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Two worlds collide: health and financial exclusion

makeanimpactcic@gmail.com (Heidi Fisher) — Tue, 10 Dec 2024 15:44:04 GMT

Two worlds collide: health and financial exclusion

Republished: 10 December 2024

Author: Heidi Fisher

We know that financial exclusion and poverty affects health, and to me it makes sense that our goal should be to increase incomes as a way to reduce financial exclusion AND to improve health, mental health and wellbeing. The two are intrinsically linked – and I believe you can’t have health without financial inclusion and vice versa.

In this blog, I’m sharing the facts and data that back this up, and calling on more joined up thinking between organisations that work in my two worlds of health and financial inclusion.

The current state of population health in the UK

Rising Health Inequalities

The truth is it’s bad and getting worse – health inequalities are growing, with deprived areas having the lowest life expectancies compared to more affluent area. There’s been no levelling up and if you live in a poorer area you’ll live 10 years less than those in more affluent areas.

The UK has seen a widening gap in health inequalities, with life expectancy disparities growing between affluent and deprived areas.
According to the Office for National Statistics, the difference in life expectancy between the richest and poorest areas in England is over 10 years for both men and women.
The Marmot Review 10 Years On highlights that health inequalities are a significant concern, with little improvement over the past decade.

If you have a low income you’re twice as likely to have a long-term health condition compared to more affluent individuals – including diabetes, cardiovascular diseases, and respiratory conditions – and more likely to have risk factors for chronic diseases as well.

But it doesn’t stop there. If you have financial difficulties or lower income you’re more likely to have mental health issues, including twice the likelihood of having anxiety and depression. According to Mind, financial stress is a leading cause of mental health issues, with 46% of people in debt also experiencing mental health problems, and Step Change found that this figure was 60%.

Financial exclusion and its direct impact on health outcomes

I know, you’re thinking, ‘Great Heidi, thanks for sharing all those soul-destroying facts.’ But let’s focus on the ‘so what?’ and look at the evidence about how financial exclusion and poor health result in poorer access to services and huge economic costs.

Here’s some facts:

The Joseph Rowntree Foundation found that financial barriers prevent 1 in 10 low-income households from accessing necessary healthcare services.
Financial instability is a significant stressor, contributing to poor mental health.
The Money and Mental Health Policy Institute found that 86% of people with mental health problems say their financial situation has worsened their mental health.
Financially excluded individuals often struggle to afford nutritious food and adequate housing, leading to adverse health outcomes.
Poor housing conditions, exacerbated by financial exclusion, are linked to respiratory illnesses and other health issues, as highlighted by Shelter UK.

The economic cost of health inequality

Health inequalities result in higher healthcare costs due to increased demand for medical services.
The King's Fund estimates that health inequalities cost the NHS at least £4.8 billion annually.
Addressing socio-economic determinants of health could reduce healthcare costs by 15%, according to a study by the Health Foundation.
Poor health outcomes due to financial exclusion led to significant productivity losses.
The Department for Work and Pensions reports that poor health is a primary reason for economic inactivity among working-age adults.
The Confederation of British Industry (CBI) estimates that ill health costs the UK economy £77 billion annually in lost productivity.
Health disparities contribute to a greater reliance on benefits, increasing public spending.
The Joseph Rowntree Foundation states that poverty and poor health significantly increases the costs of benefits.
The cost of supporting individuals with long-term health conditions through benefits payments is estimated to be over £20 billion per year.

What’s being done to reduce financial exclusion and improve health outcomes?

Let's start with a common approach: improving financial literacy. The Money Advice Service reports that 39% of adults in the UK lack confidence in managing their money – a very scary statistic. While enhancing financial literacy is essential, financial exclusion isn't solely due to poor financial decisions or lack of awareness about available services. There are deeper, systemic issues at play.

Another critical step is increasing access to affordable financial products for those excluded from mainstream finance. The Financial Conduct Authority (FCA) highlights that nearly 13 million people in the UK have low financial resilience. Community Development Financial Institutions (CDFIs) and credit unions offer crucial support, providing innovative payment solutions and financial products to those in need.

However, improving financial literacy and access to financial products isn't enough if people don’t have sufficient income to meet their basic needs. A negative budget, where outgoings exceed income, leads to chronic stress and health issues. Adequate benefits and support systems, combined with employment opportunities that pay at least the living wage, are vital.

Of course, on the flip side there are numerous services focused on improving mental health, reducing stress and physical health – but without working on the financial stressors that are creating the health issues the results are unlikely to be lasting.

