The Changing Futures programme is a £91.8 million joint funded initiative between Government and The National Lottery Community Fund, the largest community funder in the UK. The programme funds local organisations working in partnership in 15 local areas across England to better support those who experience multiple disadvantage.
Over the last year, MEAM has brought the local programme leads together for regular discussions about key aspects of the work. In this series of blog posts, we reflect on some of the topics covered, drawing on their insight and input from others in the Changing Futures programme and the wider MEAM Approach network.
In this fourth blog of the “Learning and Reflections” series, we explore how areas are using cost-benefit and cost-avoidance analysis to benefit people experiencing multiple disadvantage
Multiple Disadvantage and Cost-Benefit / Cost-Avoidance Analyses
Cost-benefit analyses (CBA) and cost-avoidance analyses (CAA) currently play a critical role in making the case for addressing multiple disadvantage within the public sector. These tools are vital for answering the difficult questions posed by local service landscapes—questions of commissioning restrictions and reduced budgets. They help show that money spent upfront or in one part of the system can create a positive impact elsewhere in the system and explore the strain on public services in granular detail.
By understanding where and how costs fall within the system, and by tracking the impact of various interventions, CBAs and CAAs provide insights into both immediate and long-term value. By focusing on small, targeted areas, such as emergency healthcare or social care interventions, they help demonstrate value with tangible metrics. For example, by examining A&E admissions before and after a service is implemented, these analyses can show whether an intervention has had a real impact on reducing crisis-related visits to the hospital.
The Challenges of Costings Work for Multiple Disadvantage
While CBA and CAA have proven valuable in securing funding and guiding service improvements, they are not without their challenges. One of the primary difficulties is that local data systems don’t speak to each other. This fragmentation can create barriers to understanding the full picture of how interventions affect people across different services. Additionally, the data required for effective cost analyses stretches over time, making it difficult to capture the details needed for an accurate evaluation. As people recover their links with services and associated data-collection points rightly reduce, making it hard to follow people long-term.
There is also the issue of underreporting or misreporting the indirect benefits that multiple disadvantage services bring to the system. The full value of these services often lies in areas that are not as easily quantified —such as improving wellbeing, better social connections, reducing the need for emergency interventions or preventing long-term health problems later in life —and this becomes difficult to incorporate into a traditional cost-benefit framework.
Even when service changes can be easily measured, challenges can arise. By nature, most CBAs and CAAs deal in marginal cost – the cost of providing ‘one more’ of the service in question. Unless multiple disadvantage interventions are having an impact on large numbers of people, it can be hard to turn these into ‘cashable’ savings.
These points highlight that CBAs and CAAs don’t exist in a vacuum. Their impact, relevance and effectiveness are deeply tied to the local context and the unique relationships between partners. Whether a CBA or CAA case will ‘land’ with different partners, at different moments, depends on local dynamics, personalities, world-views and the pressures of commissioning and service delivery.
Some changes most valued by the system may have less to do with economic cost and more to do with opportunity cost (i.e. creating space and time for people to do their work better). An obvious example would be a local police force who can focus more time on serious crime because they are able to refer people facing multiple disadvantage to a support provider.
CBA and CAA analysis may also uncover value in one service or area but fail to fully capture the broader system change happening across the community.
So knowing all this, what do we do?
The key takeaway here is that we need to hold cost-benefit analyses (CBA) and cost-avoidance analyses (CAA) within a Both/And framework. These tools are undeniably powerful evaluative instruments, but they also have limitations. Specifically, they struggle to capture the soft data—the true strength of a multiple disadvantage service—and, crucially, the authentic voice of individuals who are experiencing multiple disadvantage. The nuance of human experience, and subtleties of people’s journeys through complex systems, can’t always be measured in strict numbers.
Moving forward, we must build CBAs and CAAs into our wider data intelligently. This means integrating narrative and data to account for the full complexity of an intervention. By blending hard data with the lived experiences of those affected, we can create a clearer picture of the long-term impact and appeal to a wider group of people moved by different types of evidence. This Both/And approach isn’t just a methodological shift—it’s a recognition that data alone cannot fully capture the human side of systems change. We need to evolve the way we use CBAs and CAAs, ensuring they reflect both the tangible outcomes and the subtle, yet critical, human aspects of the work.
Given these challenges, creating an intelligent CBA and CAA is no easy feat. However, the real progress in this field will come from a collaborative approach—cross-pollinating ideas, methodologies, and technologies. Local areas succeed by sharing insights, adopting good practices, and working together to evolve these tools. This is systems change work, and just as the work itself spans across sectors and disciplines, the evaluation of that work must do the same.
Cost implications of multiple disadvantage work demand a level of curiosity, trust, and relationship-building, and there is a perhaps surprising amount of creativity involved in how local areas are organising themselves and their relationships to costings work. It’s only by embracing this holistic, cross-sector approach that we can move closer to understanding and measuring the true impact of interventions and think about how we can use this learning to leverage power and challenge restrictive commissioning and budget practice.