A conversation with Mark Joyce, Principal Officer for Changing Futures Northumbria
10 minute read
Changing Futures Northumbria closed at the end of June, after five years working with people facing multiple, entangled disadvantage – addiction, homelessness, poor mental health, domestic abuse involvement in the criminal justice system and isolation – using SIGNAL Life Maps instead of formal assessment. Hundreds of conversations later, its Principal Officer, Mark Joyce, has spent as much time thinking about what the programme’s ending reveals as what its five years achieved. I sat down with him to find out.
Where to start
Andy: Before I ask you anything else – what should I be asking? What question would tell this story with the greatest impact, and which would draw out the deepest insight?
Mark: That’s a fair place to start, because it’s the same question we asked everyone we worked with. I’d say: what did the system get wrong about the people it was trying to help – and what does that cost, not just them, but everyone downstream of them? That’s the question underneath everything else here.
The problem
Andy: You’ve talked before about complexity lying in the system, not the individual. Five years and many Life Maps on – what does the system’s file get wrong about a person, and what did working without any formal assessment prove?
Mark: When I talk about “the system,” I mean the whole ecosystem that shapes how people receive support – policy, funding, local commissioning, service design, strategic partnerships, organisational practice. It isn’t one thing. It’s a collection of interconnected, and often disconnected, parts, each with its own rules, thresholds and assumptions.
That’s why the complexity sits in the architecture rather than the individual. The system doesn’t primarily respond to people – it responds to conditions. People get access to services because they meet a diagnosis, a risk category, an eligibility threshold. We talk about person-centred, trauma-informed practice, but the broader system isn’t organised around either. It’s organised around categorisation and performance against predefined outcomes.
So, the system understands people through its own lens, not theirs. What working without assessment proved is that meaningful understanding can emerge just by creating the conditions for someone to tell their story in their own way – without immediately filtering it through eligibility or diagnosis. What came out wasn’t a catalogue of needs to match to services. It was a much richer picture of what mattered to people, what had shaped them, and what gave their lives direction.
What the file gets wrong isn’t really its content – it’s the starting point. It begins with what the system needs to know, not what matters to the person. Five years of this work has convinced me: reverse that starting point, and you get better decisions and stronger foundations for practice and policy alike.
What Life Maps made visible
Andy: You’ve said what matters to people is seldom service-shaped. So where did what matters actually turn out to live? Why do small, ordinary things – a stolen bin, a dentist, transport – keep appearing where the big presenting issues were supposed to be?
Mark: Because those small things are what actually occupies people’s attention day to day. Priorities for someone experiencing multiple disadvantage rarely organise themselves around the category’s services use. A stolen bin, a dentist appointment, unreliable transport – these can seem insignificant from a service perspective, but from the person’s side of the table, they can dominate everyday life.
Services are largely built around conditions – substance use, mental ill health, offending behaviour – and they ask people to engage with those big, emotionally demanding issues straight away. For people who are isolated, with thin or fragile support networks, that can be overwhelming. So, when we ask, “what matters to you,” people rarely start with recovery or treatment. They start with what’s in front of them today.
There’s a contradiction here worth naming: we call our services person-centred, but we organise our resources around conditions, not people. Replacing a bin or registering with a dentist might look modest, but they let someone regain agency and experience success – and in many cases that’s a more realistic route into the bigger work than expecting someone to start with abstinence or trauma processing on day one.
Andy: When is a person’s stuck red really the system’s stuck red?
Mark: This is the question that matters most in practice. It’s tempting to read a stuck red as evidence someone isn’t engaging, isn’t motivated. Often it tells you far more about the system’s limits than the persons.
Take a stolen bin. For most people, that’s an annoyance – you ring the council, navigate the automated system, get a replacement. For someone in active addiction, worried about their tenancy, or in an unstable relationship, that same task can be overwhelming. The difficulty isn’t the task – it’s that the system assumes everyone can manage these processes independently, with no provision for people whose lives are already overwhelmed.
That said, not every red is a system failure. Some stay red because someone’s working through their own process of change – what looks like inactivity can be careful consideration, or the internal pull between the familiar and the uncertain. The skill is telling the difference: is this person still making sense of change, or has the system put an unnecessary obstacle in front of something that genuinely matters to them? Too often, services don’t make that distinction, and the person carries the blame for the system’s gap.
