A step-change in the evidence base

October 20, 2022

In 2012, Making Every Adult Matter (MEAM) developed the MEAM Approach to help local areas to transform services and systems for people facing multiple disadvantage.

When the network expanded in 2017, we took the bold step of commissioning a five-year longitudinal evaluation of the MEAM Approach network. An independent evaluation team from Cordis Bright, and a research group of experts by experience, have worked alongside the network since then, collecting data and evidence about the impact of local areas’ work.

Today, we publish the final (Year 5) report from the evaluation. Alongside the evaluation of the Fulfilling Lives programme, this research represents a fundamental step-change in the evidence base on multiple disadvantage, proving that coordinated interventions improve people’s lives, reduce the use and cost of a range of key services, and help local areas to create the long-term changes to local systems that are needed for the future.

Key findings

The full report, including a summary of the key findings, is now available, alongside the technical appendix. The main findings include:

  • People facing multiple disadvantage are improving their lives and making progress towards personal goals, as evidenced by the Homeless Outcomes Star, New Directions Team Assessment and qualitative evidence.
  • There are substantial improvements in relation to accommodation. The proportion of people sleeping rough decreased from 46% at the start of support to 8% at the end of the fourth quarter to 5% at the end of the eighth quarter, a statistically significant reduction of 41 percentage points over the two-year period.
  • There are significant reductions in the use and cost of unplanned health services. People who received support over at least two years saw a 37% reduction in A&E attendances (from an average of 1.2 attendances per person per quarter pre-support to 0.8 attendances per person in the eighth quarter of support). There is a 50% reduction in non-elective acute admissions (from an average of 1.1 admission days per person per quarter pre-support to 0.5 admission days per person in the fourth quarter of support) but this was only found after the first year of support.
  • There are statistically significant reductions in contact with the criminal justice system for people supported over at least two years. Arrests reduced by 32% (from an average of 0.7 arrests per person per quarter pre-support to 0.5 arrests per person in the eighth quarter) while nights in prison reduced by 37% (from an average of 9.4 nights per person per quarter to 6.0 nights). These changes are statistically significant after two years of support only.
  • There is a wide range of data and evidence showing that the MEAM Approach helps local areas to improve the coordination and flexibility of support for people facing multiple disadvantage, including at key transition points and to achieve systems change in a range of different areas, including: culture; leadership; coordination of support; flexibility of support; infrastructure, pathways and processes; strategy and commissioning; and co-production.

Where next?

As we argue in the foreword to the evaluation report, the positive impact on individuals and service use is now clearly established.

Programmes and evaluations should now turn to focus more firmly on better understanding the systemic factors that are present in successful and mature local systems, so that these can be spread across the country. This includes the cultures, narratives, leadership and co-produced partnership infrastructure that are the hallmarks of mature systems and that are so vital to leading change.

Through its support to an expanded MEAM Approach network, MEAM is pleased to be playing its part in this next big challenge. We look forward to working alongside MEAM Approach areas as they continue to transform their services and systems for people experiencing multiple disadvantage.

For now, we wish to thank everyone involved in making this evaluation a success over the last five years including the team at Cordis Bright, the experts by experience team, the local areas across the MEAM Approach network and everyone who contributed their views and experiences or allowed their individual data to be shared.