Community services of the future - An evidence review January 2018

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Community services of the future - An evidence review January 2018
Community services of the future
An evidence review

                     January 2018
Community services of the future - An evidence review January 2018
About the Future Social Service Institute
 The Future Social Service Institute (FSSI) is a
 collaboration between the Victorian Council of
 Social Service and RMIT University, funded by
 the Victorian Government.
 FSSI supports the social service workforce to be          Authorised by
 service-delivery leaders at a time of major growth        David Hayward
 and disruption. We:                                       FSSI Director
          CO-DESIGN world-best workforce                  Edited by
           education programs                              Paul Ramcharan
          HELP TRAIN the workforce of the future          and Sally Thompson
          RESEARCH emerging trends and
           opportunities, and                              © Copyright 2018
          EMPOWER not-for-profit organisations to
                                                           Future Social Service Institute
           reorient to a global market.
                                                           e info@futuresocial.org
                                                           p (03) 9925 4619
                                                           w www.futuresocial.org
                                                           t @FutureSocialAU
                                                           f /FutureSocialAU

Page | 2              Community services of the future: An evidence review
Community services of the future - An evidence review January 2018
Contents
Executive summary ................................................................................................................ 5
Key findings ........................................................................................................................... 5
Introduction ........................................................................................................................... 7
CHAPTER ONE Flexible person-centred funding models ........................................................ 10
CHAPTER TWO Place-based services and systems ................................................................ 17
CHAPTER THREE Person-centred services............................................................................ 24
CHAPTER FOUR Workforce of the future for Community Services Industry Plan ...................... 32
CHAPTER FIVE Strengthening outcomes ............................................................................... 41
CHAPTER SIX Information sharing and technological innovation ............................................. 47
CHAPTER SEVEN Regulatory frameworks .............................................................................. 53
CHAPTER EIGHT Governance and leadership ....................................................................... 60
CHAPTER NINE Organisational and industry readiness .......................................................... 67
CHAPTER TEN Embedding evidence .................................................................................... 74
CONCLUSIONS .................................................................................................................... 80
Weighing the evidence for the community services of the future. ............................................ 80
Getting research clever - Vehicles for community sector research in the future ........................ 93
Creating the right conditions for community sector research in the future ................................ 97

Page | 3                      Community services of the future: An evidence review
Community services of the future - An evidence review January 2018
Executive summary
The Future Social Service Institute (FSSI) was commissioned by the Community Service Industry
Plan Working Group to write evidence reviews in 10 areas identified by the community sector as
priorities. The reviews would be designed to inform the Industry Plan and to gauge the future
research needs of the community sector.

Key findings
      The community sector is facing unparalleled changes inter alia:
           demand driven, individualised and marketised systems, new
           regulatory environments, transformations in management practice
           and leadership.

      Based on these 10 evidence reviews, the community sector can be
       characterised as being 'research poor'.

      Reviews of 'person-centred services' and 'place-based services and
       systems' showed little evidence and transferability of findings, were
       hampered by context and jurisdictional differences, and short-term
       research unable to sufficiently address complexity and causation.

      Consistent evidence has emerged around flexible person-centred
       funding. Better outcomes are produced with sufficient funding
       where information and support for decisions is available and where
       there are services and workers to convert funding into outcomes.

      In all reviews linked to outcomes for service users, more research is
       required for hard-to-reach groups and those who have not benefited
       from new policy and practice.

      Four of the 10 reviews explored sector processes: strengthening
       outcomes, regulatory frameworks, governance and leadership and
       organisational and industry readiness. The volume of research in
       these areas was found to be particularly low. Regulatory
       frameworks can change the governance, leadership and outcomes
       adopted in the sector. There is a chance that some approaches may
       undermine the sector’s mission. Research in all four areas is
       required along with research on the impact of new regulatory
       systems on the operation of the sector itself.

Page | 5             Community services of the future: An evidence review
 Two reviews explored future innovation: information-sharing and
       technological innovation, and embedding evidence. The speed of
       technological change applies widely across the sector, but there is
       little research around the impacts of such change. More research is
       needed on the relevance, efficacy and ethics of using Big Data,
       predictive analytics and combining datasets. Good practice in co-
       design has the potential to drive sector change based on the
       continuous flow of information on experiences and outcomes from
       those who use sector services and supports. There remain huge
       questions around sharing data, shared platforms and the
       interoperability of new IT and database systems, which require
       research attention.

      The future workforce will transform out of all recognition, especially
       short-term in the disability sector and longer term in the ageing
       sector. More systematic data collection might be supported by
       worker registration for the sector and by better access to
       administrative datasets. Given the level of change, longitudinal
       research is essential in this area, and in the associated area relating
       to workforce training.

      Wider conditions to support research in the sector suggest the need
       for: substantially greater research funding; more support to
       community sector organisations which would struggle to fund
       research themselves; and clarity on sector outcomes emerging from
       co-designed research that could drive regulation and sustainable
       service change based on best practice.

      Importantly, a way of organising 'dedicated research support' to the
       sector, but independent of any single sector interest, is required.
       Such an arrangement would establish sector-generated research
       priorities. It would search for and bring funding together for
       industry-relevant collaborative research, and it would act as a
       support at the level of co-design and production for the wider
       dissemination.

      A guiding principle of research must always be to explore the extent
       to which the values and mission of the community sector are
       conserved by any new policy, strategy or practice.

