The Child Health Equity Framework was developed as part of the Children and Young People’s Health Equity Collaborative (CHEC): a partnership between the UCL Institute of Health Equity (IHE), Barnardo’s and three Integrated Care Systems (ICSs), Birmingham and Solihull, Cheshire and Merseyside, and South Yorkshire, which ran from 2023 until 2025.
An independent evaluation was carried out by M.E.L Research using the following key research questions:
Outcomes
- To what extent have the key outcomes of the CHEC programme been achieved?
- Have there been other outcomes because of the CHEC programme?
Mechanisms
- What are the mechanisms for change in the CHEC and what impacts (intended or unintended) do they lead to?
Contexts
- What are the contextual factors that affect implementation of the programme - at the programme and at the ICS level?
Next steps
- What can be learnt from the CHEC programme to strengthen healthcare system action on the social determinants of children’s health?
An evaluation of the ICS pilot initiatives, informed by children and young people’s insights and that address one or more of the social determinants of children’s health, was carried out by IHE and is included in the CHEC evaluation report.
The CHEC programme provided important proof of concept for how ICSs, the VCSE sector, and children and young people can collaborate to strengthen the focus on health equity within local systems. Its work demonstrated how partnership-based and preventative approaches can improve outcomes for children and young people, particularly in areas such as mental health, wellbeing, and resilience, all of which sit within the remit of local commissioning and service design.
While CHEC did not directly address the broader structural determinants of health such as income or housing, it helped to raise their visibility within system discussions and reinforced the importance of intersectoral collaboration in tackling these challenges. The programme acted as a catalyst for change by embedding new ways of working, demonstrating the value of co-production, and strengthening governance and partnerships.