Evidence-based policy

What works in local growth and skills? Learning from recent evaluations

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Jason Lowther

Following the previous blog on homelessness and rough sleeping, this piece turns to another major area of local government activity: local growth and skills programmes. Here too, evaluation activity has expanded rapidly, with a mix of national frameworks, programme‑level syntheses and place‑based studies. Taken together, these evaluations offer a valuable, and still evolving, picture of what is working, what is proving harder, and what local systems actually need to deliver economic outcomes.

Four strands of evidence stand out.

MHCLG local growth evaluation

The MHCLG local growth evaluation programme is significant not just for its findings, but for its approach to evaluation itself. Rather than focusing on single programmes, it introduces a portfolio‑level strategy covering multiple funds aimed at improving sub‑national economic performance.

Recent work, including the process evaluation of the Local Growth Fund and Getting Building Fund, highlight both strengths and tensions in the model. Decentralised decision‑making and the “single pot” approach enabled locally tailored investment and stronger alignment with local strategies. Private sector involvement and local prioritisation were widely valued.  However, delivery was shaped by pressures to deliver “shovel‑ready” projects quickly, particularly in the Getting Building Fund, which sometimes limited strategic coherence and innovation. Governance arrangements, while locally responsive, were often complex, and approaches to monitoring and evaluation were variable. More broadly, the evaluation underlines the difficulty of measuring long‑term economic impact, particularly where interventions are diverse and outcomes unfold over many years.

Multiply deep dives (Scotland, Wales, Northern Ireland)

The Multiply deep dives bring a skills and employability perspective, focusing on adult numeracy provision across the devolved nations. Multiply was a £559 million UK‑wide programme designed to improve functional numeracy, with flexible, locally designed delivery models.

The deep dives use qualitative case studies, interviews with delivery partners and analysis of monitoring data, focusing on one area in each nation and drawing on wider place‑level evidence. A central finding is that local flexibility enabled innovation, particularly in embedding numeracy in real‑world contexts such as employment, parenting or financial capability.

At the same time, the evaluations highlight familiar delivery challenges. Short delivery timescales, in some cases just a year, created pressure to scale quickly, often leading to adaptation of existing provision rather than genuinely new approaches. Partnership working across councils, colleges and the voluntary sector was essential but time‑consuming to establish. Engagement with target groups remained difficult, particularly where low confidence rather than low skill was the primary barrier.

Overall, the evidence suggests that contextualised, learner‑centred approaches are promising, but require time, trust and sustained funding to embed.

UK Shared Prosperity Fund (UKSPF) interim evaluation synthesis

The UKSPF interim synthesis report provides perhaps the most comprehensive current view, drawing together 34 place‑based evaluations across the UK. It focuses on process learning rather than impact, reflecting the relatively early stage of delivery.

A clear headline is the importance of local autonomy. Across almost all areas, the ability for Lead Local Authorities to design interventions around local needs was strongly valued, particularly compared to the perceived rigidity of previous EU funds. This flexibility supported alignment with local strategies, more responsive delivery, and better integration across policy areas.

Other success factors included strong local programme management teams, continuity of provision (using UKSPF to sustain previously funded services), and the ability to combine funding streams to create coherent local offers. However, challenges were equally consistent. Tight central government timelines constrained planning and procurement, limited consultation, and created recruitment difficulties. As with other programmes, evaluation and outcome measurement remained underdeveloped.

The synthesis highlights a key tension: local freedom within central constraints. While devolution of decision‑making was real, the operating environment still imposed significant limits on what places could achieve.

UKSPF place‑based evaluations

The place‑based evaluations add depth to this picture by examining how UKSPF worked in specific localities. Using mixed‑methods approaches – including contribution analysis, surveys, interviews and case studies – across 34 areas, they explore how combinations of interventions interact within local systems.

These studies show that outcomes are highly context‑dependent. In some areas, UKSPF supported visible improvements in community facilities, local business support, and employability outcomes. In others, impacts were harder to detect, reflecting both the early stage of delivery and the complexity of local economies. What emerges clearly is that programme success depends less on individual projects than on how they are aligned and sequenced locally.

The evaluations also reinforce the importance of existing capacity and partnerships. Areas with mature governance arrangements, strong voluntary sector links, and prior experience of managing regeneration funding were better able to mobilise quickly and deliver coherent programmes.

What does this mean for local authorities?

Across these evaluations, several consistent lessons emerge.