What next?

I envision a future where my two worlds of health and financial inclusion collide more frequently. We need more collaborative efforts that recognise the interconnectedness of financial stability and health. Ending the cycle of poverty and poor health requires more than one-off interventions; it demands a holistic approach addressing all levels of the problem. Only through coordinated, multifaceted strategies can we create true financial inclusion and positive health outcomes for all.

Who’s with me?

.......................................................

"Hi, I’m Heidi, an impact measurement expert, passionate about helping you make a bigger impact in the world by maximising the impact your services have.

"I can help you to measure, manage and communicate the impact you have better to funders, investors, commissioners and other stakeholders, and to systemise your data collection and analysis so that it frees up time and doesn’t become an additional burden.

"I love helping you to measure social and economic impacts, including Social Return on Investment or value for money assessments, as part of understanding the change you make to peoples’ lives.

"Get in touch by sending me a message if you’d like to discuss your next impact project."

All the facts and figures

For the data and research geeks amongst you, here’s references and sources for all the data shared today as well as some extra ones if you want to spend several days reading around the topic:

1. Office for National Statistics ( click here )

2. Institute of Health Equity. The Marmot Review 10 Years On ( click here )

3. Public Health England. Health Inequalities Dashboard ( click here )

4. NHS Digital. Health Survey for England ( click here )

5. NHS. Mental health and wellbeing in England ( click here )

6. Mind. Financial problems and mental health ( click here )

7. Financial Inclusion Commission. Financial Exclusion Statistics ( click here )

8. Joseph Rowntree Foundation. UK Poverty 2022 ( click here )

9. Money and Mental Health Policy Institute. The financial and mental health emergency ( click here )

10. StepChange. Debt and mental health statistics ( click here )

11. Trussell Trust. Foodbank use statistics ( click here )

12. Shelter UK. Impact of poor housing on health ( click here )

13. The King's Fund. The economics of health inequalities ( click here )

14. The Health Foundation. Health equity in England ( click here )

15. Department for Work and Pensions. Economic inactivity due to poor health ( click here )

16. Confederation of British Industry. Health and productivity ( click here )

17. Joseph Rowntree Foundation. Poverty and welfare costs ( click here )

18. Department for Work and Pensions. Welfare benefits statistics ( click here )

19. Money Advice Service. Financial capability ( click here )

20. All-Party Parliamentary Group. Financial education for young people ( click here )

21. Financial Conduct Authority. Financial lives survey ( click here )

22. Fairbanking Foundation, Improving financial wellbeing ( click here )

To monetise or not?

makeanimpactcic@gmail.com (Heidi Fisher) — Tue, 10 Dec 2024 14:40:02 GMT

To monetise or not?

Republished: 10 December 2024

Author: Heidi Fisher

There are specific circumstances where it's better to use this type of approach.

Here’s a quick decision tree for you to use to see if SROI is right for your organisation .

See diagram here >

And here’s an explanation of the questions

1. What activities and outcomes do you deliver? If you’re mainly delivering health and social care (including wellbeing outcomes), employability, skills and training, or criminal justice/offender management services then it’s worth looking at SROI as there are lots of existing financial values for these types of outcomes. There are some other areas that also have financial proxies, such as environment which are mainly carbon and energy savings, but these tend to be more limited. You can of course still do SROI and use techniques such as the Value Game to get your clients to assign monetary values to the outcomes achieved.

2. Where does your income come from? If your income is mainly from the public sector it’s worth considering SROI as you can identify potential savings for the public sector, whereas if your income is mainly from grants or donations from Trusts and Foundations or individual consumers or businesses they’re unlikely to be interested in SROI. They will be much more interested in the stories, case studies and feedback (basically your qualitative data).

3. Are either your activities or your main sources of income likely to change in future? If your plan is to do more work in any of the areas mentioned above or to have more income from public sector contracts SROI would be worth considering in the future. Your other option is to do a predictive SROI – identifying the SROI your future activities will deliver rather than an evaluative SROI (which looks at the SROI your activities have already delivered).

Of course, it’s not always that straightforward and simple in real life so if you’re still unsure if SROI is suitable/worth doing, do get in touch.

A word of caution

The real value with assigning financial values to the impact that you have is that it makes it quite simple for people to understand. So, you know your SROI is £6 for every £1 you spend on your services. So it very much simplifies everything you do down to one number. But the issue with that is that you then lose all the story and the depth of what you've actually delivered.

