Understanding how a health equalities programme was contributing to change in East Kent

The challenge

Social Enterprise Kent had delivered a multifaceted programme intended to strengthen the voluntary, community and social enterprise (VCSE) sector’s role in tackling health inequalities across East Kent.

The programme combined:
 

• grant funding for VCSE organisations;

• training and capacity building;

• community engagement and targeted outreach;

• partnership working between VCSE and statutory organisations;

• and work to strengthen the sector’s collective voice and influence within the wider health system.

Social Enterprise Kent needed to understand more than how many activities had taken place or how many people had participated. It wanted to understand what change the programme had contributed to, how that change had happened, who was benefiting and what needed to be strengthened.

This was challenging because the programme was operating across a complex system.

Change was expected at several interconnected levels: in communities’ experiences of accessing support; in the knowledge and capability of individual VCSE organisations; in relationships between organisations; and in the sector’s visibility and influence within the health and care system.

Many of the intended outcomes - greater trust, stronger relationships, improved access and system influence - were also long-term, relational and difficult to capture through conventional monitoring data. Baseline and programme data were not always consistent, and it would have been unrealistic to attribute changes in health inequalities directly to one programme.

The evaluation therefore needed to build a credible account of the programme’s contribution without overstating what the available evidence could prove.

What we did

The Future Works - working with Linda Jackson of The Loom - designed and delivered a theory-based, mixed-methods evaluation focused on understanding what was changing, for whom, in what circumstances and why.

Building an evaluation around change:
We used the programme’s intended theory of change to examine how its different activities were expected to connect.

Rather than evaluating the grants, training, community engagement and partnership work as separate workstreams, we explored how they interacted. For example:
 

• Did training build the confidence and capability of VCSE organisations?

• Did grants enable organisations to respond more effectively to community needs?

• Did stronger relationships support practical collaboration?

• Did collective working increase the sector’s visibility and influence?

• What conditions helped - or prevented - these changes from happening?

This enabled the evaluation to look beyond individual outputs and examine the mechanisms through which the programme was contributing to wider change.

Combining different forms of evidence:
We brought together evidence from:
 

• stakeholder interviews;

• surveys;

• programme and monitoring data;

• document review;

• and facilitated learning conversations.

We used contribution analysis and realist-informed inquiry to test the emerging story of change. This meant looking for evidence that supported or challenged the programme’s assumptions, considering other factors that may have influenced outcomes, and being clear about where the evidence was stronger or weaker.

Evidence was considered across three connected levels:
 

1. Communities: how the programme was supporting organisations to understand and respond to barriers experienced by marginalised communities.

2. VCSE organisations and networks: changes in knowledge, confidence, relationships, capacity and practical collaboration.

3. The wider system: changes in the sector’s visibility, collective voice and ability to influence health-equalities conversations and decisions.
    

Making evaluation participatory:
VCSE organisations and partners were not treated simply as sources of data.

We created facilitated opportunities for them to reflect on emerging findings, test our interpretations and contribute their own understanding of what was - and was not - changing.

Findings were shared during the work rather than held back until the final report. This enabled the evaluation to support reflection and adaptation while the programme was still being delivered.

The final outputs brought together the evidence into a clear account of the programme’s contribution, alongside practical recommendations for future delivery, investment, partnership working and system influence.

What changed

The evaluation gave Social Enterprise Kent a more grounded and nuanced understanding of the change the programme had helped to create.

It found evidence that the programme had contributed to:
 

• stronger connections between VCSE organisations;

• a greater sense of collective voice across the sector;

• improved understanding of health inequalities and the wider health system;

• increased confidence and peer support among participating organisations;

• new opportunities for practical collaboration;

• and a stronger profile for the VCSE sector within health-equalities work.

The evaluation also highlighted the importance of Social Enterprise Kent’s role as a convenor and bridge between the VCSE sector and statutory partners. Its relationships, system connections and ability to bring organisations together were not simply administrative features of the programme - they were important mechanisms through which change happened.

At the same time, the evaluation identified important limitations and tensions.

Greater visibility did not always translate into meaningful influence. VCSE participation in system conversations could still feel tokenistic, and smaller community organisations did not always have the time, resources or infrastructure needed to engage consistently.

The work therefore made clear that reducing health inequalities requires more than funding a series of individual activities. It depends on sustained investment in:
 

• trusted community relationships;

• the capability and resilience of VCSE organisations;

• connections and collaboration across the sector;

• accessible and proportionate approaches to data and learning;

• and meaningful routes through which community insight can shape system decisions.

Social Enterprise Kent left with a clear account of the programme’s value, a stronger evidence base for future investment and practical recommendations about what needed to continue, change or be developed further. The final report was subsequently used to inform onward conversations and decision-making with system partners.

The evaluation explained where the programme had made a credible contribution to addressing health inequalities, what enabled that contribution and what the wider system needed to do next.

Our 'special sauce' on this project

A conventional evaluation might count grants, training sessions, participants and activities. Those figures matter, but they do not explain whether meaningful change occurred - or why.

Our value came from combining four forms of expertise.

1. Understanding change across complex systems. We recognised that the programme’s impact could not be understood by looking at individual activities in isolation. Change depended on relationships between communities, VCSE organisations, Social Enterprise Kent and statutory partners. Our systems-change knowledge enabled us to examine how trust, power, infrastructure, commissioning and relationships shaped what the programme could achieve.

2. Theory-based evaluation and research expertise. We brought methodological rigour to a complex and imperfect evidence environment. Contribution analysis and realist-informed inquiry helped us distinguish between activity, immediate outcomes, longer-term change and system influence - without making claims the evidence could not support.

3. Facilitation and stakeholder engagement. Understanding change required more than extracting information through interviews and surveys. We created reflective spaces in which partners could make sense of their experience together, challenge emerging interpretations and surface tensions that might not appear in formal monitoring data. This was particularly important for hearing when participation felt meaningful and when it felt tokenistic.

4. Translating evidence into action. We did not produce a report that simply described the past. We turned complex evidence into a practical account of what was working, what needed strengthening and where future investment and system action should be focused.

An evaluator with strong research skills might have produced a technically sound assessment of programme performance. A facilitator might have generated valuable reflection and learning. Our distinctive contribution was combining both, and applying a systems-change lens to understand the change that had been made, its impact, the conditions that enabled it and what needed to happen next.