First, local flexibility works, particularly when supported by capacity and stability. Both UKSPF and Multiply demonstrate the value of devolved decision‑making. However, the benefits are uneven, depending on local capability, existing partnerships, and the time available to plan and deliver.

Second, time is the missing ingredient in local growth policy. Tight delivery timescales appear across all programmes, driving a focus on “shovel‑ready” activity, limiting innovation, and constraining partnership development. Economic change, skills development and behaviour change all take longer than funding cycles typically allow.

Third, integration matters more than individual interventions. The strongest evidence, particularly from the place‑based evaluations, is that impact depends on how interventions fit together. Skills, business support and community investment are interdependent, yet funding streams and evaluation frameworks often treat them separately.

Fourth, measurement remains a weak spot. Across the local growth portfolio, there are persistent challenges in demonstrating impact and value for money. This is partly methodological, but also reflects the reality that many outcomes (productivity, employment, resilience) are long‑term and influenced by wider factors.

Finally, these evaluations underline a familiar but important point: local systems deliver national priorities. Where programmes align with local strategies, build on existing partnerships and allow room for adaptation, they show promise. Where they are constrained by short timescales, fragmented funding or complex governance, delivery becomes more transactional.

The conclusions from the local growth and skills evaluations strongly align with, and are reinforced by last month’s excellent report from the Institute for Government, Designing and delivering employment support.  The IfG goes further in diagnosing why these issues persist and what structural reform is needed. Both emphasise the value of local flexibility, integration and tailoring to place, with the IfG explicitly arguing that strategic authorities are best placed to design joined‑up employment support aligned to local labour markets and services. Likewise, both bodies of evidence highlight fragmentation and poor coordination across programmes as major barriers, with the IfG noting longstanding failures to “shift the dial” despite multiple national schemes, echoing local growth evaluations on disjointed funding and siloed interventions. The IfG report places significant emphasis on the limits of centralised systems and the need for multi‑year funding, capability and accountability frameworks.

In short, the local growth evaluations provide grounded evidence of what works in practice, while the IfG report offers a more explicit systems diagnosis: that without sustained devolution, integration and long‑term investment, the conditions needed for those “what works” approaches to succeed will remain constrained.

What works in homelessness and rough sleeping

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Jason Lowther

We’ve just started a new series of Inlogov blogs summarising the growing body of evaluation evidence in local government, and what it tells us about how councils are learning what works. Nowhere is that learning more urgent or more complex than in homelessness and rough sleeping. A series of recent national evaluations provide a rich, if sometimes uncomfortable, picture of how programmes are operating on the ground, what difference they are making, and where the system continues to struggle. 

Systems‑wide evaluation of homelessness and rough sleeping

The systems‑wide evaluation represents a deliberate attempt to step back from individual programmes and understand homelessness as a complex, interconnected system rather than a set of discrete services. Led by the Centre for Homelessness Impact with research partners, the early reports combine systems‑mapping, policy analysis and qualitative fieldwork in five local authority areas.

The core finding is stark: the system is not working as intended. Public spending and organisational effort are disproportionately focused on crisis response rather than prevention, even though this approach places increasing pressure on local authorities and delivers poorer outcomes. Fragmented funding streams, short‑term grants and inconsistent incentives across departments actively undermine joined‑up working. The evaluation does find examples of strong local partnership practice,but these are often working around the system rather than being supported by it.

The central conclusion is that meaningful progress requires sustained, cross‑government commitment to prevention, better alignment between housing, health, justice and welfare systems, and a clearer understanding of how national policy choices shape local outcomes.

Rough sleeping and complex needs process evaluation

The rough sleeping and complex needs evaluation zooms in on services supporting people facing the most entrenched disadvantage. This process evaluation examined interventions funded through the Rough Sleeping Grant and Rough Sleeping Social Impact Bonds, focusing on people with co‑occurring mental health and substance misuse needs.

Using case studies across 12 areas, interviews with service users and staff, and cost analysis, the evaluation explored how different models worked in practice. It found that progress, including improved housing stability and engagement with services, was most likely where support was flexible, persistent and relationship‑based. Small caseloads, psychologically informed approaches and multi‑disciplinary working were all important.

However, delivery was often hampered by structural barriers beyond local control: gaps in mental health provision, restrictive criteria in mainstream services, workforce instability and the limitations of short‑term funding.