Which is why, although I do love SROI, I'm very much for having a balanced approach between the two where you have the financial numbers where they're appropriate, but you still tell the story of what's actually happened in terms of your impact. You’ll also appeal to people that love numbers and those that love words as you’ll have a mix of both.

The route out of poverty?

makeanimpactcic@gmail.com (Heidi Fisher) — Tue, 10 Dec 2024 14:22:32 GMT

The route out of poverty?

Republished: 10 December 2024

Author: Heidi Fisher

But is it really as simple as I thought? That more money is the only requirement? It turns out the way in which you get more money is likely to be very important in terms of the impact it will have on your life. Let’s explore that.

I’ve researched the different types of income programmes (or universal basic income – UBI - programmes) that are currently or were previously running globally (there’s been a lot and this article mentions a few), looking for differences between the impacts of one-off lump sums (both small and larger amounts) versus receiving regular amounts.

And this is what I found:

The impact of receiving small regular amounts

Finland did a two-year Universal Basic Income experiment in 2017-18 where 2,000 unemployed people received €560 per month, unconditionally. They measured the impact on employment and well-being, and there was a slight improvement in participants' mental and financial well-being alongside a greater sense of overall life satisfaction but no significant increase in employment compared to the control group. But did it make a difference to poverty reduction? The results showed a very limited contribution.

So how do other regular payment programmes fare?

Kenya’s GiveDirectly is a universal basic income pilot that is ongoing. The learnings so far show increased financial stability, better mental health, improved nutrition, and greater investment in small businesses. But what’s really interesting about GiveDirectly is that they’re not just piloting one type of UBI. They’re experimenting and comparing the impact of one-off lump sum payments to short-term and long-term UBI schemes.

Recipients of a one-time payment of $500 (equivalent to two years of monthly payments) experienced significant improvements in entrepreneurship and income. Those who received lump sums were 19% more likely to start a business, and their net business revenues were 80% higher compared to those receiving smaller, monthly payments. The lump sum recipients could make larger investments, helping them escape the cycle of poverty more effectively than those on short-term UBI schemes.

What isn’t known yet is whether a one-off lump sum will outperform the long-term UBI – and we’ll have to wait a few years longer for the data to be available to confirm this.

“This study found a short-term UBI was the least impactful way to improve most outcomes other than in food variety. Yet short-term, small monthly payments are the most common way people in low-income countries receive cash transfers.

"While short-term monthly cash is useful for emergency relief or for supporting basic needs during critical periods (e.g., early childhood), policymakers wanting to reduce poverty by creating wealth and independence should rethink using this popular design, as both a long-term UBI and a large lump sum were found to be significantly more transformative.”

GiveDirectly (2023): www.givedirectly.org/2023-ubi-results

Well, that’s thrown the baby out with the bathwater, hasn’t it? The typical and common model of increasing income through small monthly payments is the least effective way to reduce poverty. So why do we continue to do it? Maybe this model doesn’t work in what are classed as low-income countries, but it might work in higher-income countries?

Unfortunately, in higher-income countries they also show that in terms of poverty reduction short- term regular payments don’t result in long-term impact:

A trial in Utrecht in The Netherlands in 2018-19 gave participants freedom in how they used the funds. While employment rates hardly changed, there were some health benefits and improved quality of life.

In the United States the Stockton Economic Empowerment Demonstration (SEED) gave $500 each month to 125 randomly selected low-income individuals for 18 months. Participants experienced reduced financial anxiety, improved mental health, and increased full-time employment rates compared to a control group. The programme showed the importance of cash flow in enabling individuals to pursue better job opportunities.

In New York a UBI pilot started in 2020 is giving $500 monthly for five years to a select group of residents. Early findings suggested increased employment from 29% to 63%, contradicting the claim that cash assistance discourages work. Participants reported improved mental health and financial stability. So, again we’ll be waiting to see what the long-term impacts on poverty are from this pilot.

What about one-off lump sums?

In Liberia, one-off lump sums were provided to individuals in extreme poverty through a randomised controlled trial by GiveDirectly. Individuals used the money for immediate needs, business investments, and debt repayment giving short-term benefits in terms of consumption and income generation but these didn’t last.

The return to poverty after the lump sum has been used seems evident from these projects. But most data on one-off lump sums shows they encourage entrepreneurship, business growth and financial independence – with individuals being able to make investments that weren’t possible with a smaller regular UBI without saving for significant time periods.

We can also look at data from the UK where welfare advances are given to individuals with urgent financial needs. Whilst not a UBI as these welfare advances are usually repaid from future welfare payments, the impacts are similar in that poverty reduces in the short-term as the emergency need is resolved, alongside reduced financial stress and improved housing and food security. But this is only temporary.

