1. Opportunity Nottingham system change plan and challenge: the direction for the remaining four years
Laura Greason Mark Garner
Policy & Practice Manager Project Manager
MEAM Opportunity Nottingham

2. Fulfilling Lives
BIG Lottery Multiple and Complex Needs Programme. 12 areas to: 1. Change lives 2. Change systems 3. Involve people with lived experience

3. Fulfilling Lives
establishing local led partnerships of voluntary and statutory sector agencies alongside people with lived experience;
supporting people to navigate the existing system;
understand the barriers and complexities within the system; and
work together to create a more coordinated and effective response for people experiencing multiple needs. (system change)

4. Fulfilling Lives & system change
“what difference has a partnership approach to multiple needs made for people who are not on Opportunity Nottingham’s case load?”

5. Fulfilling Lives & system change
Systems Change is NOT about:
Implementing new services into an already complicated system
Filling gaps where existing services are lost
A simple, time specific project
Just about improving practice.
Systems change IS about:
Radically changing how we work and how we make decisions about policies and allocation of resources
Embarking on a process of change together
Equalising power and involving people with lived experience of the system
Focusing on values and purpose
Collaboration

6. Creating change: what have we learnt so far?
Recognition that this isn’t about “complex people” but the way in which the system around an individual responds is complex
That system has been constructed over time
Systems by their nature they maintain their structure. They were not designed with change in mind.
As different parts of the system are designed in isolation, the interaction between competing parts often has adverse and sometimes unforeseen consequences.
But the system is constructed and maintained by people, by us! our relationships, our assumptions and our interests.
That means we can change them.
The environment in which we’re now attempting to do this work is increasingly challenging – yet a coordinated cross sector response becomes all the more important.

7. The next four years
Each of the 12 FL areas have spent the last year reflecting on learning from the programme so far & setting priorities for change.
The current Opportunity Nottingham partnership cannot achieve this on its own!
A shared sense of accountability across the city
A shared commitment to collaboration
Setting priorities
Getting started

8. The next four years Where do I sit within the Nottingham City system?
How can I share my skill and knowledge towards this ambition?
What can I do to ensure that our local system is more effective for people experiencing multiple needs into the future?

9. Opportunity Nottingham - looking back to 2013…
Original system change plan devised in 2013
Partnership involvement
Expert Citizens central to the process
Demonstrated Nottingham City’s commitment to achieving system change
Produced without benefit of programme learning.

10. Key successes Increased awareness of multiple and complex needs
Meaningful inclusion, co-production and consultation
Changes to commissioning, co-design and delivery
Development of learning and best practice.

11. System change at the mid-way point
Opportunity Nottingham is proud of its achievements in the first four years of delivery.
Commitment and buy in from partners and Expert Citizens
Delivered against the challenging backdrop of austerity, service cuts and uncertainty
Attention is turning towards legacy, and how the current partnership will continue to support people with multiple and complex needs when Opportunity Nottingham closes in 2022.
This requires a decision and input from City-wide partners.

12. Looking forward New system change plan
Based on programme evaluation and learning
Continuing importance of partnership, Expert Citizen and City-wide involvement
Legacy. We have been doing this – it’s important to have a legacy from this work – but we can’t do this alone, we as a city have a responsibility to do this.

13. Putting together the new plan
Contributions from:
Board members
Partners
Expert Citizens
Support from MEAM
Identified five priorities areas (challenges to Nottingham City)
Actions that will make the most difference

14. Challenge 1: The system works as one
Greater alignment and co-location of services
More multi-disciplinary team working
Better information sharing
Outcomes improve when we work together to address complex problems
Use of “Facts about me” form
Using the Wellbeing hub as a legacy.

15. Challenge 2: Our services are welcoming
Multiple and complex needs can be a barrier to accessing services
All City services have a responsibility to make their services accessible to people with multiple and complex needs
Services should be provided without stigma or judgement
Psychologically informed approaches and wider use of trauma informed care is needed
The Practice Development Unit can inform.

16. Challenge 3: Our system is service user led or informed
Meaningful inclusion, consultation and involvement is vital
No more ‘tick box’ exercises
Feedback!
Expert Citizens – an example of success
An agreed Nottingham City participation standard
Adopting our learning.

17. Challenge 4: We build resilience in our Beneficiaries and our workforce
Services should adopt a strengths based, progress focused approach
What does success look like?
Flexible service delivery
Don’t give up on people
Support and resources needed for the workforce to build resilience.

18. Challenge 5: We acknowledge and respond to complex needs
Every service should: Understand the causes of complexity Deliver a responsive service Greater recognition of complex needs in strategy and policy (locally and nationally) Exit strategy and legacy planning for Opportunity Nottingham.

19. Legacy – Key Questions for Nottingham
What will happen to people who are still on the project at the end of year eight?
What support will be available when Opportunity Nottingham stops taking referrals?
How can we invest in ‘what works’ at a time of austerity?
If Nottingham invests in successor support, what will the service look like?
So we have ‘the challenge’…

20. Opportunity Nottingham system change challenge…
This challenge will ensure that :
Action is taken to deliver change
Commitment and shared ownership occurs across Nottingham City
It is a document that all partners and organisations can sign up to.
Next steps:
Planning event in conjunction with One Nottingham in February More information to follow on the Opportunity Nottingham website.