Page | 6          Community services of the future: An evidence review
aged care services6. The Productivity
Introduction                                                  Commission estimates the need for 70,000
                                                              additional disability support care workers as
Background                                                    the NDIS rolls out up to 2019-
                                                              1 in 5 of all new jobs created in Australia in
The community sector in Victoria, and more
                                                                                     .7
widely in Australia, is going through and is
prospectively subject to, significant and                     Yet a growing proportion of that workforce is
ongoing change.                                               precariously employed and lower paid and,
                                                              it may be added, is gendered, with four out
The community sector is crucially important.
                                                              of every five of its employees (80%) being
Registered charities alone contribute more
                                                              women. The growing workforce alone
than $13 billion a year to the economy1, and
                                                              represents a significant challenge to the
the sector as a whole, therefore,
                                                              industry as well as to training and career
considerably more. But independent of the
                                                              pathways, as further detailed by Kyle,
economic contribution, the sector
                                                              MacDonald and Bentham in this volume.
strengthens the fabric of Victorian
communities, finds pathways to overcome
poverty and promote active citizenship, acts
                                                                            Yet a growing proportion
as a compass for policy change and
                                                                               of that workforce is
advocacy based on its on-the-ground
                                                                             precariously employed
engagement, supports significant levels of
                                                                             and lower paid and, it
volunteering and is itself a major employer in
                                                                                may be added, is
Victoria.2
                                                                           gendered, with four out of
In A Growing Industry3 the Victorian Council                               every five of its employees
of Social Service (VCOSS) states the                                          (80%) being women.
Victorian community sector employs 150,
000 people, more than any other key
industry in the economy. Due to population                    As the public sector withdraws from direct
growth, an ageing population and the                          service provision, the choice of service by
introduction of the NDIS, the sector will                     consumers, many using individualised
likely grow by 16 per cent between 2015                       funding8, now places the sector in a
and 20204, accounting for almost a quarter                    competitive market9 as block funding is
of all projected employment growth to that                    withdrawn. Whilst expenditure around
year5. The aged care workforce alone will                     individualised funding, particularly in
need to expand from 366,000 to 980,000 by                     disability have risen, sector organisations are
2050 to meet the needs of increasing                          faced with multiple accountabilities and
numbers of older Australians accessing                        outcomes-based funding in new regulatory

1                                                             6
 VCOSS (2015) Building on the value of Victoria's community    Committee TSCAR (2017) Future of Australia's aged care
sector, VCOSS: Melbourne.                                     sector workforce , Commonwealth of Australia: Canberra.
2ibid.                                                        7 Productivity Commission (2017) National Disability
3VCOSS     (2017)                                             Insurance Scheme (NDIS) Costs. Productivity Commission
    community sector charities, VCOSS: Melbourne, p.22.       Study Report: Overview, Commonwealth of Australia:
3   ibid., p.22                                               Canberra.
4ibid.,   p.22                                                8Dickinson H. & Glasby J. (2010) The personalisation
5
 Department of Employment 2017.Regional                       agenda: Implications for the Third Sector , Third Sector
Projections to November 2020. Available from                  Research Centre: Birmingham.
                                                              9
http://lmip.gov.au/default.aspx?LMIP/GainInsights/Em           Davidson, B. (2009) For-profit organisations in managed
                                                              markets for human services , Ch. 3 in King, D. & Meagher,
ploymentProjections.
                                                              G. (eds) Paid Care in Australia: Politics, Profits, Practices,
                                                              Sydney University Press: Sydney, pp.43-79;
environments (see Andrews, this volume),                   The work in each review presents evidence
the community sector will need careful                     in 10 chapters, one contributed by each
thought, leadership and governance as                      author, drawing upon their own academic
Dickinson (this volume) attests. New skills                expertise. The reviews are therefore
may be needed to address these complex                     independent of other interests.
changes when, as has been asserted, the
sector has previously struggled with such
change management.10                                                      In reading the following
                                                                           reviews the reader will
Major, and once-in-a-generation policy shifts
                                                                         very soon become aware
to marketised and personalised services,
                                                                         of the massive job facing
demographic change and workforce
                                                                         the community sector in
demands represent a real threat to the
                                                                            the next decade, the
mission and values of the community sector.
                                                                            huge shift in culture
Evidence in relation to personalisation are
                                                                          required, and the need
addressed by Laragy in this volume, as is
                                                                         for much more evidence
the emergence of place-based approaches,
                                                                             to inform the sector
by Cordoba.
                                                                           through this period of
The changes outlined above represent a                                  'multi-paradigmatic shift'.
'multiple paradigm shift' of immense
challenge. They also take place at a time in
which the rate of change in technology and                 The evidence review was commissioned by
its application in the community sector are                VCOSS and managed by the Future Social
growing, as outlined by Karanasios (this                   Service Institute (FSSI), a collaborative body
volume) and where new forms of evidence                    funded by the Victorian State Government
production are emerging (see Ramcharan,                    and RMIT University, and operating in
this volume).                                              collaboration with VCOSS. The brief was to
                                                           find academic experts who would undertake
The melange of changes outlined will
                                                           a high level environmental scan and analysis
require huge investment for change
                                                           of evidence to support the Victorian
management itself, and longer term as the
                                                           Community Services Industry Plan, which is
community sector seeks transformation One
                                                           presently in development. Each evidence
way of seeking to address the above issues
                                                           review was peer-reviewed by FSSI and
is to explore what evidence exists that has
                                                           edited to meet the brief, but without
the capacity to drive change in the sector.
                                                           changing the arguments and conclusions
This volume, in small measure, seeks to
                                                           drawn by each of the authors.
fulfil this role.
                                                           FSSI was asked to undertake these evidence
Scope of this review
                                                           reviews in 10 key areas by the Community
This volume is made up of 10 evidence                      Services Industry Plan Working Group. This
reviews, which seek to address key issues                  group identified 10 key priority areas in
for the community sector as it develops a                  consultation with the community sector,
Community Services Industry Plan for the                   where further evidence might inform the
coming decade.                                             continuing development of the Industry
                                                           Plan.

10Butcher,  J.        The third sector and government in   Australian Journal of Political Sciences , Vol. 50, No. 1, pp.
Australia: Not-for-profit reform under Labor, 2007-13      148-163.

Page | 8                    Community services of the future: An evidence review
Consequently, the 10 evidence reviews
presented in this volume have been                             In reading the following
undertaken to reflect these 10 identified                       reviews the reader will
priority areas.                                               very soon become aware
                                                              of the massive job facing
After presentation of the 10 evidence                         the community sector in
reviews, a final chapter seeks to distil key                     the next decade, the
messages to inform the Industry Plan and,                        huge shift in culture
further, to gauge the future research needs                    required, and the need
of the sector. In reading the following                       for much more evidence
reviews the reader will very soon become                          to inform the sector
aware of the massive job facing the                             through this period of
community sector in the next decade, the                     'multi-paradigmatic shift'.
huge shift in culture required, and the need
for much more evidence to inform the sector
through this period of 'multi-paradigmatic
shift'.