What does this all mean for alleviating poverty?

Small one-off lump sum – these are great for removing immediate financial needs but tend to have limited long-term impact on poverty levels.

Large one-off lump sum – these are more effective than small lump sums. The effectiveness increases when the money is used to make investments such as starting a business as these results in increases in income over time, or investments in other income generating assets.

Short-term regular payments – the receipt of a regular payment for up to two years has shown improvements in mental health and wellbeing, as well as reduced financial stress. There have been variable impacts on employment levels and entrepreneurship.

Long-term regular payments – these resulted in increased investments and business formation, because individuals knew they would continue receiving the payments for many years (in Kenya this is for 12 years). These may be a solution to reducing poverty but the cost of delivering these programmes more widely is high, and the crucial factor is whether the impacts sustain when the payments stop – evidence so far suggests that this model is likely to work best for reducing poverty by providing financial stability – but there’s not enough data to prove or disprove this conclusively.

An alternative option – an annual or infrequent larger lump sum – could this combine the advantages of both lump sums and regular payments? This would enable individuals to focus on longer-term decisions and spending, and provide enough money to allow for investments, like starting a business, in comparison to smaller regular payments where decision making tends to focus on spending on immediate priorities and needs. While this option hasn’t been tested much, it could be a middle ground that offers both stability and opportunities for economic mobility.

How does support alongside the payment contribute to the impact?

So often support comes in the form of one or the other – either you receive a payment, or you get some form of support. But what happens when the payment is combined with support? There are several projects that did this – combining a payment with mentoring, skills development or other support.

Examples include the GiveDirectly with Entrepreneurial Support in Kenya and Liberia, where some individuals received a small lump sum alongside entrepreneurial training and mentorship. The results – this additional support led to higher business success rates and increased income.

In Uganda, their Youth Opportunities Programme provided lump sums to young people alongside vocational training, mentoring and business start-up support. After four years, the young people were earning 50% more than the control group and had higher employment rates, as well as more savings and better financial stability. And the impacts sustained up to nine years after the programme ended, showing significant long-term benefits.

And there’s similar evidence from New York City’s Cash and Coaching Programme which provided a small lump sum and coaching. This led to improved credit scores, more stable housing and a reduction in the use of illegal money lenders. Also, a UBI pilot in Finland provided one off lump sums for business creation, in addition to a regular monthly UBI payment and entrepreneurship training. Individuals who received all three elements were more likely to start and sustain their business and have improved financial independence and economic mobility.

The combination of a payment with practical support appears to be a strong contender for reducing poverty, as it also addresses some of the underlying barriers that are keeping people in poverty. One off lump sums have proven they achieve more than regular payments over a short period of time, and there’s still work to be done to show it one off lump sums are better or worse than long-term regular payments.

However, this poses the questions – how long do you continue with financial support? When is the cut-off point at which poverty should be eradicated? Why are so many UBI programmes modelled on providing short-term regular payments when the evidence shows they are least effective at achieving short-term outcomes or lasting change and long-term impacts? How do we change thinking on ending poverty globally?

I don’t have the answers to these but please share your thoughts here .

McImpact – standardised or customised? Finding your recipe for Impact Measurement

makeanimpactcic@gmail.com (Heidi Fisher) — Tue, 10 Dec 2024 13:33:39 GMT

McImpact – Standardised or Customised? Finding Your Recipe for Impact Measurement

Republished: 10 December 2024

Author: Heidi Fisher

The McImpact Analogy

Imagine you walk into a McDonald's, and you know exactly what to expect. The Big Mac in Tokyo tastes the same as the one in New York City. That's because McDonald's follows strict standards, ensuring consistency in its offerings. The same concept can be applied to impact measurement, where standardisation ensures uniformity in measurement methods and results.

But wait, what if you don't want gherkins on your burger? (Seriously, who likes gherkins apart from my son?) No problem – you can customise your order. In the realm of impact measurement, customisation allows organisations to tailor their measurement approaches to their specific goals and needs .

Standardised Impact Measurement

Pros:

Consistency: Standardised impact measurement ensures that everyone follows the same rules, making it easier to compare results across organisations or projects.
Reliability: Standardised metrics have been tested and proven to provide accurate results, enhancing the credibility of your impact assessment.
Efficiency: It's like a well-oiled machine. Standardised approaches can save time and resources by eliminating the need to reinvent the wheel for each project.

