Place-Based Approaches to reducing health inequalities: Evaluation toolkit for local areas

This document is intended for local areas that are utilising place-based approaches to
reducing health inequalities (PBA) and provides a toolkit to support areas to evaluate
their interventions. In November 2019, Public Health England (PHE) piloted workshops
to introduce PBA and commissioned the University of Manchester to conduct an
evaluation of the workshops and the universal offer available through the PHE website.
As part of this evaluation, the University of Manchester has developed a set of tools
which local areas could draw on in order to address the success of PBA in their own
context. The tools provided below are based on our realist evaluation and can be
adapted to meet local need.
The full realist evaluation carried out by the University of Manchester can be found on
the PHE webpage Health inequalities: place-based approaches to reduce inequalities.
Evaluation is a vital part of any implementation, to assess a programme’s level of
success and whether it has met the desired outcomes. In the context of PBA, the
learning from an evaluation may inform whether the programme receives further funding
and resources, whether improvements can be made for future iterations, and the extent
to which it may be incorporated into organisational policy. It is also important to ensure
that no harm was done by the intervention, and that the benefits were felt equally across
the target population.
Stakeholders will have different ideas of what they want the evaluation and the
programme to achieve, and we recommend that all stakeholders are brought together at
an early stage of the process to agree how success will be measured, and the scope of
the evaluation. Given the PBA focus on bringing civic, service and community sectors
together, ideally this should also be replicated in the evaluation process.
Evaluation should be considered from the outset, to allow for the collection of baseline
data, and the establishment of appropriate data collection and monitoring processes.
Reducing health inequalities is a complex field, and we would expect that some desired
outcomes such as a reduction in the gap in life expectancy for a particular area may not
be apparent for several years. Recognising this complexity, but also the need for shorter
and intermediate term indicators to aid decision-making, we have provided suggestions
of evaluation tools which can be applied at various stages and incorporate levels of
complexity across the life of the intervention.