Page | 9              Community services of the future: An evidence review
of Health and Human Services has a
CHAPTER ONE                                                      procurement policy that purchases goods
                                                                 and services using tenders and grants to
Flexible person-centred                                          provide person-centred services in the fields
funding models                                                   of health, disability, ageing, mental health,
                                                                 families, children, youth and family
Dr Carmel Laragy                                                 violence12. While acknowledging that block
                                                                 funding continues to be used to purchase
Senior Research Fellow, Centre for Applied                       services in these areas, this chapter focuses
Social Research, RMIT University                                 on flexible person-centred funding models
                                                                 using individual funding.
Introduction
                                                                 Differences between individual funding
The introduction of person-centred                               programs nationally and internationally in
individual funding models has been driven                        different sectors tend to make direct
by advocates wanting greater choice and                          comparisons difficult. However, taken
control; and by governments with policies of                     collectively evaluations point to a surprising
human rights and economic imperatives.                           uniformity about success factors and both
Governments believe that a competitive                           large scale randomised studies and small in-
marketplace will deliver more responsive                         depth case studies regularly come to similar
and accountable services11. This chapter                         conclusions. People need adequate funding,
reviews national and international literature                    information and support to make informed
on person-centred individual funding                             decisions, and appropriate services to
models and identifies factors that contribute                    purchase. These factors are shown in Figure
to their success. The Victorian Department                       1.

                  Figure 1: Key factors determining outcomes in person-centred individual funding models

                                                       Funding level

                                            Information           Availability
                                             & support            services &
                                              provided             workers

11ProductivityCommission. (2017). Shifting the Dial: 5 Year      12

Productivity Review. Canberra:                                   https://dhhs.vic.gov.au/funding-grants-and-tenders-0 , (last
https://www.pc.gov.au/inquiries/completed/productivity-          accessed 19th Jan, 2018).
review/report/productivity-review.pdf, Last accessed 18 th
Jan 2018.

Page | 10                   Community services of the future: An evidence review
Case Study
  A widow aged 83 had a Consumer Directed Care aged care package. She regularly
  attended her local church services and functions until her mobility decreased. Church
  members provided her with car transport until the point when she needed more support
  than they could provide. She was distressed at the prospect of being unable to atten d
  church and losing her social network. She spoke to her service provider about changing
  her support arrangements and having a support worker accompany her to church
  services and functions. When her provider was unable to provide staff at the necessary
  times she rang a few others and found one who could assist if she was willing to pay
  penalty rates and reduce her hours of support. She accepted these conditions, changed
  her provider, and continued her social participation and maintained her social network .

The aged care case study above                           Scheme (NDIS) is considered well-funded
demonstrates how individual funding can                  through the initial Medicare levy of 0.5%
give people more choice and control if                   and a further 0.5% levy to be imposed in
service providers are flexible and responsive            201916.
to their needs. In this example an aged care
provider held and managed the older
                                                         funds and 'the person' has some choice as
                         isted with planning
                                                         to where supports are purchased. When
and payments. The guidelines required that
                                                         ref
the funds be spent with a registered service
                                                         family member or representative may be
provider. As funding is a key determinant of
                                                         assisting them. This does not deny that
outcomes, discretion is needed when
                                                         family members may have separate needs
comparing research findings across
                                                         and that their views may differ. Some
programs and across countries. The United
Kingdom (UK) austerity measures have had
                                                         and funds can be spent with few
a devastating impact on programs and the
                                                         restrictions, these exist in some European
outcomes they achieve13. Individual budgets
                                                         countries including Germany17 and Sweden.
have been reduced, and staff have been
                                                         Australia has followed the UK and the US in
pressured to make decisions for people
                                                         requiring that spending be restricted to a
instead of building a relationship and
                                                         tightly defined plan. Key features across four
assisting the person make their own
                                                         key dimensions are shown in Figure 2. The
decisions14. Critics argue that cost cutting
                                                         research studies discussed below often do
measures
                                                         not describe the program design and what
rights, and principles of choice and control
                                                         dimensions exist, which makes comparisons
have been discarded15. In comparison to the
                                                         difficult.

13Larkin, M. & Mitchell, W. (2015) Carers, Choice and    Practitioners? British Journal of Social Work, 46: 3, pp.
Personalisation: What Do We Know? Social Policy &        719-736.
Society, First View Articles, pp.1-17.                   16Productivity Commission.(2017). National Disability
14Lymbery, M. (2014) Social Work and Personalisation:    Insurance Scheme (NDIS) Costs: Study Report . Canberra:
Fracturing the Bureau-Professional Compact? British      http://www.pc.gov.au/inquiries/completed/ndis-
Journal of Social Work , 44, pp.795 811.                 costs/report/ndis-costs-overview.pdf, (last accessed 18th
15Hamilton, S., Tew, J., Szymczynska, P., Clewett, N.,   Jan 2018)
Manthorpe, J., Larsen, J. & Pinfold, V. (2016) Power,    17
                                                            Alakeson, V. (2010) International development in self-
Choice and Control: How Do Personal Budgets Affect the   directed care , Issue Brief, The Commonwealth Fund, 78,
Experiences of People with Mental Health Problems and
                                                         pp.1-11.
Their Relationships with Social Workers and Other

Page | 11                  Community services of the future: An evidence review
Figure 2: Key dimensions of individual funding models Importance for community service organisations

                                   How funds are                                         Where funds can be
  Who holds the funds:
                                     managed:              Assistance provided:               spent:
     Person or service
                                    Self-manage /             Little or none               Open market or
         provider
                               professionally managed                                     registered services

The introduction of person-centred                               evaluations showed that it was quite
individual funding models is changing every                      successfuli.When the program expanded to
aspect of community service organisations'                       the capital Perth, a small number of service
service model. Ethics and values are                             providers used the flexible funding creatively
challenged in a fee-for-service market                           to facilitate community living arrangements
economy where the most vulnerable can be                         for people with disability18. Notably most
overlooked; financial systems have to be
reconfigured to manage individual                                and continued to function as they had under
payments; and workforce recruitment is                           block funding. Most people did not know
precarious with financial resources being                        they had individual funding. This example
                                                                 shows that simply allocating people an
Major cultural and organisational changes                        individual budget does not necessarily bring
are required to navigate this new landscape.                     about change.
Factors that need to be addressed are
                                                                 Victoria commenced the Futures for Young
outlined below. Some factors, such as
                                                                 Adults program in 1996 and allocated an
allocated funding, are beyond an
                                                                 individual budget for students with disability
                                                                 transitioning from school19. The Support &
proactively managed drawing on evidence
                                                                 Choice program followed in 2003. Like
outlined below about maximising outcomes
                                                                 evaluations of many individual funding
in the sector.
                                                                 programs, an evaluation was conducted the
National trends                                                  following year when the program was in its
                                                                 infancy and findings showed upheaval and
Australia has a long history of individual                       uncertainty20. Despite this limitation, the
funding in the disability sector. The Western                    evaluation identified key factors needed for
Australian Local Area Coordination program                       success that are reported in nearly every
commenced in 1988 for people living in                           individual funding assessment. These are
rural and remote areas where there were no                       adequate funding, user friendly processes
services. A network of supports was                              and practices, skilled facilitators, support to
organised for the person that employed                           make decisions and access services and
family and community members

