Building the economic case for community capacity-building

1. Building the economic case for community capacity-building Presented at the ‘People with disabilities participating fully and safely in the community’ conference, held by the National Disability Authority in Dublin 13th October 2011 Annette Bauer a.bauer@lse.ac.uk Personal Social Services Research Unit (PSSRU) London School of Economics and Political Science

2. About PSSRU • Our mission: To conduct high quality research on social and health care to inform and influence policy, practice and theory. • Established in 1974 at the University of Kent; two new branches opened in 1996 at the LSE and the University of Manchester. • LSE Health & Social Care led by Professor Martin Knapp. • Linked with the Institute of Psychiatry, London and the National Institute for Health Research.

3. Building the economic case for community capacity-building The work summarised here was partly funded by the Department of Health. Carried out under the lead of Martin Knapp and with colleagues Margaret Perkins and Tom Snell. A fuller description of the work in our paper: Martin Knapp, Annette Bauer, Margaret Perkins, Tom Snell (2011) Building community capacity: making an economic case; Think Local Act Personal. We continue to work in this field (more on this later).

4. Building the economic case for community capacity-building What is community capacity-building? Why evaluate CCB economically? How to measure the economic value of CCB? Examples: Time banks & Debt advise and signposting by community navigators Where from here?

5. What is Community capacity-building • Definition • Asset-based, developmental approach. • Understands obstacles that prevent people (and organisations) from achieving their goals. • Empowerment of local people and neighbourhoods to initiate action themselves. • Leads to measurable and sustainable results at an individual, community, societal level. • Generates social capital (!)

6. What is Community capacity-building? A lot of reasons why it is worthwhile: Trust Confidence Knowledge & skills Social networks & support Fun Empowerment Self-esteem Participation Independence Self worth & Identification Happiness Safety Quality of life Activity

7. What is Community capacity-building? “[…] social capital refers to the networks of social relations that provide access to needed resources and supports … Any study of social capital should encompass the investments that people make […] and the returns to those investments in the form of economic, social and health outcomes for individuals, communities and societies.” Policy Research Initiative (2003), Social capital: Building on a Network Based Approach, Canada, October 2003

8. Why measuring the economic value of community capacity-building? In a world of scarce resources we also need to know: Is CCB good value for money? Can it stop needs before they arise, does it meet them when they do and is there active participation? – Project level Does greater community capacity and governance reduce the demand on the welfare system? – System level

9. How to measure the economic value of Community capacity-building? Befriending Interventions to Older People = Continuous social and emotional support Mead et al., 2010 Reduced Isolation/ Loneliness Mental wellbeing Cacioppo et al., 2006 Wilson et al., 2007 Beekman, 1997 McCusher, 2007  Access to services (£)  Quality of life  (£)  Crises, home services, hospital  (£)

10. How to measure the economic value of community capacity-building? Barriers Lots of qualitative but less of quantitative evidence Process evaluation more common than outcomes evaluation Organic nature of community development (co-production) Cumulative impact over time to a range of beneficiaries

11. How to measure the economic value of community capacity-building? Beneficiaries relationships Direct beneficiaries/ direct involvement No involvement/ Direct beneficiaries Participants e.g. improved health Cares and family members e.g. extra leisure time Direct involvement/ Indirect beneficiaries No involvement/ Indirect beneficiaries Volunteers e.g. self-esteem Population impact e.g. reduced crime rates

12. How to measure the economic value of community capacity-building? Our modelling approach: - Ex-ante model. - Cost-benefit approach. - One year time horizon. - Hypothesis building required. - Comparison group derived from the literature. - Evidence from (grey-)literature, expert opinions - Outcome dimensions: Public service utilisation, productivity, quality of life. - Costs of intervention: from national sources.

13. Example: Time banks • Community currency = Hours of time. • Exchange of skills, practical support, resources (e.g. recreational activities, IT, languages, child minding, transportation). • Low administration costs compared to volunteering schemes: Time bank coordinator and overhead costs, IT support for database. • Range of qualitative and some quantitative evidence from evaluation reports e.g. Rushey Green Practice.

14. Example: Time banks Calculating the net benefit - £450 Resource Input + £506 Economic value service hours + £580 Productivity gains + £240 Reduced benefit claims Average net benefit per person £876 QoL Improvement + £645 Average net benefit per person £1,545

15. Example: Community navigators • Act the interface between the community and public services: Social, emotional and practical support and signposting to public services. • A focus on debt and housing related issues in deprived areas; here: Debt • Evidence on consequences of debt came mainly from two national surveys: the English and Wales Civil and Social Justice Survey 2004, the Advice Agency Client Study 2007 • Effectiveness of intervention from Williams and Sansom 2007, Pleasence et al 2007

16. Example: Community navigators Calculating the net benefit - £340 Resource Input - £180 Debt advice agency + £990 Productivity gains + £140 Reduced benefit claims Average net benefit per person £610 QoL Improvement + £840 Average net benefit per person £1,450

17. Examples • Limitations • Hypothetical, based on assumptions from the literature • Lack of comparison groups (we don’t know for sure what would have happened without…) • Works with averages and ‘typical’ values (service delivery aspects not considered) • Standardised, methodological approach is still missing

18. Where from here? • Policy & research recommendations • Data collection/ self evaluation for CCB projects, with a focus on costs and outcomes; • Development of agreed set of principles and methods for economic evaluation in this area; • New innovative research methods – action research based; • Developing service models (organisational form, ownership, delivery aspects).

19. Where from here? • PSSRU Projects • England CCB (planned start Nov. 2011): wide range of CCB projects; participatory approach; collection of costs and outcomes data over 12 months period via standardised (but locally adjusted) self-evaluation tools • European CCB with focus on older people (envisaged): role and impact of CCB in 5 countries and identification of best practice; innovation models tested against their economic pay-offs; development and scaling up of innovative service models