This document discusses four local authority case studies on using evidence to inform decisions related to adult social care, public health, and community planning. It outlines the challenges local authorities face in accessing, applying, and measuring evidence on wellbeing. Key difficulties include lack of time, difficulty generalizing evidence from other areas, and challenges capturing qualitative impacts like improved wellbeing. Public health is seen as using evidence more rigorously, but social care evidence struggles to be heard in health forums. The document also explores ideas for how the What Works Centre for Wellbeing could help by addressing complex issues, publicizing forthcoming evidence, and providing clear guidance on applying evidence in different contexts.

1. Evidence and wellbeing
Local authority case studies
September 2018
Stewart Martin
stewartmartinemails@gmail.com
www.linkedin.com//in/stewartmartin1
Pippa Coutts
pippa@carnegieuk.org
www.carnegieuktrust.org.uk

2. Local authority case studies

3. Local authority case studies
Four local authorities
• Desk research, field visits and
telephone interviews
• Spoke to: Directors of Public
Health, Heads of Service,
Research Manager, Practice
Experts, Managers, Officers and
Commissioners
• Focused on adult social care and
public health (England),
Community Planning (Scotland)
• Four case study reports
produced.

4. Concept of wellbeing
“It’s hard to find anything that we are doing that isn’t wellbeing. …
Wellbeing is the red thread”

5. Evidence Use
“If it lands on the right day on the right month to be relevant to the thing that you’re
thinking about commissioning then that’s great and that’s good news.
If it doesn’t then it disappears in an overload of emails and the next crisis.”

6. Evidence
The sources of evidence
Local authority staff reported accessing a range of sources of evidence that included:
• regional, national and international networks
• professional and personal networks, utilising LinkedIn and other forums
• industry awards and publications – e.g. the MJ and LGC and their annual awards
• organisations such as the National Institute for Health and Care Excellent, Social Care
Institute for Excellence, Improvement Service, Early Intervention Fund, and Kings Fund
• local corporately produced evidence and intelligence, including research team(s)
• experts-by-experience and co-production
• individual research, with some citing ‘Google’ as their starting point.

7. Evidence
Difficulties in using evidence
1. A primary complaint was a lack of time available to access and review evidence and
share best practice
2. Research evidence is beneficial but difficult to access and often not timely
3. It can be hard to apply good practice from other areas when those areas are
considered to be very different: scale / population / different funding levels
4. Local level data can be difficult to obtain, with national and county-level data proving
less effective when not broken down to a more local level to inform activity
5. Local authorities have lots of data but find it difficult to turn it into evidence
6. Councillors generally preferred local case-study based evidence of impact rather than
more quantitative information or evidence from other parts of the country
7. Professional expertise is an important source but sometimes goes unchallenged
8. Approaches and ability to use evidence differ within the authorities themselves

8. Public health’s approach
“Their evidence is really different and very tight, you know, they have a lot of stats,
they have analysts….
…I don’t feel it’s as tight, my rationale for what I commission… but it’s still evidence-
based I suppose.”

9. Public Health’s approach
Different approaches
• Public health (and health professionals more widely) are thought to have a different
approach to the use of data and evidence when compared to the wider local authority –
generally thought to be more academic, rigorous, quantitative and better resourced
• Non-public health council staff favour more qualitative, case-study based evidence
• Concerns were raised in how social care evidence is received within NHS forums
• Recognition that there are different types of evidence. One interviewee said, “I love a
good bit of data, you have to be aware that the data can’t tell you everything”
• Public health’s reintegration within local authorities in England appears to have been
very positive. In Scotland, local authorities and NHS partners in CPPs and in HSC Boards
• Public health often lead the Joint Strategic Needs Assessment (JSNA) process –
outlining the current and future health and social care needs in their local area

10. Community Planning Approach, in Fife
• Focus on tackling poverty and promoting wellbeing across Fife
• Focus on outcomes. A local outcome improvement plan, led by Fife Partnership
• No additional Council corporate plan
• Underlying delivery plans include the HSC Strategic Plan and the Health Inequalities
Strategy, with more of focus on individual wellbeing
• Area specificity of the plan makes it difficult to use available data sets, such as the
Community Planning Outcomes Profile
• Asked community planning partners what is their vision for Fife
• Monitor progress through the State of Fife report which comprises a set of key indices
corrected for national trends to allow assessment of local impact
• Know Fife data set where can access data for a lot of geographies. Good for smaller orgs
looking for lower level data.

11. Joint Strategic Needs Assessments
“They’re really valuable and they’re really great, they’re just not done often enough
and their data becomes quite old.”

12. Joint Strategic Needs Assessments
Reflection on the use of JSNAs in England
• Demand for JSNA needs assessments is high and local authorities have a significant
challenge in meeting those demands with often limited resources allocated to doing so
• JSNA production has evolved over time and are now often led by those in public health
• Commissioners find it difficult to access appropriate JSNA needs assessments that are
available and up-to-date at the right point in their commissioning cycle
• JSNA needs assessments are being produced across the country but the case studies
offered little evidence of any joint working beyond upper-tier authority boundaries
• It is common for needs assessments to contain lots of data but little evidence of what
works in addressing the problems cited
• Needs assessment formats varied considerably between authorities although all were
held online and supplemented by additional resources

13. Measuring personal
wellbeing
“One client, he smiled for the first time in, like, years and that is massive, but how do
you capture that on some sort of scale?”

14. Measuring wellbeing
Difficulties in measuring wellbeing
• Local authority staff employ a range of wellbeing measurement tools – most commonly
the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS), but also the ONS wellbeing
questions, outcome stars, and through contract monitoring and tools produced in-house
• It is thought to be very difficult to properly evidence impact on individual wellbeing
• There is often a focus on easier to measure activity and outputs rather than outcomes
• Providers organisations often struggle to produce evidence of their impact on
wellbeing, often instead over-relying on case study examples
• Improvements in wellbeing are often assumed without being properly evidenced, their
measurement listed as an apparent afterthought after output and activity measurement
• Focusing on safeguarding is often the priority - it is assumed to improve wellbeing, or at
least prevent its deterioration, but leaves less scope for more aspirational work in
improving individual wellbeing

15. How ‘What Works’ might help
“I dream of the day that we say we’ve found the perfect wellbeing tool.”

16. How What Works might help
Some initial ideas
• Address some of the biggest issues that are methodologically complex such as what
works in: preventing people needing public services; preventing those in social services
getting worse and needing more; helping young people look after themselves; and
preventing mental ill health
• Ensure that evidence of what works is well publicised and forthcoming evidence
reviews and related products and their release dates are published well in advance
• Ensure evidence reviews consider their applicability to different areas e.g.
demographics, scale of funding involved, geographical considerations
• Produce clear pathways: issue  policy problem  what can commissioners and
policymakers do about it  what is the grade of evidence that suggests its effective
• Collate and share examples where evidence of what works has been applied elsewhere

17. How What Works might help
Your further ideas
What else can we do?

18. thank you
www.whatworkswellbeing.org
@whatworksWB