Rough Sleeping Initiative process evaluation

The Rough Sleeping Initiative (RSI) process evaluation complements earlier impact analysis by explaining how and why the initiative achieved results. While the impact evaluation estimated a significant reduction in rough sleeping in RSI areas, the process evaluation explored local delivery through surveys of all funded authorities and in‑depth qualitative case studies.

Local authorities consistently reported that RSI funding enabled them to expand outreach, create specialist roles, and strengthen partnerships with health and voluntary sector providers. Rapid mobilisation, local flexibility and visible political commitment were key strengths. Many areas highlighted the value of multi‑disciplinary teams and assertive outreach in engaging people who had been sleeping rough for long periods.

At the same time, the evaluation identified familiar challenges: recruitment difficulties, reliance on short funding cycles, and the risk of losing skilled staff when funding ends.

Next Steps Accommodation Programme evaluation (briefing paper)

The Next Steps Accommodation Programme (NSAP) evaluation focuses on what happened after the incredible emergency response of “Everyone In” during the Covid pandemic lockdowns. It draws on two waves of interviews with service users in 34 local authorities, around 12 and 18 months after they were placed in longer‑term accommodation.

The findings are cautiously positive. Many people reported improved stability, safety and wellbeing, and a reduced use of emergency services. Sustained accommodation outcomes were more likely where individuals received ongoing, tailored support alongside housing. However, the evaluation is clear about its limits: the absence of baseline data, attrition over time, and the likelihood that those still in contact with services are the “success cases”.

Crucially, it highlights risks to sustainability, particularly affordability pressures, isolation, and unmet support needs.

Capital Letters process evaluation

The Capital Letters process evaluation adds an important organisational and commercial dimension to the evidence base. Capital Letters was established in 2019 as a borough‑owned, non‑profit company to reduce homelessness and temporary accommodation use in London by collectively procuring private rented sector homes, reducing competition between boroughs and driving better value for money.

The evaluation, based on interviews with boroughs, board members, landlords and MHCLG officials, alongside document and performance data review, focuses on how the initiative was set up, governed and sustained. It finds that Capital Letters had early success in demonstrating the potential of scale, shared negotiation and coordinated landlord engagement. Boroughs valued the ambition to change market dynamics rather than simply manage them.

However, the evaluation also highlights significant challenges. Achieving financial self‑sufficiency while meeting social objectives proved extremely difficult, particularly in a highly pressured London housing market. Tensions emerged between commercial risk, borough expectations and the constraints of homelessness legislation. Governance and accountability arrangements were complex, and uneven borough engagement limited the company’s ability to operate at the scale originally envisaged. Ultimately, despite grant support, Capital Letters was unable to become financially sustainable and subsequently wound down operations in 2025.

What does this mean for local authorities?

Read together, these evaluations paint a coherent but challenging picture of what local government can do in homelessness and rough sleeping.

First, prevention and system change demand stability. The biggest barriers to progress lie beyond individual projects. Short funding cycles, fragmented policy levers and misaligned national incentives consistently undermine local efforts, even where practice is strong. Councils can innovate, but without longer‑term certainty the system pulls them back towards crisis response.

Second, relationships and capability are critical. Outreach teams, assertive support for people with complex needs, and sustained tenancy support all rely on skilled staff, trust and persistence. These are precisely the elements most at risk from time‑limited programmes and competitive commissioning.

Third, housing supply and affordability are constraints. The Rough Sleeping Initiative and Next Steps evaluations both underline that service innovation only works when there are viable move‑on options. Capital Letters reinforces this at a system level: even ambitious collective approaches struggle when the underlying market is stacked against local authorities.

Fourth, collaboration is necessary but tricky. Whether through multi‑disciplinary teams or borough‑owned companies, partnership working requires time, governance capacity and shared risk. The evidence suggests collaboration works best when it is supported by clear national frameworks, realistic financial models and space to mature, rather than when it is required to develop and achieve results rapidly.

Finally, these evaluations show the growing value of learning‑focused evaluation in local government. They do not offer simple answers or “magic bullet” models. Instead, they help councils articulate what they are already experiencing on the ground and provide credible evidence to challenge policies and funding arrangements that make homelessness harder, not easier, to resolve.

The learning is no longer about whether local authorities know what works. It is about whether the wider system will allow them to do it.

What Works?  Local Government is Finding Out

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Jason Lowther

At last month’s Smith Square debate, we had an interesting discussion (among other themes) on how innovation spreads.  I mentioned that I was frustrated at the lack of traction that many evaluation reports seem to get, and that so many basically say “we don’t know so probably do more research”.  However, over the last 18 months, government has released a wave of evaluation evidence across multiple themes that are priorities for local government.  Partly in answer to my challenge, over the next few weeks we’ll be looking at what each of these can tell us about “what works” in their area: homelessness and rough sleeping, local growth and skills programmes, democratic engagement, the Community Ownership Fund (COF), and others.

