Leeds GATE

Working to improve the quality of life for Gypsies and Travellers

0113 240 2444

Crown Point House,
167-169 Cross Green Lane,
Leeds LS9 0BD

Short term funding, evaluation and marginalised communities

Ellie Rogers's picture
By Ellie Rogers |  July 20, 2017 |

It is a persistent struggle in the voluntary sector for sustainable funding. Whilst we can at GATE generally expect a three-year cycle from many funders, we have recently been commissioned for and been partners in other commissions for, 1 year projects. These projects inevitably carry evaluations, both quantitative and qualitative.

There are obvious barriers to delivering a project in a year, particularly when (as is well documented) your main currency is trust. But as we enter another period of evaluation for another 1-year project (only 3 months after we did the last one!) I am prompted to think about equity in service delivery.

The two projects I am reflecting on are an Outreach Nursing Project and a Health Advocacy Project. Both projects are acknowledged as necessary bridges for Gypsies and Travellers to receive equitable access to services, they aim to build bridges and pave wider roads whilst supporting people’s tunnels. See Leeds GATE’s Roads, Bridges and Tunnels work for more information. The projects would not be funded by statutory health commissioners if they did not recognise that these communities face multiple barriers to accessing and navigating statutory services and as such receive a less equitable service and poorer health outcomes. So these bridges aim to enable statutory access. In the classic picture I link to here - they demonstrate the need for equity rather than equality in access, and an eventual goal of removing systemic barriers (widening the road).

 

And here’s my point - we should also think about equity when thinking about evaluation. I don’t have to take part in multiple qualitative evaluations to receive my healthcare. I might be asked to reply by text to my doctor on a patient and families survey or I might from time to time be asked if I’d like the opportunity to take part in a focus group. But I will not routinely be visited at my home by a string of academic or otherwise evaluators wanting to know all about my health problems and how x service helped me to address them. There is an assumption and concensus that the service being provided to me is a necessary one, it's performance and quality should be monitored but it doesn't need to prove its existence. 

Is it not another inequity in access that we demand so much from people in evaluations of short term projects? The same people we recognise as having poorer outcomes and less social capital, we ask to participate hugely more than we would your average citizen. And we ask them to contribute to this with no guarantee of continuation funding for what are, as acknowledged through their very funding, essential services.

I would suggest we need to stop looking at these services as an add on and start looking at them as necessary services, then we need to look at how we monitor and evaluate necessary services, which probably isn’t on a year by year basis and via in depth evaluation.

Taking a step back from these evaluations - that I have been very involved in and passionate about - I can’t help but feel a bit like the orientalist. Do these evaluations promote inclusion and make a case for bridging services or do they simply make the case for difference?  Continually going round this cycle of interviewing people in research to look at what’s wrong, putting in short term funding to address it and then again interviewing people about this - what message is this sending? Is it that we don’t trust or believe people’s experiences, the evidence, the previous evaluation? Or is that we think people are so remarkably different and other to us that we need to look at them again and again to satisfy our curiosity?

Some of our ideas about solidarity and commissioning from the margins are again powerful here. We have identified that for loads of marginalised groups there are similar systemic barriers (road blocks) and similar bridges work to get around them, there is also a wealth of evidence and evaluation about best practice to draw on. Can this learning across a number of groups help to combat the curiosity and place the problem back where it should be located - in the system not in communities? Can a bulwark of people all saying the same thing, convince commissioners that this is not a “minority interest group”, should not be included as an after-thought when all the money’s already been spent, but that commissioning should start from the margins, start from the points of severe inequity in access and outcome and work its way in?

I’m reminded of comments at a conference earlier this month about how things haven’t changed for Gypsy Traveller health in 30 years. Well, maybe this is a part of why things never change, because actually a lot of parts of the system are invested in them not changing. Perhaps is we could commit as much funding to delivering these necessary services as we do to proving the case for them (again and again in every city in the UK with no joined up strategy to share that learning!), things would have changed by now.

Please also see our health advocacy evaluation - learning and best practice guidance available here.

Next article: "Health Advocacy - saves money, changes lives"