18Forsyth,L., Doyle, N., & Zubrik, R. (2016). Consumer           19Laragy,  C. (2004) Self-determination within Australian
Directed Care reforms: Navigating the competitive aged           school transition programmes for students with a disability
care landscape . Australia:                                      Disability & Society, 19: 5, pp.519-530
                                                                 20
https://home.kpmg.com/au/en/home/insights/2016/08/cons             LIME Management Group (2005) Evaluation of Support &
umer-directed-care-reform-war-for-care-talent.html (last         Choice Implementation: A report for the Victorian
accessed 18th Jan 2018)                                          Department of Human Services

Page | 12                   Community services of the future: An evidence review
supports, available services to purchase,                                 turnover, more unfunded work, and
and a welcoming and inclusive community.                                  more casual and less well-paid work
Two major evaluations of the early stages of                             There is a severe workforce shortage
                                                                          and it is estimated that 1 in 5 new
processes and outcomes. These studies                                     jobs over the next few years will
were conducted by the Productivity                                        need to be in disability support to
Commission21, and the National Institute of                               meet demand
Labour Studies (NILS) at Flinders University,                                                              ere
                                                                          there are insufficient support
evaluation22. Findings from the two studies                               services and no competition the
                                                                          Productivity Commission
are similar and some aspects reflect findings
                                                                          encouraged the NDIS to consider all
from an aged care Consumer Directed Care
                                                                          options to overcome this shortage,
evaluation23:
                                                                          including block-funding and skilled
         Many (but not all) NDIS participants                            migration.
          received more disability supports                              While the majority of NDIS
          than previously, had more choice                                participants did not change
          and control over the supports they                              providers, their confidence grew over
          received, had improvements in their                             time
          quality of care, greater                                       Service providers had to change
          independence and an increase in                                 their business models; there was
          overall wellbeing.                                              increased merger and acquisition
         People who missed out included:                                 activity; entry of new providers; exits
          those with psychosocial disability;                             from the sector; and more guarded
          complex and multiple disabilities;                              relationships between providers
          language and cultural barriers;                                When group-based services ceased
          transitioning into the community                                because of funding changes, some
          from the criminal justice system; the                           participants lost the opportunity to
          homeless; and the socially isolated.                            mixed socially
                                                                         Some non-NDIS participants
         Poor quality of staff and NDIS                                  received fewer services while others
          workforce pricing constraints are
          negative factors                                                received no supports at all
         Planners need specialised training to                          Support for carers (within and
          engage in pre-planning and planning                             outside of the NDIS) diminished with
          conversations and produce quality                               the introduction of the NDIS.
          plans
         The workforce had decreased
          opportunities for training, increased

                                                                disability-insurance-scheme/ndis-evaluation-intermediate-
21Productivity Commission.(2017). National Disability           report (Last accessed 18th Jan 2018)
                                                                23Department of Social Services. (2015). Formative
Insurance Scheme (NDIS) Costs: Study Report . Canberra:
http://www.pc.gov.au/inquiries/completed/ndis-                  evaluation of the Home Care Packages Programme:
costs/report/ndis-costs-overview.pdf (last accessed 18th        Detailed findings report.
Jan, 2018)                                                      https://agedcare.health.gov.au/sites/g/files/net1426/f/docu
22Mavromaras, K., Moskos, M., & Mahuteau, S.                    ments/09_2015/formative-evaluation-of-the-home-care-
(2016).Evaluation of the NDIS, Intermediate Report .            packages-programme-detailed-findings-report.pdf (Last
National Institute of Labour Studies (NILS), Flinders           accessed 18th Jan 2018)
University. https://www.dss.gov.au/disability-and-
carers/programs-services/for-people-with-disability/national-

Page | 13                    Community services of the future: An evidence review
Major national and international                              Support
trends                                                        Across all sectors the provision of support
Professor Beresford from the Centre for                       was a key success factor in individual
Citizen Participation at Brunel University,                   funding programs. The UK offered everyone
London classified findings from his studies                   receiving disability support Direct Payments,
on individual funding programs under eight                    which is a self-managed model that requires
headings24. These headings will be used                       people to manage with no assistance.
below to present a summary of the literature                  People could pay for coordination support
reviewed and to point to best sector practice                 from their allocated budget, as occurs in
given the evidence reviewed above.                            Australian aged care Consumer Directed
                                                              Care programs. UK evaluations found that
Funding                                                       vulnerable people, e.g. the aged29 and those
                                                              with mental illness30 struggled to self-
Welfare spending cuts in the UK25 and the
                                                              manage and did not record positive
USA26 have severely reduced service
                                                              outcomes.
provision. Australia is in the 'fortunate'
position of having NDIS disability support                    In contrast, the United States (US) Cash and
funding increased with the Medicare levy.                     Counseling program conducted in 15 states
Other areas of social services such as                        demonstrated the benefits of providing
health, education and aged care struggle to                   planning and administrative assistance. All
provide services within their allocated                       people self-directed their supports and
budgets. Despite this injection of funds into                 managed their services, including vulnerable
disability services, not everyone needing                     aged31and others with mental health
support has all their needs met27. There are                  issues32. The extensive randomised
also grave concerns for people with disability                controlled evaluations using qualitative and
deemed ineligible for the NDIS because                        quantitative measures found that most
previously available state-based services are                 people achieved positive outcomes. The
closing28. Yet adequate funding and                           significant difference between the UK and
coverage are key components that produce                      US models was the unlimited planning and
best outcomes.                                                administrative assistance provided in the US
                                                              to the person being supported at no
                                                              additional cost to them. The support staff