Cons:

One Size Fits All: Standardised metrics may not capture the uniqueness of every project or organisation, potentially missing out on important nuances.
Limited Flexibility: Straying from the standard may be discouraged, making it challenging to adapt to changing circumstances or stakeholder demands.
Missed Opportunities: Standardised measurement may not uncover unexpected positive outcomes or additional areas of impact, limiting the organisation's ability to learn and grow.

Customised Impact Measurement

Pros:

Tailored Results: Customised impact measurement allows organisations to focus on the outcomes and metrics that matter most to them, providing a more accurate representation of their impact.
Adaptability: Organisations can adjust their measurement methods as their goals evolve or new challenges arise.
Innovation: Customisation encourages creativity and innovation in impact measurement, potentially leading to the discovery of new and unique ways to create positive change.

Cons:

Lack of Comparability: Customised measurement can make it challenging to compare results with other organisations or projects, potentially hindering collaboration and benchmarking efforts.
Resource-Intensive: Developing and maintaining a customised impact measurement system can be time-consuming and costly.
Credibility Concerns: Critics may question the validity of customised metrics, especially if they lack standardised validation.

Finding the Right Balance

So, where do you strike the balance between standardised and customised impact measurement? It's essential to recognise that there's no one-size-fits-all answer. Organisations should consider their unique objectives, stakeholders, and the nature of their impact when deciding on their measurement approach.

Much like ordering at McDonald's, sometimes you want the classic Big Mac, and other times you crave something a bit different. The key is to find the right mix of standardised and customised measurement methods that align with your mission and deliver the results you desire.

The McImpact analogy reminds us that there are merits to both standardised and customised impact measurement. While standardisation ensures consistency and reliability, customisation offers flexibility and tailored insights. The key is to strike a balance that serves your organisation's unique goals and needs. Just like ordering at your favourite fast-food joint, it's all about finding your recipe for success in impact measurement.

Impact measurement and management: keeping it simple

makeanimpactcic@gmail.com (Heidi Fisher) — Tue, 10 Dec 2024 12:49:57 GMT

Impact measurement and management: keeping it simple

Republished: 10 December 2024

Author: Heidi Fisher

It’s too time consuming
It’s too complicated
We don’t have the resources internally to do this
It’s too confusing – there are lots of different methodologies and we don’t know which to use/which is the right one (is there a right one??)
We don’t have to report on outcomes to our funders/commissioners/board etc. so what’s the point in doing this?
We already collect lots of data why do we need to collect more?

First up, let’s get clear about what impact measurement and management (IMM) are. Here’s how I define them:

Impact measurement

Impact measurement is the process of designing systems, consulting with stakeholders, collecting data and measuring the impact you have.

Impact management

Impact management is about what you do with the information you have obtained through the impact measurement process to continually improve your organisation so you can increase the level of positive impacts and reduce negative impacts.

Lean Social Impact Approach

Now you know what IMM is, let’s look at the five stage Lean Social Impact Approach I use with clients to make doing it as simple as possible:

Define
Plan
Measure
Analyse
Learn

See diagram here >

1. Define – be clear about your vision/ultimate goal – what problem are you solving and what does the world look like once you’ve solved that problem? What difference does that make to people and the planet?

Try to define your ultimate goal in one sentence. For example:

Reducing health inequalities for all so people can stay active.
Improving peoples’ live by developing their skills and improving access to opportunities.
Creating sustainable use of resources.

2. Plan – once you know what your ultimate goal is identify what outcomes (changes) need to happen to people or the planet for that goal to be achieved. Focus on two key stakeholder groups, and identify two outcomes that happen to them as a result of your work. The reason for picking just two stakeholder groups and two outcomes is to keep it simple – so you’re only measuring four outcomes to start with. You can get more complex in the future and measure more outcomes for more stakeholders, but right now it is about getting started without being overwhelmed.

How will you know if each outcome has been achieved? For example, for increased self confidence you might get people to self-report or score changes in this; for training it will be when they’ve completed the training, for health improvements you might record how often they visit their GP, and for things like reducing plastic waste you could measure how much is recycled and how much goes to landfill.

Then plan how you’ll collect information on these outcomes – will you use surveys, focus groups, case studies, interactive methods, sketch notes, photos, games or something else? And how often will you need to collect the data – just once, or at the beginning and later on to evidence that there’s been a change?

Don’t forget to ask something along these lines too: “Were there any other changes (positive or negative) that happened as a result of our support?” so you can track unintended and negative outcomes too.

Finally, at this stage think about what other information you might want (if you don’t collect it already on a registration form) – such as a person’s age, employment status, health conditions etc. so you can see if these affect what outcomes they achieve.

