Barnardo’s: Evaluation of The Children and Young People’s Health Equity Collaborative (CHEC)

The Children and Young People’s Health Equity Collaborative (CHEC) was a three-year partnership between Barnardo’s, the UCL Institute of Health Equity (IHE), and three Integrated Care Systems (ICSs) – NHS Birmingham and Solihull, NHS Cheshire and Merseyside, and NHS South Yorkshire. Its vision was that all children should enjoy good health and positive wellbeing, reduce child health inequalities and improve the outcomes for CYP from underserved communities by acting on the social determinants of health.

The CHEC sought to demonstrate how health systems can meaningfully strengthen child health equity through action on the social determinants of health, working in partnerships with, local government, and voluntary, community and social enterprise (VCSE) partners, while embedding the views of children and young people (CYP) into strategic decision-making.

Methods

The evaluation of the CHEC was designed to capture both outcomes and learning, using a mixed methods approach across the three participating ICSs. Data collection included:

▪        Document review of ICS board papers, strategic plans, reflective diaries (completed by ICSs, Barnardo’s and IHE), and internal programme reports.

▪        Interviews and focus groups with over 80 stakeholders, including ICS strategic leaders, operational leads, data leads, VCSE partners, and Health Equity Champions.

▪        Case studies and examples of good practice highlights that explore local innovations in-depth.

▪        Framework analysis aligned to the Child Health Equity Framework and programme objectives, assessing contribution to systems change.

Key Findings

Although direct attribution of system-level change to the CHEC programme cannot be established, triangulated evidence from interviews, documentation, and data review suggests that CHEC contributed to progress across the following domains.

Raising the profile of the social determinants of CYP’s health – During a period of wider system reform, including the establishment of the ICSs and the CORE20PLUS5, the CHEC contributed to embedding the social determinants of children’s health within local and national agendas (although this varied across the three ICS areas, with some having made progress on this prior to being part of the CHEC). Leaders we spoke to reported that issues such as poverty, housing, and school attendance are now more visible in long-term strategies, with children and young people no longer treated as an “afterthought” within local health systems, traditionally dominated by adult priorities.

Delivering interventions to address the social determinants of children’s health – Evaluation of the CHEC pilot initiatives – ranging from targeted interventions with underserved families in Cheshire and Merseyside and South Yorkshire, to a study of the potential for social value and corporate social responsibility in procurement to address wider social determinants of health in Birmingham and Solihull – highlights how initiatives guided by child health equity principles can have positive impacts on the health and wellbeing of participating children and young people, with the potential to reduce inequalities. Early findings from the targeted interventions suggest benefits for the at-risk groups engaged, while in Birmingham and Solihull, emerging partnerships between suppliers and community organisations show promise in strengthening support for local children and families. The ongoing challenge for health and care systems is how to focus on the upstream drivers of child health equity and design, deliver, and link services and initiatives in ways that match both the scale and the specific nature of local needs.

Strengthening governance and strategic priorities – The programme strengthened the focus on children and young people’s health within system-level discussions and supported ongoing work towards the re-prioritisation of children’s health alongside adult services. Through its collaborative approach and advocacy, CHEC complemented wider national and local movements to promote health equity, contributing to collective efforts that encouraged greater recognition of CYP within governance and planning structures. 

Building sustainable data infrastructure – Each ICS area has developed or improved their approach to analysing, presenting, and acting on data which is equity-focused and relevant for equity in the social determinants of health. The dashboards created, or enhanced, as part of the CHEC are continuing beyond the programme and have set templates for wider adoption, showing how ICSs can integrate the social determinants of health into routine monitoring and commissioning. 

Increased visibility and influence of CYP – the CHEC created formal mechanisms, including the development of the Child Health Equity Framework and the role of Healthy Equity Champions, which gave CYP a stronger voice within ICSs. While their input has not yet translated into consistent strategic influence, their presence has begun to shape conversations, interventions, and local planning, signalling the foundations for deeper involvement in decision-making. Champions across the programme gained skills, confidence, and networks, while also shaping interventions and policy priorities.

Embedding co-production and strengthening VCSE partner roles – The CHEC contributed to the strengthening of the VCSE sector as trusted partners of statutory services and young people. Organisations such as Chilypep in South Yorkshire demonstrated how sustained youth engagement can influence interventions, governance, and system-level strategies. However, there was limited evidence that VCSE partners were systematically included in decision-making and further development of the CHEC programme should consider how the VCSE, and the data they hold, could contribute more. 

Developing a proportional, universal approach – Across the CHEC initiatives, local areas are demonstrating elements of a proportionate universal approach – providing universal services and support, with more help given to those in most need. This approach is essential for improving health and wellbeing for all children, reducing health inequalities through action on the social determinants of health, and improving outcomes for children and young people from underserved communities – core aims of the CHEC programme.

National visibility and influence – the CHEC has been referenced in the Hewitt Review, parliamentary committees, and other national forums and NHS conferences. This visibility reinforced local activity, helping ICSs secure senior buy-in and aligning child health equity with broader NHS and government priorities.

The report was lauched at the Kings Fund event on 25th November 2025 (attended by Wes Streeting).  It is available on Barnardo’s webite.  It is hoped this project (and the evaluation) will help shift the focus to addressing the social determinants of children’s health.