Page 9 - WCEN Dr Rochelle Burgess evaluation report\ Baloon

Executive Summary
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Executive Summaryy
The following evaluation report presents findings from a multi-site ethnography of the Wandsworth
Community Empowerment Network (WCEN). Development of a theoretical model highlighted that the
WCEN approach was theoretically innovative through its development of a preparatory stage prior to
coproduction activities. This initial phase is cognisant of the importance of shifting power relationships,
developing trust within and across groups in the network, and committing to engaging in these
supportive processes over time. This key phase led to a series of specific outcomes for both
communities and statutory partners, who worked collectively to coproduce health services in Wands-
worth.
Findings highlighted that the WCEN model resulted in significant shifts at four key levels: identities,
ideas, practices and individuals. Evidence demonstrated that identities of communities have shifted,
because of a process of empowerment, which shaped the way communities participated in ventures
with one another and with statutory agencies. Statutory agencies views of communities shifted,
viewing them as meaningful partners, autonomous actors, with important assets to contribute to
mutual engagements. This fed into shifts in the conceptualisation of coproduction. The nature of
practices of engagements between statutory and community groups shifted. These changes included
the development of safe-spaces, which shifted engagement between statutory agencies and commu-
nities within environments for mutual learning and a tangible space to redress imbalances of power.
Barriers to systems change included risk adversity within statutory agencies, primarily around financial
risk. However, some evidence suggested that risk adversity might be linked to issues of shifting power
to communities. Other barriers included professional values such as a view of the individualisation of
health and views of coproduction, that only value nominal participation from communities. Findings
also suggested that redistribution of financial resources would help to solidify small systems change
currently achieved within the WCEN network.
Risks to the future development of the network linked to dangers around scaling-up work before
capacity had been built, the need to foster community resilience to shifts in wider political priorities and
reforms. The risk of losing organisational identity was also noted as formalisation of the network could
affect the qualities of passion and commitments that underpin current engagements. Lastly, concerns
were raised around the likelihood of coproduction being positioned solely as a cost-savings activity,
which would therefore limit its ability to result in meaningful changes within communities that could
lead to a reduction of inequalities.

The report concludes with recommendations in three key areas to sustain progress and to build on
current strengths in systematic ways. First, there is a need to streamline focus in programmatic areas,
in order to avoid burn out of already over-committed, albeit passionate individuals. Secondly, WCEN
should work towards distributing leadership across the network. This would even out capacity in
community sites that are less developed, and bolster the capacity of well-established sites for the
delivery of services. This is critical in supporting future expansion in relation to new coproduction
projects. Thirdly, the report suggests WCEN should commit resources to develop mechanisms of
accountability within the network. Specifically, efforts should be made to establish a framework of
monitoring and evaluation of health improvements and patient outcomes linked to coproduced
interventions. The formal health economy in the United Kingdom (UK) is currently facing a series of
challenges in maintaining high quality service delivery amidst a climate of restructuring and cost
savings.

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