3. Measure – this is the practical stage where you actually have to get on and do the data collection. And this is typically where it all falls down – as no-one takes responsibility for making sure the data is collected. But that’s not going to be you because you want to know what impact your work is having!

So get out there, collect the data and collate it somewhere. Typically most people use a simple spreadsheet to record the data but there are lots of online survey tools and AI tools that will collate and analyse the data for you.

4. Analyse – my favourite stage as you’ll get to look at what your data is telling you about your impact.

Which outcomes have you successfully achieved? Which outcomes haven’t been achieved? Do certain stakeholder characteristics link to different success rates for outcomes? If they do, do you need to change how you deliver your activities to remove barriers/address specific issues so you can improve the level of outcomes in future?

Based on the data, how well are you achieving your ultimate goal?

5. Learn – what are you going to do based on what you found out to continually improve and refine what you do, so you can maximise your impact?

Are there other outcomes that are important to your stakeholders that you need to measure in future? Do you need to measure outcomes for other stakeholder groups?

Did things go wrong during the data collection stage – that you want to change so it’s easier to collect data in the future, or you can get better data?

Finally, do you need to change what you do so you can maximise your outcomes in the future?

So there you have it – five stages to impact measurement and management. But, of course, it never really ends, as you start again based on what you’ve learnt, and do it better next time. What’s stopping you?

Health economics and SROI

makeanimpactcic@gmail.com (Heidi Fisher) — Tue, 10 Dec 2024 12:14:55 GMT

Health economics and SROI

Republished: 10 December 2024

Author: Heidi Fisher

This is why you’ll often see RCTs (randomised control trials) recommended – as you can compare one group of people who received the new intervention to those that didn’t.

But what it doesn’t do is look at the wider social and non-economic impacts or build in different stakeholders’ perspectives (health economics is predominantly focused on answering the question “does this new intervention save us money?”).

So in my opinion (I’m sure some of you will see this differently), Social Return on Investment (SROI) can be considered an extension of traditional health economics evaluations, because it goes beyond a simple cost-benefit analysis in several ways:

1. Broader scope for your impact assessment: traditional health economics evaluations, such as cost-benefit analysis or cost-effectiveness analysis, focus primarily on the economic and health-related outcomes of a healthcare intervention, whereas SROI considers a much broader range of social, environmental, and economic impacts. It captures both positive and negative outcomes that may not be quantified in monetary terms.

2. Stakeholder engagement: SROI places a strong emphasis on engaging stakeholders, including patients, community members, and funders, so the perspectives of those affected by the programme are considered in the assessment.

3. Valuation of non-monetary outcomes: SROI involves assigning monetary values to non-monetary outcomes, such as improved quality of life, enhanced well-being, or reduced social inequalities. This valuation process recognises that some benefits of healthcare interventions cannot be easily expressed in monetary terms.

The valuation of non-monetary outcomes is why I love SROI – because we should always be thinking more than money and focusing on the long-term social impacts of healthcare decisions we’re taking now.

4. Reporting and communication: SROI results are often presented in a narrative format, making them more accessible to a broader audience, including policymakers, donors, and the community. It goes beyond technical economic analysis to tell a compelling story of the programme's social value.

In summary, while both health economics and SROI aim to evaluate the impact of healthcare interventions, SROI expands the scope and approach to assessment by including a wider range of outcomes, stakeholder engagement, qualitative data, and a narrative presentation.

Although SROI is born out of traditional cost-benefit analysis it isn’t a simple extension of this approach. Instead, it represents a more holistic and inclusive approach to understanding the social value generated by a programme or intervention.

My recommendation: do SROI to get the full picture of the impact of your intervention.

#HealthCare #SocialReturnOnInvestment

Discover a fresh look with our all-new website!

Tue, 24 Oct 2023 12:25:52 GMT

Discover a fresh look with our

all-new website!

published: 24 October 2023

Author: Make An Impact CIC

Under First Stop's direction we have taken all steps within our means to ensure that the new website broadly complies with W3C and the Equality Act standards.

So what's new?

✨We have undergone a stunning transformation to provide a modern and

user-friendly experience.

✨Discover the blogs, resources, and tools to help you excel in the world of impact measurement and social enterprise.

✨Your Impact is our priority, we’re dedicated to helping you measure and maximise your impact. With our new website, we're taking our commitment to the next level, providing you with tools to drive positive change in your community and beyond.