24                                                            29
  Beresford, P., Fleming, J., Glynn, M., Bewley, C., Croft,     Moran, N., Glendinning, C., Wilberforce, M., Stevens, M.,
S., Branfielde, F. & Postle, K. (2011) Supporting People:     Netten, A., Jones, K., Jacobs, S. (2013) Older people's
Towards a person-centred approach, The Policy Press:          experiences of cash-for-care schemes: evidence from the
Bristol.                                                      English Individual Budget pilot projects Ageing and
25
  Department of Social Services. (2015). Formative            Society, 33: 5, pp.826-851.
                                                              30
evaluation of the Home Care Packages Programme:                 Hamilton, S., Tew, J., Szymczynska, P., Clewett, N.,
Detailed findings report.                                     Manthorpe, J., Larsen, J., & Pinfold, V. (2016) Power,
https://agedcare.health.gov.au/sites/g/files/net1426/f/docu   Choice and Control: How Do Personal Budgets Affect the
ments/09_2015/formative-evaluation-of-the-home-care-          Experiences of People with Mental Health Problems and
packages-programme-detailed-findings-report.pdf, (last        Their Relationships with Social Workers and Other
accessed 18th Jan 2018)                                       Practitioners? British Journal of Social Work , 46: 3,
26USAhttp://money.cnn.com/2012/08/09/news/economy/we          pp.719-736.
lfare-reform/index.htm (last accessed 18th Jan 2018)          31San Antonio, P., Simon-Rusinowitz, L., Loughlin, D.,
27Warr, D., Dickinson, H., Olney, S., Hargrave, J.,           Eckert, J. K., Mahoney, K. J., & Ruben, K. A. D. (2010)
Karanikolas, A., Kasidis, V., Wheeler, J. (2017). Choice,      Lessons from the Arkansas cash and counseling program:
control and the                                               How the experiences of diverse older consumers and their
NDIS.http://socialequity.unimelb.edu.au/news/news-            caregivers address family policy concerns Journal of Aging
archive/choice-control-and-the-ndis-report, (last accessed    and Social Policy, 22: 1, pp.1-17.
18th Jan 2018)                                                32
                                                                Barczyk, A. N., & Lincove, J. A. (2010) Cash and
28
  LIME Management Group (2005). Evaluation of Support &       counseling: A model for self-directed care programs to
Choice Implementation: A report for the Victorian             empower individuals with serious mental illnesses Social
Department of Human Services.                                 Work in Mental Health, 8: 3, pp.209-224.

Page | 14                     Community services of the future: An evidence review
providing personal assistance worked to                     Informal care
establish a positive relationship with the
person. Sector outcomes are likely to be                    A literature review conducted in 2015
better where such support is provided.                      examined the impact of individual funding
                                                            on carers of people with mental illness. This
Workforce
                                                            for carers when the person receiving support
Two recent NDIS workforce reports raised
                                                            spent less time in psychiatric hospitals and
concerns that have implications across all
                                                            criminal justice settings, gained employment
social service sectors. The Productivity
                                                            and had a better quality of life36. However,
Commission reported workforce shortages33,
                                                            carers became stressed and burdened when
and a joint university-union study found that
                                                            no appropriate support was available to
pay rates for support workers were too low to
                                                            assist with managing support services and
attract and retain a suitably skilled
                                                            these tasks fell to family carers. The
workforce34.
                                                            Productivity Commission also reported
                                                            positive outcomes for some carers
                                                            participating in the NDIS, although little data
                Casualisation of the
                                                            were available, and they recommended
              workforce and split shifts
                                                            more data be routinely collected4. As some
                were increasing and
                                                            marginalised NDIS participants did not gain
              workers were not paid for
                                                            any benefits from the NDIS, it follows that
                    travel time.
                                                            their carers probably did not as well. Flexible
                                                            individualised funding models need to
This report identified a wide range of                      consider their effects on with family
workforce concerns including low pay rates,                 caregivers and maximise their benefits.
not allowing time for mandatory training,                   Institutionalisation
building relationships with participants,
communicating with supervisors and other                    Beresford found in his individual funding
workers, or the completion of paperwork.                    studies in the disability (including mental
Casualisation of the workforce and split                    health) and aged care sectors that some
shifts were increasing and workers were not                 organisations continued to expect people to
paid for travel time. Similar issues were                   fit into their regime. The organisations were
identified in the UK35. A major exploration of
workforce changes is required as a result of                needs. Similarly, an Australian aged care
the introduction of flexible funding and                    study of Consumer Directed Care found that
marketised services (see MacDonald, this                    change management was challenging when
volume).                                                    all systems, processes and attitudes had to
                                                            change radically37. Strong sector leadership

33Hamilton,   S., Tew, J., Szymczynska, P., Clewett, N.,    35Hussein,  S. & Manthorpe, J. (2012) Structural
Manthorpe, J., Larsen, J. & Pinfold, V. (2016) Power,         marginalisation among the long-term care workforce in
Choice and Control: How Do Personal Budgets Affect the        England: evidence from mixed-effect models of national
Experiences of People with Mental Health Problems and         pay data Ageing and Society, 34: 1, pp.21-41.
Their Relationships with Social Workers and Other           36You, E., Dunt, D. & Doyle, C. (2017) How would case

Practitioners? British Journal of Social Work , 46:3,                                                 -directed care
pp.719-736.                                                 environment in Australia? Health and Social Care in the
34Cortis, N., Macdonald, F., Davidson, B. & Bentham, E.     Community, 25: 1, pp.255 265.
(2017) Reasonable, necessary and valued: Pricing            37Laragy, C. & Allen, J. (2015) Community aged care case

disability services for quality support and decent jobs ,   managers transitioning to consumer directed care: more
SPRC, Sydney.:                                              than procedural change required Australian Social Work,
https://www.sprc.unsw.edu.au/media/SPRCFile/NDIS_Prici      68: 2, pp.212 227.
ng_Report.pdf (last accessed 18th Jan 2018)

Page | 15                   Community services of the future: An evidence review
and peer support were effective in assisting                people were accessing more mainstream
with change management (see Dickinson,                      services, improvement is needed if inclusion
this volume).                                               is to be achieved.

Organisational structures                                   The transition to a market-led service system
                                                            is blurring the distinction between specialist
Beresford found that organisational                         and mainstream services. Specialist service
structures can be overly bureaucratic,                      providers are required to compete in an
dominated by managerialism and                              open market and their viability is precarious
preoccupation with negative risk which                      if they cannot adapt. There are also
                                                            concerns a market service system is leaving
Similar observations have been made of the                  vulnerable people without support if they
NDIS38. Models achieving dignity of risk                    cannot navigate the service system.
tend to produce better outcomes as
                                                            Person-centred individual funding models
evaluated by those using services.
                                                            have been widely promoted as increasing
Occupational practice
                                                            assumption that people can purchase
Numerous Australian and international                       services and supports from a wide selection
studies reported that professional staff often              in the marketplace. However, there are
found it difficult to adapt to new ways of                  intrinsic tensions in a market economy
working which required them to share power                  where no one is responsible for protecting
with people using the service39.                            the rights of vulnerable people. Disability
Professionals had to unlearn old practices of               advocates who lobbied for the introduction
having authority to make decisions about                    of individual funding envisaged collective
                                                            peer support40. However, this ideal has not
facilitate and empower others. Many                         been realised, especially where: there are
professionals found this change threatening                 budget cuts; no support is provided; and
and challenging. As with institutional                      there are no appropriate services to
change, strong leadership, training and peer                purchase. Interestingly the Productivity
support contributed to effective change                     Commission recently suggested that block
management strategies.                                      funding be reconsidered in areas where
                                                                                     and necessary
Access to mainstream services
                                                            services have not emerged in the market.41
The Productivity Commission4 identified that
the interface between NDIS disability and
mainstream services is poorly defined and
better coordination is needed between
different levels of government. While some