This week, I’ll have a go at seeing the story the collection as a whole might be telling us about the pressures, strengths and future direction of local government systems. They reveal a landscape where councils are doing a great deal right, but also where structural conditions, funding models and capacity constraints limit what even the best local practice is able to achieve.

A shared diagnosis: rising demand, systemic pressure and fragmented delivery

Most of the recently published evaluations echo the same system‑level diagnosis: demand is rising faster than capacity. In homelessness, systems‑wide analysis shows local authorities facing increasing crisis presentations driven by housing shortages, welfare constraints and cost‑of‑living pressures. In UKSPF and Multiply, compressed timeframes and short‑term funding cycles created operational strain and restrict innovation.  The Community Ownership Fund interim evaluation suggests that without the fund many pubs, community centres, sports facilities and heritage buildings would likely have been lost from community use, but also highlights long lead‑in times, complex project management demands, and volunteer burnout as recurring challenges.

Prevention consistently outperforms crisis response, but funding architectures still favour the latter

Across homelessness evaluations, the conclusion is clear: prevention is more humane, more effective and delivers better value for money than crisis response. Yet central‑local funding arrangements often reward short‑term, visible ‘rescue’ rather than long‑term preventative investment. Skills and economic development evaluations show similar dynamics. Multiply deep dives find that providers would benefit from multi‑year cycles that allow them to embed contextualised numeracy provision and build trusted relationships. Instead, annualised funding introduces uncertainty and forces a focus on quick (rather than effective) delivery.

The COF evaluation also surfaces a version of this problem. It shows that community ownership has deep preventative value, protecting assets before they disappear, strengthening social infrastructure, and avoiding long‑term local decline. But early rounds of COF were more accessible to groups with high pre‑existing capability, meaning communities most at risk were sometimes least able to prevent asset loss. Later rounds have improved this, lowering match‑funding requirements, widening eligibility, and offering stronger pre‑application support to disadvantaged communities. The lesson resonates across sectors: preventative systems require accessible, stable and equitable funding frameworks.


Local flexibility and community empowerment are major drivers of success

One of the clearest conclusions across the recent evaluations is that local flexibility works. UKSPF’s devolved decision‑making has been widely praised for enabling councils to design interventions aligned to local priorities. Multiply’s flexible design allowed councils to embed numeracy learning in real‑world contexts that resonated with learners.  The COF interim report finds that COF has been “uniquely positioned” to meet community needs, enabling groups to save valued assets and renew pride in place. Communities report increased participation, stronger local identity and early signs of improved social cohesion following COF‑supported interventions.

Workforce, capacity and governance: the quiet constraints shaping outcomes

A recurring thread across the evaluations is the impact of workforce shortages and operational capacity. Staff churn, fragile volunteer bases, rising caseloads and short‑term contracts constrain delivery, limit innovation and prevent organisations from embedding learning. Investing in capacity (skills, governance, leadership and organisational resilience) is critical for successful place‑based policy.

Partnerships make the biggest difference, but they need careful stewardship

From rough sleeping multi‑disciplinary teams to UKSPF delivery partnerships with VCSE organisations, strong collaboration emerges as one of the most important influences on success. Evaluations show that where councils act as effective system convenors (aligning partners, coordinating case management, sharing data and creating shared goals), outcomes improve.

What does all this mean for local government?

Three big implications stand out across the evaluations.

First, councils are increasingly system‑shapers, not simply programme‑managers.  The evaluations underline that successful outcomes depend on how councils orchestrate local systems (such as housing, economic development, VCSE partners and community groups) rather than on the quality of any single programme.

Second, stable, long‑term funding is essential for prevention, equity and innovation.  Short‑term cycles undermine prevention, limit strategic planning and exhaust delivery partners. The COF findings show how programme design changes can increase equity, but also how instability can disadvantage the communities most in need.

Finally, capacity‑building is central to reducing inequality, even when the policy focus is capital investment.  Across the board, councils, community groups and VCSE partners need investment in skills, leadership and organisational resilience. It’s essential that as a sector we develop systematic and accredited processes to deliver the necessary education and training.