✨We're here to support your mission. Whether you're an established social enterprise or just starting your journey, you'll find the resources and guidance you need to make a meaningful impact.

We would like to extend our heartfelt gratitude to First Stop Design for their outstanding work in bringing our vision to life. Their expertise and creativity have played a crucial role in making this website a reality.

Explore our new website to experience our fresh look and content.

#newwebsite #socialenterprise #impactmeasurement

5 Top tips to grow your social enterprise in the fastest and easiest way possible

makeanimpactcic@gmail.com (Heidi Fisher) — Fri, 20 May 2022 10:50:08 GMT

5 Top tips to grow your social enterprise in the fastest and easiest way possible

Originally published: 6 August 2021

Author: Heidi Fisher

I could go on with this list, but one thing is clear – you have bought in to a reason for your social enterprise not growing.

The problem with this, and it is a problem, is that none of these reasons are real. Yes, there may be truth to these external factors but how does that explain why some social enterprises are continuing to grow anyway? It can’t be down to luck, and it isn’t – it’s a result of your personal beliefs about your social enterprise, how successful it can be and how much money you are comfortable earning, as well as your daily actions.

These put a limit on the size your social enterprise can grow to.

Whatever the external problem with your social enterprise, it is most definitely a consequence of your beliefs or your inconsistent daily actions. Most social entrepreneurs want a quick fix solution to their stalled growth, and that can be done but if you want to grow your social enterprise then my top tips are to consistently as set out below.

Beliefs matter – decide today that you’re changing your beliefs about what is possible. Don’t fanny around saying you can’t change your beliefs – because you can. Decide what you believe is no longer true and what your new reality looks like.

Morning Routine – I know a lot of people harp on about morning routines but that’s because they work. Developing a morning routine is the thing that has had the single biggest impact on how much I get done and what I achieve. And it doesn’t involve getting up at 5am unless that’s what you want to. Own your morning – do the things that move your social enterprise forward first, rather than jumping straight on to social media or responding to emails.

Build your network – this is so important. The amount of people who refer to me because they know me (and hopefully like me) makes a huge difference to how easily things happen. If you’re sat there hiding away and not connecting with others how will anyone know how great you are or what you’re doing?

Follow up – this doesn’t mean stalk people! Just make sure you follow up any enquiries, and if you’re ghosted send another follow up. Everyone is busy – being ignored isn’t necessarily a sign of a lack of interest, it means other things are more important right now. If you don’t check the answer will always be No!

Only do what you are good at – sounds obvious but there are a lot of people who think they are good at everything (stop deceiving yourself). Do what you’re good at – and also do what you enjoy – because it will be very evident from the results where your strengths are.

5 top tips – not rocket science.

The time for social enterprise has come

makeanimpactcic@gmail.com (Heidi Fisher) — Tue, 17 May 2022 11:25:40 GMT

The time for social enterprise has come

Originally published: 14 January 2021

Author: Heidi Fisher

How often do we hear this rhetoric in mainstream media; usually said by people who have to appear like they a) know what they’re talking about, and b) are trying to convince others they actually care.

But, how often do the people who say this actually DO something?

This is what I've noticed with people using this talk with regard to social enterprise:

“The time is now” “We must make social enterprise mainstream”

Thing is though, social enterprise is still a marginalised idea that few people grasp never mind embrace.

If the time really is now, then what evidence is there that something’s being done, especially as independents and small businesses have been treated so badly through the lockdowns, losing their livelihoods and merely existing, whilst bigger businesses are able to stay open and access £ms in furlough and rate reliefs.

Well, if you’d have asked me 6 months ago, I’d have said there isn’t

much to go at at all, however, is it possible we’re seeing a slight

shift in the right direction?

As lockdown tightens its grip over more and more small business owners, we’re seeing the growing discontent with big business and

billionaire shareholders taking profits at the expense of

workers who are living in poverty.

It’s true that the structures are starting to be challenged, as people are speaking up for their support of local and, to be honest, I’m excited.

Let’s not forget that is was only a few months ago that Arcadia Group collapsed into administration, as well as the anti-black Friday movement that encouraged people not to buy from Amazon…I mean, is this a sign?

If it is, then let me say this;

The time for a greater spread of equity in a more horizontal format is approaching, as the time for the old vertical top down world is up.

The time is now, people.

Choose local. Choose social.

Guest Blog: We must not stay silent – from Michelle John

makeanimpactcic@gmail.com (Heidi Fisher) — Fri, 30 Jul 2021 09:29:15 GMT

Guest Blog: We must not stay silent – from Michelle John

Originally published: 30 July 2021

Author: Heidi Fisher

Now it could be argued that in some cases, they’re right. As time moves on, society changes and so too do the problems within it. But in many other cases, the reason they believe it didn’t happen was because it wasn’t openly talked about at that time.