38USA:                                                      40Mladenov,  T., Owens, J. & Cribb, A. (2015)
http://money.cnn.com/2012/08/09/news/economy/welfare-        Personalisation in disability services and healthcare: A
reform/index.htm (Last accessed 18th Jan, 2018) Warr, D.,   critical comparative analysis Critical Social Policy, 35: 3,
Dickinson, H., Olney, S., Hargrave, J., Karanikolas, A.,    pp.307 326.
Kasidis, V.,   Wheeler, J. (2017) Choice, control and the   41Hamilton, S., Tew, J., Szymczynska, P., Clewett, N.,

NDIS: http://socialequity.unimelb.edu.au/news/news-         Manthorpe, J., Larsen, J. & Pinfold, V. (2016) Power,
archive/choice-control-and-the-ndis-report (Last accessed   Choice and Control: How Do Personal Budgets Affect the
18th Jan, 2018)
39You, E., Dunt, D. & Doyle, C. (2017) How would case
                                                            Experiences of People with Mental Health Problems and
                                           -directed care   Their Relationships with Social Workers and Other
environment in Australia? Health and Social Care in the     Practitioners? British Journal of Social Work , 46: 3,
Community, 25: 1,pp.255 265                                 pp.719-736.

Page | 16                  Community services of the future: An evidence review
driven by the central idea that for the
CHAPTER TWO                                                   provision of effective services stakeholders
Place-based services and                                      process to address the issues as they are
systems                                                       experienced within a geographical space, be
                                                              it a neighbourhood, a region or an
                                                                          42
Dr Pushkar Sebastian Cordoba                                                .

Lecturer, Social Work, GUSS, RMIT                             Place-based services and systems have
University                                                    been the focus of significant attention over
                                                              the past few years at a policy, research and
                                                              community level43 44 45 46. This interest is
Introduction                                                  driven by the central idea that the complex
                                                              psychological, health and social issues that
An overview of the key literature and                         people experience require government and
evidence for place-based services and                         community sector services that concentrate
systems requires consideration of the main                    on the social and physical environments,
understandings and debates in this                            working collaboratively with all key
emergent area, highlighting the evidence                      stakeholders. There is significant evidence
base for these approaches and case studies                    to demonstrate the relationship between
exemplifying what such approaches look like
when operationalised. These are provided                      including for example the extensive work on
below and consequent to these a series of                     the Social Determinants of Health47 48.
points relevant to the community sector are                   Research has conclusively shown that
presented as topics for future discussion.                    people living in disadvantaged areas have
                                                              poorer outcomes in key indicators including
Literature on place-based services
                                                              health, education, employment and general
and systems                                                   wellbeing49 50 51. This is not to say that these
Defining what constitutes place-based                         issues are limited to people living in certain
services can be challenging given the                         areas, one of the limitations of this approach
absence of a universally agreed upon                          but, rather, that services need to take into
definition. Despite this, there are some                      consideration the significant influence that
common characteristics to all approaches,                     place and context has on health and
                                                              wellbeing. In addition to individual

42
  Bellefontaine, T. & Wisener, R. (2011) The Evaluation of    47
                                                                   Commission on the Social Determinants of Health (2008)
Place-Based Approaches: Questions for Further Research :      Closing the Gap in a Generation: Health Equity through
Policy Horizons, Canada.                                      Action on the Social Determinants of Health , World Health
                                                              Organisation: Geneva, Switzerland
43                                                            48
  Moore, T.G. & Fry, R. (2011) Place-based approaches to         Hughes, P., Black, A., Kaldor, P., Bellamy, J. & Castle, K.
child and family services: A literature review , Murdoch      (2007) Building Stronger Communities, University of New
                                                              South Wales Press: Sydney, NSW.
Hospital Centre for Community Child Health: Parkville,        49
                                                                 Australian Institute of Health and Welfare (1999) The
Victoria                                                      Burden of Disease and Injury in Australia , AIHW cat. No.
44
   Smyth, P. (2008) Place based policy at the crossroads:     PHE 17.
A summary report of the social inclusion and place based      50
                                                                 Edwards, B. & Bromfield, L.M. (2009) Neighborhood
disadvantage workshop, Brotherhood of St Laurence:                                                                        -
Fitzroy, Victoria.                                            social behavior: Evidence from an Australian national
45
    Ibid                                                      sample Children and Youth Services Review , 31: 3,
46
   Wilks, S., Lahausse, J. & Edwards, B.                      pp.317-324.
(2015) Commonwealth place-based service delivery              51
                                                                  Baum, S. (2008) Suburban Scars: Australian Cities and
initiatives: Key learnings project, Australian Institute of   Socio-economic Deprivation, Urban Research Program
Family Studies: ACT                                           Research Paper 15, Urban Research Program, Griffith
                                                              University: Brisbane, Queensland.

Page | 17                      Community services of the future: An evidence review
approaches, place-based approaches                                     Government and community sector
provide a strategy to address issues like                               services specifically designed to
disadvantage and health inequality by                                   meet the needs of communities,
developing services and systems that are                                groups, locations of communities
designed to collaboratively meet the specific                           and all relevant stakeholders being
needs of a particular location52 53.                                    engaged to foster collaborative
                                                                        decision making.
                                                                       A partnership-based approach
               Place-based approaches                                   between all stakeholders including
                  provide a strategy to                                 the community sector and the
                   address issues like                                  broader community, between service
                disadvantage and health                                 providers, and between
                inequality by developing                                communities, community sector and
               services and systems that                                government.
                      are designed to                                  A particular emphasis on developing
                 collaboratively meet the                               local skills and capacity building
                   specific needs of a                                 The ability of services and systems
                   particular location.                                 to adapt to new learnings
                                                              Stakeholder interests being seen as one
Place-based approaches have been                              aspect of a larger framework for service
developed both locally and internationally to                 delivery that also encompasses individual
address a varied range of policy issues                       and broader policy work programs that
including health54, housing55, mental                         require time and adequate funding and
                                                              resourcing focusing on long-term outcomes.
health56, social inclusion57, family wellbeing58
and sustainability59. Despite this great variety              Furthermore, the literature identifies the
of topics and approaches, the literature60 61                 main characteristics of effective place-based
identifies a series of guiding principles that                approaches62, which include:
are shared by place-based interventions                                Multilevel approaches that focus on
regardless of context, which include:                                   individual need and larger contextual
                                                                        factors.

