School of Health in Social Science

Theory of Change for the Health of Homeless People in Edinburgh

Carnegie UK Trust (CUKT) is a recognised expert in wellbeing policy and measurement, and it promotes evidence-informed decision-making and cross sectoral working.  As a part of these aims, CUKT produced research, InterAction, which explored how academics and the third sector can work together to influence policy and practice. Building on this knowledge, in 2018, CUKT supported the Collaboration for the Health of Homeless People in Edinburgh to engage with stakeholders, and agree its objectives.


A theory of change articulates how given actions are expected to make a difference in the world. It is a model or theory which underlines why a particular strategy and actions should result in the desired social change. Effective theories of change outline a path of change, from activities to long-term outcomes or goals and specify the intermediate outcomes (or preconditions) that need to be in place for the desired long-term outcomes



To develop the theory of change, we invited stakeholders from The Edinburgh Access Practice, NHS Health Scotland (apologies given), Inclusion Edinburgh (City of Edinburgh Council), the third sector, University of Edinburgh College of Arts, Humanities and Social Science and Heriot Watt University, to work through the steps in the process of drawing up an initial theory of change. Firstly we agreed that main target group for the collaboration is people experiencing homelessness, in Edinburgh. Then, we discussed the higher aim of the Collaboration and agreement was reached that the collaboration aspired to contribute to “improve the health and wellbeing” of this group of people. Following on from this we focussed on more immediate outcomes, and what activities might contribute to achieving them. Lastly, we tried to link the activities and outcomes to make a pathway towards our higher aim, and suggested some assumptions that needed to be in place to facilitate the impact of the activities. These might also be viewed as risks.There was an initial scoping with the partners from the third sector, NHS and Local Authority in March to May 2018, which highlighted the differences in opinion people had about the purpose of the Collaboration. So, to develop a shared understanding of the target audience and the long-term goal of the collaboration we decided to develop a theory of change for the Collaboration.

A good Theory of Change is a process as much as a product, so the current theory of change should be a living document, and can be developed with the ongoing dialogue between stakeholders and perhaps the oversight of small working group (e.g. 3-4 people). For example, we haven’t yet looked at how you’d measure the success, or otherwise, of the collaboration. The theory of change working group could identify indicators and measures that enable you to assess if the outcomes are being achieved.