Take mental health for instance – decades ago, symptoms we now know to be part of a diagnosable mental health problem would be attributed to something else. And if someone was displaying behaviour which really made them stand out – they’d be simply hidden away in an institution for the rest of their life. Problem solved. Or not!

One area where the ‘not in my day’ proclaimers are particularly vocal is domestic abuse – an especially hidden form of which is my specialism.

Child to parent abuse

I’m Michelle John, the Founding Director of an organisation called PEGS. I set PEGS up because I have first-hand experience of Child to Parent Abuse, and I knew there were other parents out there feeling as desperate and as lonely as I did.

I wanted there to be an organisation which acted as a safe place for those parents, carers and guardians who were experiencing physical, emotional, financial or sexual abuse from their children (ranging in age from pre-school to adulthood and beyond). A place where they could talk openly about their experiences without fear of judgment, blame or disbelief.

A huge part of the problem, I’ve come to realise, is that we’re just not talking about CPA as a society. We’ve seen dedicated campaigners fight for intimate partner domestic abuse to have its rightful place in the spotlight over the past few decades. Abuse from a partner or ex-partner needs to be talked about, solutions need to be highlighted to victims, and it must not be shied away from. The work these campaigners have done is essential.

And yet you’d think their work would have paved the way for society being more open to talk about other forms of domestic abuse, such as CPA. And it really hasn’t, in my experience.

Ignoring it doesn’t work

Little babies often put their hands up to their face during a game of hide and seek and think that makes them invisible. We laugh at that adorable notion – and yet we’re doing the same to some of society’s most important issues!

Simply pretending something isn’t there doesn’t magic it out of existence. And actually, it causes so many more problems for the parents who are already going through hell in their own home.

It means when they approach professionals such as their GP or a teacher for support, that professional has a limited chance of even fully understanding what CPA is. So, that professional might tell them the child is well behaved at school, might suggest it’s their parenting to blame, or might not even believe them about the extent of the problem.

I’ve had desperate calls from parents because a professional has told them to just ‘take the weapon off’ their child who was threatening them. I know parents who’ve had to physically barricade themselves in their room to stop their child harming them. And I’ve lost count of the number of parents who’ve reported being told to ‘just parent them’.

Support from loved ones

And it’s not just professional knowledge that is lacking because we ignore CPA (and many other ‘taboo’ subjects in society). It also means that many parents are isolated from their friends or family if and when they disclose that they are being abused. It’s difficult for their loved one to understand when they may not even have heard the words ‘Child to Parent Abuse’ before.

Even the parents themselves might not understand what CPA is, and therefore the behaviour can escalate well above and beyond ‘normal’ childhood defiance before they even recognise that there is a problem in their household.

The solution

The answer is simple: talk openly about societal issues, even if they’re

not comfortable topics.

How we reach that solution is the tricky part – educating all of the relevant groups (professionals, media, and the general public) is a time-consuming job, and needs to be done in the right way using the correct terminology and giving them enough knowledge to really understand the topic.

At PEGS, we’re doing what we can by raising awareness on social media, at speaking engagements, and across organisations such as police forces and social care teams. But we need many more advocates to join us so that we can realise a widespread change in the way society views CPA.

And while Child to Parent Abuse is my specialism, it’s important for us to stop thinking about a wide range of topics as ‘taboo’ or not for discussion. Ignoring them, using euphemisms to describe them (like years ago when nobody said the word cancer but instead used terms like ‘the big C’) or segregating those experiencing them (as with mental health) has been proven not to work!

Education, open conversation, media coverage and knowledge sharing on the other hand – these are the tools which really do work in affecting change. They can help new solutions to be devised, more research to be undertaken, and – perhaps most importantly – help those experiencing the problem feel included in society and that they still matter!

I’ve often said that CPA is at the stage intimate partner abuse was 30 years ago and – while I am committed to working tirelessly for as long as it takes, it’d be fantastic if the doors I was pushing to open were at least unlocked!

Talking about problems won’t eradicate them, but it will break down some of the barriers that parents face when trying to access support. Surely, we owe it to those struggling around us to at least acknowledge their issues rather than pretending they don’t exist?

Find out more:

Website: www.pegsupport.co.uk

Facebook: @PEGS.support

Twitter: @PEGS_support

Instagram: @pegs_support