    • reductions in levels of need and risk
    • Fewer negative interactions with public services, such as arrests and visits to A&E

Changes to systems

  • Attitudes towards multiple disadvantage have shifted, with a greater recognition of the role and impact of trauma.
  • There is a better understanding of the need for involving people with lived experience of multiple disadvantage in the design and delivery of services.
  • New structures exist to enable greater collaboration and coordination across agencies and sectors, and Fulfilling Lives leaves behind a local workforce better equipped to support this group.
  • Multiple disadvantage is also now firmly on the national political agenda: the Changing Futures programme has adopted much of the learning from Fulfilling Lives.
  • However, changing systems takes time. Even after eight years, challenges remain.
    • The programme made less progress in addressing siloed and short-term commissioning.
    • While the role of navigators on the programme has been effective in supporting better outcomes for individuals, there is no reduction in the need for this support as the service user journey remains complex and difficult.
    • Fulfilling Lives staff have advocated on behalf of beneficiaries and supported them into services, but there is only so much they can do if appropriate and accessible services do not exist.
    • More needs to be done to make mental health services in particular more accessible to people experiencing co-occurring substance

Evidence about multiple disadvantage

In 2019, four briefings on multiple disadvantage using the Common Data Framework were published. These provided a unique and valuable addition to the evidence base. Read each briefing here –

Systems change priorities

During the last several years of the evaluation, we focused on generating evidence to support the systems change priorities set by the Systems Change Action Network (SCAN). Each of the 5 main priorities have been explored and reports published:

1. Developing and expanding the role of co-production in creating effective systems change

Coproduction: Principles into practice

2. Embedding a culture of systems thinking and ‘what works’ in creating systems change

Creating systems change: Evaluating the contribution of the Fulfilling Lives programme

The role of lived experience in creating systems change

3. System-wide workforce development, including the importance of trauma-informed and strengths based approaches

Summary: Workforce development and multiple disadvantage

Briefing 1 - Involving people with lived experience in the workforce

Briefing 2 - What Makes an Effective Multiple Disadvantage Navigator?

Briefing 3 - Upskilling the Wider Workforce

Briefing 4 - Working With Commissioners and Policy-Makers

4. Improving access to services – particularly mental health services

Full report - Improving access to mental health support

Summary - Improving access to mental health support

5. Improving service transitions – including hospital discharge and prison release

Improving service transitions for people experiencing multiple disadvantage: Prison release

'More than a roof' - addressing homelessness with people experiencing multiple disadvantage

COVID-19 Response

Challenges and opportunities - Evidence from Fulfilling Lives partnerships on the response to the COVID-19 pandemic - This report draws together the experiences and perspectives of staff, volunteers and Fulfilling Lives programme on the changes they have helped implement or observed in response to the COVID-19 pandemic

There are many more national evaluation and partnership-level evaluation reports available in the Fund’s evidence library.

Our responses to Government


Our programme partners

Between 2014 and 2022, the 12 Fulfilling Lives partnerships designed, tested, and delivered tailored programmes of support which responded to the local context, environment and needs of people experiencing multiple disadvantage.

See all of our programme partners

Each partnership had different system change priorities but worked towards the same three outcomes:

  1. People experiencing multiple disadvantage manage their lives better through access to person centred and co-ordinated services.
  2. Services are tailored and better connected, with service users to fully take part in effective service design and delivery.
  3. Shared learning and the improved measurement of outcomes will demonstrate the impact of service models to key stakeholders and influence future programme design by local services.

We also work with the Making Every Adult Matter coalition to provide specialist support to partners.

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Fulfilling Lives: Changing systems for people facing multiple disadvantage

In Changing systems for people facing multiple disadvantage (PDF 7509KB), each of the 12 Fulfilling Lives partnerships created a local systems change plan with a series of priorities for the remainder of the programme up until 2022.

This document contains 58 systems change priorities from across the partnerships, and when taken together, five common themes emerged which are outlined in the document.

Multiple Disadvantage Day

On 3 July 2019, the Fulfilling Lives partnerships launched the first ever Multiple Disadvantage Day. The aim of the day was to reduce the stigma experienced by some of the most disadvantaged people in society and educate the public on why a person may experience multiple disadvantage.

As part of the awareness day, there was a dedicated website featuring resources and first-hand stories.

Think people (not problems) to address homelessness issues

Written by Laura Furness, Head of the Fulfilling Lives programme at The National Lottery Community Fund, this blog examines what action we can take to help those who are facing multiple disadvantage.

Fixing the hamster wheel of homelessness

This case study from Opportunity Nottingham, one of the partnerships funded through this programme, explores what we mean by the term ‘systems change’. It documents the approach that the partnership has taken, the challenges they have faced to date and shares key learning on what has worked and what hasn’t for beneficiaries in Nottingham.

The Fulfilling Lives Evaluation website

As well as producing independent evaluations of the partnerships’ progress, the Fulfilling Lives Evaluation team have collated a number of reports case studies and stories which focus on key themes and topics within the programme.

These illustrate how partnerships have established approaches, changed and developed their practice as opportunities have arisen and overcome challenges.