The emerging picture is of local government doing extraordinary work under extraordinary pressure. But the future of place‑based policy will depend on giving councils and communities the tools, stability and capacity to shape local systems, rather than firefighting the consequences of systemic constraints.

Next time I will be diving in more detail into what the evaluations tell us about “what works” in tackling homelessness and rough sleeping.

Empowering People with Learning Disabilities

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Cllr Ketan Sheth

I recently chaired a landmark event hosted by The Advocacy Project, where community leaders, local government officers, NHS representatives, and voluntary sector partners converged at Hampstead Old Town Hall to confront a pressing issue: the systemic inequalities faced by people with learning disabilities. This event was more than a conversation – it was a catalyst for change.

Acclaimed playwright Stephen Unwin shared insights from his poignant book, ‘Beautiful Lives: How We Got Learning Disabilities So Wrong’, inspired by his son Joey’s experiences. Unwin’s words laid bare the dark history of societal attitudes towards people with learning disabilities, exposing the stark reality that despite progress, these individuals remain disproportionately disadvantaged in healthcare, social services, education, and beyond.

The discussion illuminated the critical role local government plays in shaping inclusive policies. By leveraging commissioning powers, local authorities can ensure services are co-designed with people with learning disabilities, prioritising their needs and preferences. This can address the stark health inequalities highlighted in the Learning Disabilities Mortality Review (LeDeR) programme, which revealed concerning disparities in healthcare outcomes.

Katherine Shaw, CEO of The Advocacy Project, underscored the imperative of confronting this history and committing to a future where dignity, equality, and human rights are non-negotiable. The Advocacy Project’s work with local government exemplifies this commitment, amplifying the voices of those with lived experience to inform responsive, respectful, and community-rooted services.

Through user involvement projects and partnerships, The Advocacy Project demonstrates the power of collaboration. For example, their work with local authorities has led to more accessible community services, improved mental health support, and increased participation in local decision-making. These tangible outcomes show that when people with learning disabilities are involved in shaping services, communities become more inclusive.

Local government’s role in education, housing, employment, public health, and adult social care is crucial. By promoting inclusive policies and supporting initiatives like person-centred planning and supported internships, local authorities can break down barriers and foster resilient communities. This can help tackle loneliness, improve mental health, and ensure economic participation for people with learning disabilities.

Moreover, local authorities can learn from The Advocacy Project’s approach to co-production, ensuring that services are designed and delivered with people with learning disabilities, rather than for them. This shift in approach can lead to more effective, person-centred support. By adopting this approach, local authorities can ensure that services are tailored to meet the unique needs of individuals, promoting greater independence and autonomy.

As local government leaders, policymakers, and community advocates, we are tasked with a profound responsibility – to listen, learn, and act. Let us strengthen partnerships, centre lived experience, and forge a more inclusive future for all. The Advocacy Project’s work is a beacon for this change, highlighting the importance of inclusive policies. Indeed, it’s essential to recognise the long-term benefits of such policies, including economic benefits, improved health outcomes, and increased social cohesion. By working together, we can create a more inclusive and equitable society, where people with learning disabilities are valued and supported to reach their full potential, contributing to a richer, more diverse community.

In conclusion, the event reinforced that inclusion is a collective responsibility. Local government’s leadership and partnerships are vital in driving this agenda forward. Let us heed the call to action, champion the rights of people with learning disabilities, and work tirelessly towards a more equitable society.

Councillor Dr Ketan Sheth is Chair of the Community and Wellbeing Scrutiny Committee at Brent Council

Tackling social problems: why don’t we do ‘what works’?

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Jon Bright

One of the most significant problems in public policy has been the persistent failure to draw on evidence of “what works”—and, perhaps more crucially, what doesn’t.

Despite a growing interest in evidence-based policy, we still have a long way to go in identifying and scaling up successful practice. Take, for example, the findings from Nesta’s 2013 report, which revealed that only three out of seventy programmes implemented by the Department of Education were well evaluated (1). Sadly, this gap in evidence was not confined to education and still applies today (2).

Public sector managers need to know what works, what doesn’t and where they should experiment intelligently. However, until the late 1990s, there was little emphasis on evidence as a basis for policy and we haven’t moved as fast as we should have since then. As a result, we have been slow to innovate, evaluate, and scale up new ideas that add value.

What have been the consequences?

That’s not to say there haven’t been some stellar examples of innovation. But these have usually been down to exceptional people or circumstances. In most public organisations, knowledge of best practice is either lacking or hard to access. Public sector managers, particularly outside of professional disciplines, often lack the skills to assess evidence or adapt successful policies to different contexts. In some cases, even when they are aware of evidence, politicians may override advice in favour of projects shaped by political pressure, ideology, or personal interest.