52Churchill, B., Doherty, Y. & Hansen, E. (2012) People       based-service-delivery-initiatives/executive-summary (last
and Place: Developing a Research Program for                  accessed 18th Jan 2018).
                                                              58
Understanding and Addressing Place-based Health                 Australian Institute of Family Studies (2010). The national
Inequities in Tasmania, University of Tasmania/Department     evaluation of the Communities for Children initiative . Family
of Health and Human Services: Tasmania.                       Matters No. 84. https://aifs.gov.au/publications/family-
53Yeboah, D.A. (2005) A framework for place based health      matters/issue-84/national-evaluation-communities-children-
planning Australian Health Review , 29: 1, pp.30-36.          initiative (last accessed 18th Jan 2018).
54                                                            59
  Department of Education (2015) An Overview of Child           United States Environmental Protection Agency (2014).
and Family Centres:                                           Partnership for Sustainable Communities: Five Years of
https://documentcentre.education.tas.gov.au/Documents/O       Learning from Communities and Coordinating Federal
verview-of-Child-and-Family-Centres.pdf (last accessed 18th   Investments, https://www.epa.gov/smartgrowth/partnership-
Jan, 2018).                                                   sustainable-communities-five-years-learning-communities-
55Klein, H.          Neighbourhood renewal: revitalising      and-coordinating (last accessed 18th Jan 2018).
disadvantaged communities in Victoria Public                  60Centre for Community Child Health (2011) Place-based

Administration Today, 1: 1: pp.20-29.                         approaches to supporting children and families, CCCH
56Department of Health (2016) Support for Day to Day          Policy Brief No. 23, Centre for Community Child Health,
Living in the Community:                                                            Hospital: Parkville, Victoria.
http://www.health.gov.au/internet/main/publishing.nsf/conte   61Department of Health and Human Services (2012) Place-

nt/mental-d2dl (last accessed Jan 18 th, 2018).                  Based Approaches to Health and Wellbeing Issues Paper,
57Australian Institute of Family Studies (2015)                  Tasmanian Government: Hobart, Tasmania.
                                                              62
Commonwealth Place-Based Service Delivery Initiatives,           Centre for Community Child Health (2014) The evidence:
Key Learnings project, Research Report No. 32:                what we know about place-based approaches to support
https://aifs.gov.au/publications/commonwealth-place-                           : Centre for Community Child Health,
                                                                                            , Parkville, Victoria.

Page | 18                   Community services of the future: An evidence review
     Collaboration and improved                         evaluations. It is therefore challenging to
           communication between                              conclusively demonstrate an impact6667.
           communities and services.
                                                              Varying forms of evaluation methods have
          Prioritising the co-design of services             been utilised to measure the impact of
           creating opportunities for the
                                                              place-based approaches, including
           community.                                         formative, summative, impact and
          Utilising and building on community                developmental approaches68.
           strengths and competencies to
           create sustainable change.
          Tailoring services to meet local
           needs.                                                           measurement methods]
          Having adequate time and                                        fall short of capturing the
           resourcing.                                                    full range of policy issues,
          Using evidence-based interventions                               local perspectives, and
           with a clear theory of change.                                 learning processes at play
                                                                            when governments seek
                                                                              to enable bottom-up
Evaluations and the evidence base
                                                                                   community
Place-based services and systems have                                            development.
faced several challenges in order to
demonstrate their effectiveness. There are
numerous difficulties that have arisen from                   There is a clear tension between the
past attempts at evaluations, including                       approaches, characterised by attempts to
poorly designed methodologies and the
inherent challenges of demonstrating                          that utilise more process and community
causality with complex multifaceted issues63.                 experience focused designs69. The literature
The existing research is varied with evidence                 identifies the further development of
of place-based approaches having                              evaluation methods as an area that requires
measurable improvements in some cases64,                      significant attention in order to demonstrate
but also questionable impacts in others65.
Addressing issues like health inequality                      and performance measurement serve
through place-based services for example,                     primarily as management tools for decision,
may take several generations or involve                       making and accountability purposes. They
causal factors beyond the scope of short                      fall short of capturing the full range of policy
term place-based approaches or                                issues, local perspectives, and learning
                                                              processes at play when governments seek to

63Wilks,  S., Lahausse, J. & Edwards, B.                      inequalities work? A systematic review of evidence Critical
(2015) Commonwealth place-based service delivery              Public Health, 17: 4, pp.317-335.
initiatives: Key learnings project, Australian Institute of   67Griggs, J., Whitworth, A., Walker, R., McLennan, D. &

Family Studies: ACT.                                          Noble, M. (2008) Person- or place-based policies to tackle
64Neighbourhood Renewal Unit (2005) Research report 17:       disadvantage?: not knowing what works , Joseph Rowntree:
NDC 2001 2005 an interim evaluation, The Stationery           York, UK.
Office (TSO): London: http://extra.shu.ac.uk/ndc/ (Last       68 Wilks, S., Lahausse, J., & Edwards, B.

accessed 18th Jan, 2018).                                     (2015) Commonwealth place-based service delivery
65Pastor Jr, M., Benner, C. & Matsuoka, M. (2015) This        initiatives: Key learnings project : Australian Institute of
could be the start of something big: How social movements     Family Studies, ACT.
                                                              69
for regional equity are reshaping metropolitan America ,        Kelly, T. (2010) Five simple rules for evaluating complex
Cornell University Press: New York.                           community initiatives Community Investments, 22:
66                                        Macdougall, C.      1,pp.99-22, p.36: www.frbsf.org/publications/community/
(2007) Do area-based interventions to reduce health           investments/1005/T_Kelly.pdf

