Severe Multiple Disadvantage (SMD)

This programme will focus on improving the experiences and outcomes of people living in Nottingham experiencing severe multiple disadvantage (SMD). We know that people experiencing SMD can feel services are difficult to access and their care is fragmented.  We also know that people experiencing SMD can sometimes be frequent users emergency services, but their outcomes are still poorer than the general population.

As SMD is multi-faceted and complex, we need a system-focused approach that brings together lived experience and a range of organisations within the voluntary and community sector with statutory organisations across health, social care, housing, and criminal justice. 

In Nottingham city, we have an existing strong partnership that can support the development of this much needed system approach. As a partnership, we will:

• Make sure we listen to the voices of people with lived experience and to frontline workers so that we can identify and address barriers to care, improving the support people receive

• Improve access to services, resolving problems through greater flexibility and making sure that staff know how to engage effectively with people that experience SMD

• Help services work more closely together, planning and delivering services around the person rather than expecting people to navigate what can be a very complex system

• Develop our understanding of the experience of SMD and how that impacts on people’s lives

Changing Futures

Nottingham city is one of 15 areas in the county to take part in the national Changing Futures programme. Changing Futures Nottingham is a critical part of our programme to support people who experience severe multiple disadvantage.

Find out more about Changing Futures here.

How will we know we have made a difference?

• We will use the Public Health Outcomes Framework indicators on income and earnings, employment, education and training and fuel poverty
• We will work with partners on sharing local data and insight on employment, income, and cost of living pressures
• People experiencing SMD feel involved in all aspects of their care and their experiences/voices influence the design and delivery of the support that they receive
• People experiencing SMD are able to access the help they need at the right time
• Citizens with the greatest need are able to receive one to one support that will help them navigate services and achieve their aspirations
• Staff working in all sectors feel better equipped and supported in working with citizens that are experiencing SMD
• There is more cross-organisational working between services so that citizens experiencing SMD don’t get lost in the system
• There is a greater focus on the outcomes for people that experience SMD, to include own goals and ambitions as well as wider outcomes relating to health and social care

Read about our other programmes of work…