As a result, we keep reinventing policies rather than refining and improving them over the longer term. This makes it much harder to tackle persistent social problems. What’s worse, some policies have been introduced despite evidence that they probably wouldn’t work (3). And even when successful programs are found, we struggle to replicate or scale them up in different contexts.

The Challenges of Policy Transfer and Scaling

This is the core of the problem. A good example is the attempt by English police forces in the early 2000s to replicate a successful gang violence reduction program from the US. Unfortunately, they ignored the detail underpinning the most important components of the US model and the results were largely unsuccessful (4).

In contrast, Strathclyde Police in Scotland carefully adapted the model and successfully reduced gang-related violence. Between 2004 and 2017, the murder rate in Strathclyde halved, and the rate of knife crime dropped by 65%. This example underscores the importance of understanding not only what works, but why it works and how it can be adapted to local contexts (5).

Scaling up successful interventions presents additional difficulties. Long-term success depends on increased funding which is rarely guaranteed. Family Nurse Partnerships (FNPs), for example, have been shown to be effective but have only benefited a small fraction of eligible children in the U.K., despite their positive impact on school readiness and early education outcomes (6). There must be a better way.

Why Is This Still a Problem?

There are several reasons why doing ‘what works’ is a difficult nut to crack. not least of which is the political environment in which decisions are made. Politicians may also reject evidence-based proposals for understandable reasons: cost, public opposition or concern about how they will land with colleagues and the media. Sometimes the timing’s just not right.

Moreover, public sector organisations are often risk-averse. Innovation requires a supportive culture, special funding, expertise, and incentives—elements that are frequently absent. On the plus side, the requirement to produce a business case for new policies does encourage the search for evidence.
The most common objection to evidence-based policy is that we often don’t have the evidence. I deal with this below.

Finally, until recently, there have been too few organisations charged with bringing evidence to decision-makers.

The What Works Centres

The good news is there has been some progress. Ten independent ‘what works’ centres have been set up in recent years to provide evidence-based guidance to policymakers. These centres, covering areas such as health, education, crime, homelessness, ageing and children’s social care, help to bridge the gap between research and practice (7). Their role is to provide unbiased, rigorous, and practical advice to help public services become more effective (8).

However, the work is far from complete. While the centres have made significant strides, there is no agreed, systematic way of incorporating ‘what works’ into the development of policy and delivery of services. Additionally, there has been no independent review of the centres’ overall impact on public policy in the 10 +years since they were founded.

What next for What Works?

The Centre for Public Impact (CPI) argues that a lot of evidence simply isn’t robust enough as the sole basis for social policy (9). It suggests we should use the term ‘evidence-informed’ alongside ‘evidence-based’ and proposes a combination of evidence, expertise, and experience as the best bet for designing policies that will work in most places.
Evidence-informed practice – Centre for Public Impact

To progress the evidence-based policy agenda, five points need to be addressed:

  1. Government Commitment: Government should invest more in research and development. While private companies like Volkswagen allocate a substantial portion of their budget to R&D, most government departments spend less than 1%. Senior civil servants must also be better equipped to understand and apply evidence-based policies (10).
  2. Local Government Involvement: Much of the ‘what works’ conversation takes place at the national level. Local government and civil society must be more involved to ensure better policy and bigger impact. The Welsh Centre for Public Policy is thought effective because of its close working with the devolved government.
  3. The Limits of Evidence: Often, evidence is incomplete or not easily applied to specific contexts. Furthermore, while the Centres are good at synthesising evidence, they don’t take account of the politics of policy making. Local policy makers often query the relevance of evidence when it doesn’t address their main policy questions (11). Evidence often needs to be combined with professional expertise and local experience to tailor policies to local needs.
  4. Scaling Up Good Practice: Public sector organisations need better systems for integrating successful new approaches into their mainstream services. This reduces the need for special funding. Similarly, successful programmes should be repackaged in a form that makes them easier to replicate at scale (12).
  5. Support for Local Managers and Practitioners: User-friendly, evidence-based information is crucial. For example, the Education Endowment Foundation assesses interventions based on evidence strength, cost and impact. This helps schools make good decisions. Other centres also provide ‘what works’ toolkits (13)

During 2024/25, there have been developments in the Network. For example, the Centre for Local Economic Growth has advised local authorities and emphasised tailored interventions that consider local contexts and needs. The Centre for Children’s Social Care has been recommending practices to improve outcomes for children in care. There has been greater collaboration among the Centres including a unified digital platform to disseminate findings. Looking ahead, new centres on climate resilience and digital inclusion are anticipated. The UK government has renewed its funding to the Network.

