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 13 th October 2011 Annette Bauer Personal Social Services Research Unit (PSSRU) London School of Economics and Political Science

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.

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). Building the economic case for community capacity-building 3

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? Building the economic case for community capacity-building

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 (!)

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

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 Why measuring the economic value of community capacity-building?

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

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 How to measure the economic value of community capacity-building? Barriers

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

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.

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

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

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

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

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).

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