Page | 19                   Community services of the future: An evidence review
enable bottom-up community                                    elements needed in an evaluation, most of
                   70
                                                              which are absent in the field, including:
Developmental methods have been the                                    Causality Evaluating place-based
focus of recent literature given their                                  services needs to be done using
suitability in responding to the needs of                               international best practice such as
complex and constantly evolving service                                 matched comparison areas,
systems and communities71 72. The method                                longitudinal data and sophisticated
prioritises a continuous and collaborative                              statistical analyses since using
approach to evaluation that is iterative and                            randomised trials is difficult.
developed concurrently with the program. In                            A theory of change Evaluations
doing so it provides a more flexible and                                require a clear program logic to
inclusive approach for evaluating innovative                            demonstrate the link between goals,
service systems.                                                        actions and outcomes so that they
                                                                        can be measured.
Another key and emergent concept is that of
contribution analysis73. Contribution analysis                         Attribution Considering the
is a more recent approach to evaluation that                            influence that other programs at a
can provide a systematic process for                                    local, state or national level may
determining the effectiveness of place-based                            have when trying to determine the
services. The focus is on determining the                               effectiveness of a program, as there
causal links between complex issues,                                    may be several overlapping services
communities, interventions, theories of                                 operating in the one area to address
change and outcomes74.                                                  a similar issue
                                                                       Residential mobility Any methods
                                                                        utilised need to account for
                   Another key and                                      population flows into and out of the
              emergent concept is that                                  area in determining whether the
               of contribution analysis.                                system is effective
                                                                       Cost-effectiveness Analysis of the
                                                                        costs related to the provision of
In 2015, Wilks et al75 compiled a wide-                                 services, including clarity about the
ranging analysis of Commonwealth place-                                 long-term benefits.
based service delivery initiatives, with an
emphasis on both local and international
examples of programs and their evaluation.
The authors highlight the importance of
evaluation for place-based approaches. In
their analysis they identified five critical

70Bradford, N., and Chouinard, J. (2010). Learning through    73 Stocks-Rankin, C.-R. (2014) Reflective Literature Review
Evaluation? Reflections on Two Federal Community              of Contribution Analysis [online]
Building Initiatives. The Canadian Journal of Program         http://blogs.iriss.org.uk/contribution/files/2015/06/Reflective
Evaluation 24, no. 1: 55‐77.                                  -Literature-Review-of-Contribution-Analysis-Stocks-Rankin-
71 Bellefontaine, T. & Wisener, R. (2011) The Evaluation of   2014.pdf
Place-Based Approaches: Policy Horizons, Canada.              74 Bellefontaine, T. & Wisener, R. (2011). The Evaluation of

http://www.horizons.gc.ca/en/content/evaluation-place-        Place-Based Approaches. Canada: Policy Horizons, op cit.
                                                              75Wilks, S., Lahausse, J. & Edwards, B.
based-approaches (Last accessed 19th Jan, 2018).
72
   Patton, M.Q. (2011). Developmental Evaluation: Applying    (2015) Commonwealth place-based service delivery
Complexity Concepts to Enhance Innovation and Use: The        initiatives: Key learnings project , Australian Institute of
Guilford Press, New York.                                     Family Studies: ACT.

Page | 20                   Community services of the future: An evidence review
Case studies
To better contextualise some of the points raised in this paper, two specific examples of place-
based approaches both locally and internationally help to demonstrate what such approaches
entail and what they can achieve.

 New Deal for Communities - UK
 The NDC program was launched in 1998 by the British government with the aim of reducing
                                                                                      1
                                                                                       . The
 program operated for 10 years spending £1.71bn on supporting locally developed strategies
 that led to over 6,900 services or projects.1 The program sought to achieve its main aim by
 establishing partnerships in 39 areas, each region with approximately 9,900 people, to
 achieve six key objectives.1
        Transform the 39 areas over 10 years
        Achieving holistic change in relation to three place-related outcomes: crime,
         community, and, housing and the physical environment, and three people-related
         outcomes: education, health, and unemployment
                              tween these 39 areas and the rest of the country
        Achieve value for money transformation of these neighbourhoods
        Secure improvements by working with other delivery agencies such as the police,
         Primary Care Trusts, schools, JobcentrePlus1, and their parent local authority
        Sustain a local impact after NDC Program funding ceased
 Using an outcomes-based approach the final evaluation report1identified NDC areas as

 unemployment, community and housing and the physical environment; for 26 out of the 27
                                                                                           1

 recognition that this change was brought about because of NDC initiatives. The evaluation
 found that more broadly the NDC had: begun to reduce the gaps in NDC areas compared
 with the rest of the country, the program was cost effective, partnerships between service
 providers improved, efforts to engage local communities were positive but required significant
 consistency and commitment.
 While the program had a demonstrated positive impact in certain regards, further analysis of
 longitudinal and cross-sectional data has highlighted some limitations in the findings from the
 evaluation and the disparity between different NDC areas.1 Further criticism centred on the
 level of community participation in the program.1
Go Goldfields - Australia
Go Goldfields is a place-based approach to service delivery initiated by The Central Goldfields
Shire Council in 2010. Their aim was to develop a collaborative approach to addressing some
of the pressing issues facing the local area1. The program is an alliance of over a dozen
organisations and receives funding from the Victorian state government and other partners.
In Victoria, the Central Goldfields Shire has rated 79th out of the 79 local government areas
on numerous health and social indicators, highlighting the need for a more holistic and
place-based approach.1 The main outcomes were:

        a reduction in the incidence of notifications to DHS Child Protection Services
        improved communication and literacy skills, more opportunities and positive life
         experiences for children and their families
        improved community connectedness for children, youth and families
        improving youth connection to appropriate training and education to achieve
         employment outcomes;
        increased breastfeeding rates.

The result is a series of action groups, programs, services, health and educational campaigns
and strategies aimed at achieving the outcomes. Further details about the programs and the
groups can be found on the Go Goldfields website1.
In 2015, the first evaluation report was published identifying possible improvements in some
areas and clear challenges and limitations, characteristic of several place-based
approaches1. The evaluation applied a Collective Impact framework, focusing on process and
experience. Several methods were utilised with qualitative and quantitative data collected
using surveys, interviews and secondary statistical data analysis. The evaluation report
identifies a greater awareness from the community of early childhood communication and
literacy needs, some improvement in childhood development data, improved service
coordination and greater opportunities for social connections. Challenges are predominantly
characterised by the difficulties of programs to address intergenerational issues (impact of
parent literacy on child literacy), the impact of broader structural issues (employment
opportunities) and poor levels of engagement from the community (potentially undermining

While the program has clear benefits in some respects, the limitations highlight some of the
main issues that need greater consideration into the future.
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