There is widespread acknowledgement that youth work is crucial in addressing inequalities, and a beneficial aspect of informal education, care and support for young people. Despite such acknowledgement, evidencing this work is challenging.
Working alongside Chilypep, a young people’s empowerment project, we organised three workshops between January and March 2022 with stakeholders from the voluntary community sector (VCS) asking:
• From your experience, what are the key priorities that need addressing to reduce health inequalities for children and young people?
• How does the work the VCS currently do address or contribute to reducing health inequalities? What’s different/unique about your approach?
• What research is needed to enable the VCS youth sector to maximise its contribution to reducing inequalities?
The workshops were well attended by a range of professionals from across England, and included primarily VCS members but also academic, NHS and statutory service members. The work the organisations provided was eclectic, ranging from open youth work provision to targeted work with young cares and young offenders, to LGBTQ+ support groups and work with young families. This resulted in diverse discussions and perspectives. Over the three sessions we had around 50 participants.
Key messages from the workshops
Reducing ‘patchy provision’
Echoing the broad and diverse range of topics relevant to young people’s health and wellbeing in which VCS youth services are engaged, ‘key priorities’ to reduce health inequalities for young people were eclectic, and often linked to the specialisms of the participants (e.g., trauma-informed care, addressing sedentary lifestyles/obesity levels, better employment services, work to tackle food poverty, addressing loneliness/isolation, support for care leavers, gender dysphoria). Crucially, poverty was discussed as a salient and pervasive issue across all priority areas.
A recurring topic was greater funding for youth services to increase service capacity, availability and accessibility. This was particularly the case in light of what was described as a ‘postcode lottery’ of service provision and access to services, and ‘patchy provision’ due to funding priorities within and across different areas.
‘Access to youth provisions is patchy due to government funding being withdrawn’ (Participant)
A tension between focusing on generic and universal services vs more bespoke and targeted services for at ‘risk’ groups was identified, alongside wider calls for greater early identification and early intervention work. A suggested way to overcome issues of where to target and direct resources for services was to have youth-informed services, and to have greater consultation with young people around their needs and experiences. The VCS was seen to be ahead of statutory and health services (e.g., Council Youth Services, CAMHS) in terms of co-production with young people and advocating and amplifying young people’s voices, therefore, the VCS could offer a model around how to better involve the voices of young people in service design and provision.
There was a perceived gap between health services (especially VCS and statutory services) working together, with communication and information sharing being a key issue. Greater synergy between VCS and the statutory sector was suggested, especially due to the holistic approaches needed to target complex and multifaceted issues around health inequalities.
Strengths of the VCS approach to addressing health inequalities
VCS youth services were consistently noted to be ‘doing a lot with a little’, with them ‘plugging gaps’ and picking up ‘missed’ young people from other services.
‘VCS picks up what statutory services can’t provide…support for young people while they are on waiting lists for statutory services’ (Participant)
There was a suggestion that VCS were seen as ‘less’ qualified and specialised than many statutory services. This lack of formality was at times noted as being an important facilitator to engagement from young people, as VCS were portrayed as more trusting and friendly. However, it also was perceived to result in little appreciation of the varied and complex work they do.
The VCS were seen to have more creativity and freedom to innovate and test new ways of working and respond to young people’s needs, resulting in a more ‘youth focused’ approach than statutory service often provides. This was seen as a benefit, especially in terms of the VCS being adaptable and able to respond more quickly to young people’s needs than the statutory sector, but funding was highlighted as an issue.
‘VCS is more flexible and can respond more quickly but continuous funding is challenging’ (Participant)
Having more flexibility and time when working with young people, compared to statutory services, was seen as a key strength and benefit of VCS youth services, as this provided more time to develop trusting relationships with young people, and to identify their key issues.
‘because we’re not time limited – we can be much more flexible…we can do more with smaller pots of money’ (Participant)
This was noted in their abilities to not only signpost, but to physically support young people to other services and healthcare appointments, removing important barriers to engagement (e.g., cost, accessibility, transport).
Pressure to evidence VCS work and measure outcomes
From our discussions, better ways to record and evidence VCS work was a key priority. There was frustration from VCS stakeholders that they believed they were doing valuable and effective work, but it was difficult to evidence this to other services and funders who have set ideas of what ‘impact’ is and how it should be measured. This was often seen as not reflecting the nature of VCS youth work or young people’s experiences.
‘how do we evidence what we do, how can we show the importance of what we do in a way that people and NHS services listen to’ (Participant)
Our participants saw meaningful change in young people as difficult to achieve and document over short time periods, with this directly contradicting current funding models where short-term funding is issued, requiring quantified evidence of beneficial impact as outcome measures. Further, the pressure to continually work to secure short-term funding contracts, and to record impact, was noted to be having detrimental impacts on services already stretched budgets, and upon staff time and resources.
Having to compete for funding was also noted to have potential impacts on VCS partnership working, resulting in more competition and less cooperation between VCS.
‘the VCS works really well together with other charities and organisations…this can be challenging sometimes when charities are all fighting for the same funding’ (Participant)
A more pragmatic appraisal of impact
There is a need to better evidence the role and work of VCS youth services in ways which both reflect the work they do, and which reflect young people’s experiences of their services. By focusing on quantitative measures recorded over short time periods as proxies for meaningful change, we risk missing the value of qualitative accounts from young people and those working directly with them.
A focus on short-term outcome-specific ‘quick wins’ is myopic, and does not reflect the incremental long-term outcomes which indicate real change and impact for young people – change which VCS stakeholders discussed as often taking a considerable amount of time and effort to achieve. However, the nature of VCS funding is pushing services away from long-term youth-focused approaches, towards services which are more measurable (aka more easily fundable). This may be sacrificing real change for young people, for measurable outcomes for funders.
As de St Croix (2017) argues, the emphasis on measurement and outcomes has led to cultures of performativity, and aggregation to rigid measures which must be adhered to display effective practice. This, as our VCS stakeholders discussed, may reduce opportunities for innovation in practice (a valued strength of VCS) due to resources being directed at recording ‘impact’. Ironically, the time spent on attempting to record and display impact may be taking time away from VCS to actually achieve impact and meaningful change for young people through direct work. The VCS was consistently noted as providing many benefits for young people and benefits beyond statutory services, but what is crucial to appreciate is that, as one participant told us, ‘these strengths can only exist with the proper funding!’.
Dr Nicholas Woodrow is a Research Associate at the University of Sheffield in the School of Health and Related Research.
Dr Hannah Fairbrother is a Senior Lecturer in Public Health at the University of Sheffield in the Health Sciences School.
Eleanor Holding is a Research Fellow at the University of Sheffield in the School of Health and Related Research.
Mary Crowder is a Research Associate at the University of Sheffield in the School of Health and Related Research.
Dr Naomi Griffin is a Research Associate at Newcastle University in the Population Health Sciences Institute.
Pip Kyle is a PhD Candidate at Newcastle University Business School.
Dr Vanessa Er is a Research Fellow at the London School of Hygiene and Tropical Medicine.
Lesley Pollard is the Chief Executive Officer of Chilypep.