What the numbers can honestly say
Andy: The figures are striking – green shifts running at roughly two to three times the national rate, agency moving in the same range, and “CFN will” becoming “I will” in people’s own words. What’s honest to claim from a cohort this size, and what convinces you it’s real?
Mark: The findings are striking, and I don’t think they can be dismissed lightly. But I want to be cautious about what we claim. A cohort this size doesn’t let us draw universal conclusions, and we don’t yet know enough about how CFN’s cohort compared with the wider national SIGNAL population – if people arrived with more reds and ambers to begin with, there’s simply more room for cumulative improvement.
What I can say confidently is that responding to what matters to people produced markedly better outcomes than many of the people we worked with had experienced anywhere else. Many had spent a decade moving between services, consuming more and more public resource while things got worse. Against that backdrop, what we saw in a relatively short period is hard to ignore.
My confidence isn’t just the data – it’s twenty-six years in this field, and I’ve rarely seen change like this happen this fast. The only comparable experience I have is recovery-oriented services built on the principles of twelve step peer-based, mutual-aid fellowships, where relationships, hope and peer support are central. And that comparison matters, because around half our workforce brought lived experience of their own recovery. There’s a phrase in recovery communities – “recovery is infectious.” I don’t think that’s the whole explanation, but I can’t discount it either.
It’s a combination: a person-led approach, time to build trust, practical support around what mattered, and a workforce that embodied the possibility of change. Untangling exactly how much each contributed is work for future research. Together, though, they make a compelling case that what we saw was real.
What the closure reveals
Andy: CFN ended because the funding programme ended – nobody failed, that’s simply the architecture. What does that architecture do to learning like yours, and what would a funding system built to keep what works actually look like?
Mark: This comes back to the mismatch between how fast practice can change and how slowly systems evolve. Through our own test, learn and grow approach, across two hospital sites in a single NHS Trust, we cut unplanned admissions for alcohol related harm/illness in a small cohort by 76% in a relatively short period. That evidence emerged quickly. But generating evidence is only the first stage – the harder challenge is the system absorbing it, understanding why it worked, and reorganising in response. That takes policy, commissioning, funding and governance evolving together, and it’s slow. It took over a decade for “recovery” to become an explicit objective in national drug strategy after the evidence for it existed. We’re not immune to that same lag.
So CFN didn’t end because it failed. It ended because the national funding for phase one of the programme reached its natural conclusion – a feature of the architecture, not a judgement on effectiveness. The Changing Futures programme continues, with a move away from funding based on competitive tenders to a more focused approach in phase two, where allocations are informed by levels of deprivation, an indicator of the prevalence of multiple disadvantage.
The challenge this shift creates is in the transfer of learning between phase one and phase two. Whilst new areas are building their own approaches, some of what has already been learned risks being lost – simply because the relationships that could carry it forward no longer exist.
I don’t think the answer is funding more CFN teams indefinitely – that was never the ambition. The distinction that matters is between scaling and spreading. Scaling means more capacity like ours. Spreading means embedding the principles – responding to what matters, trusting relationships, trauma-informed practice, the value of lived experience – across services that already exist. Moving CFN from outlier to exemplar.
Practically, that means services designed to move people from being done for, to doing with, to doing by – increasing shared responsibility until people are genuinely self-determining. And it means commissioning differently: joint commissioning across sectors instead of separate pots for substance misuse, mental health, housing, criminal justice – commissioning a response to multi disadvantage itself, with pooled budgets or pooled staff and expertise where full pooling isn’t possible. Bring the resources to the person, rather than expecting the person to navigate very disconnected system alone.
The future isn’t about preserving Changing Futures as a programme. It’s about the learning it generated becoming the blueprint for how services are designed and delivered. If that happens, the programme will have done its job – not by surviving, but by changing what comes after it.
The one sentence
Andy: If policy, commissioning and funding could keep just one sentence from five years of CFN, what’s the sentence?
Mark: Start with what matters to people, not what matters to the system.
“The system changes when we stop asking people to fit services and start asking services to fit people.”
Changing Futures Northumbria closed its doors at the end of June 2026. What it learned did not close with it – not yet. Whether it survives depends on whether the systems now absorbing its evidence can move at anything like the pace its practice did.
