Equally well test sites evaluation

In 2007, a Ministerial Task Force on Health Inequalities, led by the Minister for Public Health, was established to identify and prioritise practical actions to reduce the most significant and widening health inequalities.

Go to the Equally Well Test Sites Evaluation.

The Task Force’s report, Equally Well (external link), was launched in June 2008.

In October 2008, eight test sites were announced as part of the delivery of the Health Inequalities Task Force report recommendations. The test sites aim to reduce health inequalities through collaboration between local public services in the redesign, improvement and targeting of services for the benefit of the people who need them the most. A national level evaluation was commissioned by NHS Health Scotland in January 2009.

The main focus of this evaluation was on the service redesign objectives of the eight test sites and what lessons could be learned overall.


Evaluation Aim

The aim of this evaluation was to improve understanding of what works and what doesn’t when embedding change within existing local services in order to address health inequalities.


Key Evaluation Questions

  • How does the approach adopted in the test site differ from that which went before, as a result of the focus placed on tackling health inequalities? How would the test sites describe the distinguishing characteristics of this approach; that is, what distinguishes it from a more general population health improvement approach they have used? Has it resulted in reallocations of resources and in what way?
  • How has partnership working between agencies been developed, or altered, in order to better address inequalities? What have been the barriers to successful partnership working: what have been the enablers?
  • How is learning taking place and what lessons are emerging? What approaches are effectively supporting the recording and sharing of learning within the test site and beyond?
  • What steps are being taken towards sustained integration of service redesign within the test site localities? What evidence is there of how service redesign has translated to practice in ‘frontline’ or direct services? How is the service redesign process supporting staff in ‘frontline’, or direct services, to think differently about targeting services to those experiencing health inequalities?
  • From the experience of the test sites to date, what are the three most significant things that each has achieved that hadn’t been achieved before test site status?
  • What national-level actions are needed to enable the impact of local work to be maximised and replicated in other areas?

The test sites are:


  • Whitecrook, West Dunbartonshire - targeting the high prevalence of smoking in the area
  • East Lothian - looking at health inequalities in early years in Prestonpans, Musselburgh East and Tranent
  • Govanhill, Glasgow - looking at community regeneration and development
  • Blairgowrie - looking at delivering health inequality sensitive services in a rural setting for people with multiple and complex needs
  • Lanarkshire - focusing on sustained employment and barriers to people finding employment
  • Fife - focusing on anti-social behaviour in relation to alcohol and underage drinking
  • Dundee - focusing on methods of improving wellbeing
  • Glasgow City - looking at integrating health into current and future city planning

Equally Well Learning Notes

During the course of the evaluation, two learning notes have been published in order that lessons learnt could be more widely shared. These learning notes address:

  1. Service Re-design, joined-up working and community engagement.
  2. Sustainability and change.


The Notes are written specifically for people directly involved in the Test Sites. However, they may also be of practical interest to managers in the public sector, to the Scottish Government, and to agencies supporting transformational change in public services


Equally Well Test Sites Evaluation Report Update

The eight Equally Well Test Sites have submitted evaluation reports to the Scottish Government to provide an up-date on Test Sites progress towards tackling their specific health inequalities issues.

The Scottish Government have produced a report from the local evaluations that draws key lessons from across the Test Sites with the purpose of disseminating learning to the Test Sites to help them make future improvements in Year 3.

This analysis provides an understanding of what evidence Test Sites have in place, and what are the key lessons which the Test Sites have learned when developing their approaches to address health inequalities.


Dissemination of Learning

NHS Health Scotland is working with the Scottish Government to disseminate the learning from the evaluation. We hope to engage with others to advance our collective thinking about tackling health inequalities. We will be focussing our dissemination and communication activities on four themes emerging from the evaluation:

  • Being smarter about partnership working
  • “Doing things differently”
  • Evaluation, learning and knowledge exchange in collaborative contexts.
  • Health inequalities – moving beyond area-based targeting.

NHS Health Scotland is now running a series of round table sessions to explore the themes which have emerged from the evaluation. The first of these round tables, ‘Doing Different Things, Doing Things Differently’, was held on Tuesday 18 October 2011. The aim of this round table was to bring together a mix of Local Government, NHS, Scottish Government and Third Sector leaders to advance our thinking about tackling inequalities.


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Updated 24 July 2014

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