The ‘what works’ movement is a major step forward in improving public policy. To maximize its impact, its leadership needs to be refreshed, local government and civil society better engaged, and systems created to incorporate successful practice into mainstream services.

Jon Bright is a former civil servant who worked in the Cabinet Office and Department of Communities and Local Government between 1998 and 2014.

References

  1. Cited in The What Works Network (2018) The What Works Movement Five Years On. P15.
  2. Mulgan. G and Puddick. R, (2013) Making evidence useful- the case for new institutions, National Endowment for Science, Technology and the Arts (NESTA).
    See also Institute for Government event in October 2022 ‘What works’ in Government: 10 years of using evidence to make better policy. At this event, David Halpern commented that only 8% of sample of Government programmes had evaluation plans in place.
  3. Wolchover. N, (2012) Was DARE effective? Live Science 27.3.2012; and College of Policing (2015) Scared Straight Programmes, Crime Prevention Toolkit.

4. Knight. G, (2009) How to really hug a hoodie. Prospect. November 2009. See also, Tita. G, Riley. J,
Ridgeway. G, and Greenwood. P, (2005) Reducing Gun Violence Operation Ceasefire. National Institute of Justice (USA); and Braga. A. Kennedy. D, Waring. E, Morrison Piehl. A, (2001) Problem-oriented policing, deterrence, and youth violence: an evaluation of Boston’s Operation Ceasefire. National Institute of Justice.

5.Big Issue (2020) How Scotland’s’ Violence Reduction Unit breaks the cycle of crime, Big Issue 11.9.2020;
Craston. M, et al, (2020) Process evaluation of the Violence Reduction Units Home Office Research Report 116, August 2020; O’Hare. P, (2019) How Scotland stemmed the tide of knife crime, BBC Scotland news website, 4 March 2019; and Batchelor. S, Armstrong. S, and MacLellan. D, (2019) Taking Stock of Violence in Scotland, Scottish Centre for Crime and Justice Research August 2019.

  1. National Institute of Health Research (2021) Family Nurse Partnerships Building Blocks 5-6 study.
  2. Gov.UK (2013, updated 2022) What Works Network, Evaluation Task Force. https://www.whatworksnetwork. org.uk/
  3. The What Works Network (2018) The What Works Movement Five Years On.
    See also Breckon. J, and Mulgan. G, (2018) Celebrating Five Years of the UK What Works Centres, NESTA.
  4. Snow. T, and Brown. A, (2021) Why evidence should be the servant, not the master of good policy Centre for Public Impact.10.8.2021
  5. Halpern, D presentation at an Institute for Government (2022) event op cit.
  6. Private correspondence with Jason Lowther, Head of INLOGOV.
  7. Little. M, (2010) Improving children’s outcomes depends on systemising evidence-based practice… Demos
  8. Education and Endowment Foundation – Teaching and learning toolkit. An accessible summary of education evidence https://educationendowmentfoundation.org.uk/

REASONS TO BE HOPEFUL – HOW THE GAP IN LIFE EXPECTANCY BETWEEN ENGLISH REGIONS WAS NARROWED

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Nicholas Hicks and Jon Bright

In this blog, we discuss a major success in health policy that’s been largely forgotten.

What happened?
During the 2000s, a government strategy to tackle health inequalities in England led to a reduction in geographical differences in life expectancy. Furthermore, this success reversed a trend that had been increasing. It was achieved by reducing death rates caused by coronary heart disease.


The chart below shows an overall reduction in coronary heart disease mortality and a reduction of nearly 20% (19.07%) in the gap between the national average and the poorest areas. [Barr et al 2017]


This is the only period in the last 50 years when inequalities in death rates between rich and poor have narrowed. It was a considerable achievement and an historic result.

What was the impact in terms of lives extended?
This policy meant that many millions of people lived longer and healthier lives. Much of the benefit was probably due to reductions in smoking and managing risks such as high blood pressure and cholesterol. In 2000, 38% of the adult population smoked and smoking was twice as common amongst those on low incomes. Today, only about 13% of the adult population smoke, the lowest since records began.

