Evaluating preventative approaches to health inequalities
We are excited to be working in a new partnership with Homerton Hospital to evaluate their City and Hackney Neighbourhoods programme using our new solution for evaluating place-based systems change.
The Neighbourhoods programme brings residents, voluntary sector, health, education and care services together in City & Hackney’s eight neighbourhoods, to work together on what matters to local people and address health inequalities and improve health outcomes by using more preventative approaches.
Renaisi are leaders in place-based evaluation, having focussed on the role of ‘place’ in change for many years. We also know Hackney and the City well. We started life within Hackney Council, managed the EC1 New Deal for Communities between 2001 and 2011, and have worked in the borough for most of our 25 years.
To supplement our local knowledge, we have:
- grown our in-house expertise in Health and Social Care;
- experience working alongside vulnerable and marginalised communities;
- practical experience of developing and delivering initiatives to support place-based systems change; and
- tried and tested methodologies to measure place-based change.
A new solution for place-based systems change
We are using our new solution for evaluating place-based and systemic change for this project, which allows us to be both developmental and rigorous, while involving people in the process of evaluation.
The model means we can track and report on incremental change over a long period, giving the Neighbourhoods real-time learning to monitor progress, as well as supporting them to understand their overall longer-term contribution to change.
For the Neighbourhoods programme we have co-designed a multi-level evaluation framework that supports the team to understand the changes being enabled by their approach to integrated care.
Our framework looks to measure outcomes at three key levels:
- impact for residents, including things like improved health outcomes for local people and accessibility of services for the whole community;
- more cohesive cross sector workforce;
- and better infrastructure.
We are establishing a baseline by charting and analysing public health indicators and clinical data collected by NHS teams, alongside outcomes data from local groups, and service activity against our framework. These outcomes and indicators will be measured annually to assess change.
To understand the process for change, we are also doing in-depth, qualitative research throughout with residents and service providers, a value-for-money assessment of one particular service, and a cross-sector workforce survey across all eight neighbourhoods.
Finally, we plan to do a contribution analysis to test specific links between the outcomes for residents and the systems shifts enabled by the Neighbourhoods team. This will involve identifying where there is strong evidence to link the approach to the outcomes and testing the ‘contribution story’ through additional qualitative research, including interviews and focus groups, as well as a literature review to understand whether similar initiatives in other areas have led to the same outcomes.
All of which is intended to help track and understand if this approach to tackling health inequalities works. We look forward to sharing more as we learn.