How and why does Local Area Coordination work for people in different contexts?

The increasing adoption of Local Area Coordination (LAC) across the UK as a strengths-based approach to acting on inequalities which impact on individual health and wellbeing, and reducing reliance and avoidable use of health and social care services, has catalysed increasing calls for evidence to justify economic commitment.
In a time of austerity where extreme pressure is on resources to prove short-term outputs, Pawson and Tilley’s (1997) realist evaluation methodology holds significant promise in asking critical questions of how and why programmes work. Ultimately such philosophical standpoints facilitate opportunities to examine whether the sustainability of programmes are cost-effective for the system in the longer term.
This paper draws upon the findings of a realist evaluation of LAC on the Isle of Wight (IOW) and establishes how and why the programme works for people and local communities. A blend of realist approaches; Q-method and realist interviews was adopted within this study. The study’s sample were a cross-section of people who engaged with the LAC programme across the IOW.
The findings of the evaluation established that the Local Area Coordinators ability to facilitate a ‘golden triangle’ of listening, trust and time were factors which made LAC work. It was also clear that LAC worked for different people in different ways, demonstrated through the contextual differences between three subgroups who were categorised based on shared viewpoints, and presented through the holistic narratives, and corroborating interview data.