But this achievement was not down to health policy alone. Importantly, it was also due to coordinated action across Government to tackle inequalities more generally. This is because many of the factors that affect health lie outside the health sector.

What were the policy drivers?
This work started in 2000 with the NHS Plan (that committed Government to publishing inequality targets), and the Department of Health’s National Service Framework for Coronary Heart Disease, and continued over several years.

These policies led to a national commitment to reduce inequalities. In the wake of the NHS Plan, the Government set Inequalities targets and incorporated them into national Public Service Agreements (PSAs). These Agreements required central government Departments to do better in those parts of the country where outcomes were poorest. This applied not only to health but also to low income, family functioning, education, employment, and crime. These wider issues are major influences on people’s health and targeted action on these made it more likely that health-specific interventions would succeed.

PSAs defined the goals of the 2002 and 2004 Comprehensive Spending Review. Departmental budgets were only agreed once each Department produced credible plans showing how they would contribute to the inequality targets.

What did all this mean in practice for people living in poorer regions?
Health-specific interventions included smoking cessation clinics; improving the distribution of GPs – many disadvantaged areas had no GP service; more resources for disadvantaged areas; national guidance on best practice; and improved access to mental health services. Action to tackle the wider causes of poor health included improving housing (the Decent Homes Standard); increasing household income (the Minimum Wage, Tax Credits); investment in education and skills; reducing the number of young people not in education, employment and training; teenage pregnancy prevention; and investment in early years (Sure Start and family support).

This approach is consistent with Prof Michael Marmot’s conclusions in his 2010 report, ‘Fair Society, Healthy Lives‘ .


What did evaluators find?
Evaluators found that regional inequalities decreased for all-cause mortality and that the strategy was broadly successful in meeting its ambitious targets. Writing in 2017, Barr et al they concluded that ‘future approaches should learn from this experience”. They noted that current policies were probably reversing this achievement of the previous decade. See also Holroyd et al’s systematic review.

In our main paper REASONS TO BE HOPEFUL we discuss the evaluations in more detail.


Health inequalities-narrowing the gapOct2023FinalDownload

What lessons should we draw?
There are five main lessons to draw from this evidence:

  1. When Government takes a coordinated approach to a problem – and sticks with it over time – the results can be impressive, even with problems thought to be intractable.
  2. Health is a good proxy for Levelling Up. Narrowing the health gap between regions is a good proxy for ‘levelling up’ more widely. Health inequalities are in large part due to poverty, poor education, and poor housing. Regional inequalities in educational attainment and crime also narrowed.
  3. Leadership and persistence are essential. A ‘whole of government’ approach requires good cross departmental working, full engagement with local government, and leadership from the Prime Minister.
  4. Tackling the nation’s problems needs longer term policy making so successful approaches don’t fizzle out whenever there’s a change of Government. As we’ve seen, benefits achieved up to 2010 may have been lost by 2017. Maintaining progress requires cross-party, long-term collaboration.
  5. This approach worked by influencing mainstream budgets via better targeting and evidence-based interventions, rather than relying only special ring-fenced funding

Today, the big health challenges today are obesity, diabetes and related conditions. Again, poorer populations are much more affected. Will today’s politicians rise to the occasion?

Dr Nicholas Hicks BM BCh FRCP FRCGP FFPH is an Honorary Senior Research Fellow, Nuffield Department of Primary Health Care Sciences at the University of Oxford and a Senior Strategy Advisor, Department of Health and Social Care. He is also an Associate Fellow, Green Templeton College, University of Oxford. He was seconded to the Department of Health Strategy Unit and helped draft the inequalities chapter of the NHS Plan in July 2000 ([email protected]).

Jon Bright is a former civil servant who worked in the Cabinet Office and Department of Communities and Local Government between 1998 and 2014.

References

  1. Meadows D. Leverage points: places to intervene in a system.
  2. NHS Plan. A plan for investment; a plan for reform. Department of Health (2000): 106-7
  3. Health inequalities – national targets on infant mortality and life expectancy – technical briefing . Department of Health March 2002
  4. Spending Review 2002: Public Service Agreements, HM Treasury 2002 para 1.12
  5. Holdroyd I, Vodden A, Srinivasan A, Kuhn I, Bambra C, Ford JA. Systematic review of the effectiveness of the health inequalities strategy in England between 1999 and 2010. BMJ Open. 2022 Sep 9;12(9):e063137. doi: 10.1136/bmjopen-2022-063137. PMID: 36134765; PMCID: PMC9472114.