Evaluating Integrated Care Innovations:NICHE Anchor Institute’s Impact on Overcoming Constraints in Tackling Health Equity in Rural Coastal Communities

Yuen, Johnny, Webster, Jonathan, Hardy, Sally and Odell, Joanne (2025) Evaluating Integrated Care Innovations:NICHE Anchor Institute’s Impact on Overcoming Constraints in Tackling Health Equity in Rural Coastal Communities. In: International Conference on Integrated Care (ICIC25). Lisbon 14th- 16th May, 2025. UNSPECIFIED.

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Abstract

Background: Established in 2022, the NICHE Anchor Institute at the University of East Anglia aims to tackle the health disparities and service delivery challenges faced by residents and health and social care professionals in Norfolk and Waveney’s rural and coastal communities through integrated care models. These areas experience workforce burnout and shortages, geographical isolation, and socio-economic deprivation, impacting the delivery of and access to quality integrated healthcare. NICHE’s mission is to ignite, innovate, and embed sustainable, community-driven solutions that transform integrated healthcare practices and workforce development. In its second year, NICHE focused on implementing these efforts, while the current year is dedicated to evaluating their impact, refining strategies, and enhancing models that empower local communities to sustainably strengthen integrated care systems. Approach: NICHE’s internal evaluation, commencing in the fourth quarter of 2024 and culminating towards the wrap of NICHE in late 2025, focuses on assessing its place-based, collaborative, and context-sensitive efforts aimed at transforming integrated healthcare practices, enhancing workforce development, and promoting community participation to build resilient, localized integrated care systems. To achieve this, the evaluation employs a critical realist framework (1,2), integrating ecological model systems thinking (3) and participatory evaluation (4). This comprehensive approach allows us to explore the context-mechanism-outcome (CMO) that underpin effective integrated healthcare transformation and the conditions under which they occur. In keeping with NICHE’s “evaluate-with” philosophy, we work collaboratively with over 50 healthcare professionals, community leaders, and local stakeholders involved in NICHE projects to catalogue their journey. We conduct semi-structured interviews, ripple mapping exercises, and thematic analysis to gather insights. This participatory methodology, which emphasizes co-design and active involvement, ensures that evaluation is carried out alongside the communities and professionals, making the findings more relevant and actionable within integrated care contexts. The breadth and depth of NICHE’s projects are reflected in their diverse impact areas, ranging from enhancing integrated care service delivery and workforce development to fostering community resilience and local leadership. By engaging a wide spectrum of participants at different stages of the project lifecycle, NICHE leverages local expertise to co-create integrated care models tailored to the socio-economic and cultural contexts of rural coastal communities. The collaborative nature of the internal evaluation fosters local ownership and ensures the development of sustainable, impactful solutions that extend beyond immediate project outcomes, creating lasting change within the community and integrated care systems. Results: Quarterly reports and service evaluation of NICHE projects have begun to pinpoint significant outcomes and showcase ripple effects from NICHE’s place-based, collaborative efforts in integrated care. By tailoring healthcare practices to align with the socio-economic and cultural realities of Norfolk and Waveney’s rural coastal communities, NICHE has already shown improvements in the delivery and accessibility of integrated healthcare services. Customized integrated care pathways have been developed to respond effectively to the unique needs of the local population, enhancing service quality and reach. We anticipate further increases in workforce resilience as NICHE’s projects continue to support career development through leadership training and skill-building activities tailored to the demands of these regions. These efforts aim to empower local professionals to navigate integrated healthcare complexities effectively, strengthening retention and engagement within the workforce. The co-designed, participatory approach central to NICHE’s projects has fostered a strong sense of community ownership and participation, helping build an integrated and responsive healthcare system. As the evaluation progresses, these findings will illustrate how NICHE’s targeted efforts create meaningful, sustainable change, influencing policies and practices at multiple levels within the integrated care system. Implications: The transferable experience of NICHE offers valuable learning for other regions and organizations aiming to tackle health disparities through tailored, place-based integrated care interventions. The internal evaluation of NICHE highlights the critical importance of context-sensitive, community-driven approaches in addressing health inequalities, particularly in rural and coastal communities. Through its collaborative partnerships and capacity-building initiatives, NICHE has established a scalable model for sustainable health and integrated social care transformation that is adaptable to other communities facing similar challenges. This model demonstrates how localized, co-designed solutions can effectively enhance integrated healthcare delivery, workforce resilience, and community involvement. Future steps include disseminating the evaluation findings to influence policy at both local and international levels, ensuring that the NICHE model can be expanded and adapted beyond Norfolk and Waveney. Additionally, NICHE plans to conduct longitudinal studies to assess the long-term impact and scalability of its efforts, providing further evidence of its effectiveness. By embedding critical realism, participatory evaluation, and practice development, NICHE not only impacts the immediate integrated healthcare landscape but also offers a blueprint for sustainable and equitable healthcare solutions that can be replicated in other underserved communities, ensuring broader health equity and resilience.

Item Type:	Book Section
Uncontrolled Keywords:	integrated care,sdg 3 - good health and well-being ,/dk/atira/pure/sustainabledevelopmentgoals/good_health_and_well_being
Faculty \ School:	Faculty of Medicine and Health Sciences > School of Health Sciences
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Centres > Mental Health and Social Care (fka Lifespan Health)
Depositing User:	LivePure Connector
Date Deposited:	04 Dec 2025 10:30
Last Modified:	04 Dec 2025 11:30
URI:	https://ueaeprints.uea.ac.uk/id/eprint/101241
DOI:

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