In today’s financially constrained climate, public health evaluations are essential. They demonstrate whether programmes like exercise referral services are effective and highlight how they can be improved. Involving residents in shaping these evaluations makes them more relevant and tailored to community needs.
Between May 2024 and May 2025, Southwark Council worked with PHIRST Elevate, one of 10 NIHR-funded Public Health Intervention Responsive Studies Teams (PHIRST). Based at the University of Edinburgh, PHIRST Elevate were tasked with assessing the borough’s exercise referral programme, the ‘Integrated Healthy Lifestyle Service’.
The service helps Southwark residents become more physically active through a central ‘hub,’ which acts as the first point of contact and matches people with suitable exercise opportunities.
Throughout the evaluation, PHIRST Elevate worked closely with local residents to co-design methods and ensure findings were communicated in accessible ways. Public involvement was central from the outset.
A gym session delivered through Southwark Councils' 'Integrated Healthy Lifestyle Service'
1. Shaping evaluation methods
Getting the evaluation plan right ensures that you build a solid foundation for the evaluation to succeed, and local insights here were crucial. PHIRST Elevate worked with Southwark residents to tackle questions such as:
Using these insights, we designed the evaluation to be tailored to the needs of service users and the community in Southwark.
2. Adding context and prioritising findings
We also worked closely with Community Health Ambassadors - local residents trained to share accurate health information with the public. Using their networks, they can provide the research team with crucial context to the evaluation’s findings. For example, they explained that self-referral rates to the hub might be low due to perceptions that GP referrals carry more weight and confusion over eligibility.
The ambassadors also helped prioritise which findings mattered most to the community. These included: limited awareness that self-referral was possible, little knowledge of free or discounted gym access after programmes, and the absence of a resident group providing regular feedback on services.
Through my involvement, I was able to connect services and the community. This will encourage accessibility and trust, especially within the BAME groups.
We bring insights that are different from researchers or the council. We have lived experience, we know the community very well, and are always involving them. They tell us their challenges – we know what is on the ground. It is important that we are involved.
3. Strengthening recommendations
Community Health Ambassadors went on to highlight that the community would benefit from establishing links between existing community services and the Integrated Healthy Lifestyle Service. They also had lots of ideas around how to ensure there is continuous feedback from residents and service users to improve the exercise referral service longer-term. This input fed into the recommendations in the final evaluation report.
We want to create messages that people can relate to. It’s important that we are not just listened to, but that our ideas are implemented.
4. Co-presenting findings
Community Health Ambassador Omotola Wonuola co-presented final findings to Southwark Council in June 2025. She represented the community voice, explained contributions and highlighted opportunities to connect with other community services. She helped us add local context and insight, while building new relationships between the council and members of the community. You can listen to her reflections and top tips for public involvement here.
For both Ese and Enduement, this was their first experience collaborating with academics. Enduement, who has previous outreach experience, enjoyed the shift to evaluation work and has since joined another NHS public involvement project, commenting, “I am inspired, I want to be more involved and do more collaborations”.
From the council’s perspective, the process had lasting impact. Maria Bujor, Public Health Programme Manager at Southwark Council, noted: “The involvement of local residents and public health champions throughout the evaluation has strengthened our commitment to community-led service design.”
It was brilliant to work with local residents on this evaluation, from planning right through to reporting the final results and supporting Southwark to implement the findings. Their knowledge and insight into local conditions and context helped make the work more relevant and hopefully more useful to local communities. We really benefited from the collaboration.
Southwark Council is currently redesigning the exercise referral service based on the evaluation’s recommendations. Once the new service is finalised, PHIRST Elevate and the Community Health Ambassadors will help communicate changes to local people in Southwark.
Understanding what has been implemented and how the service is now improved is most important to the community.
View the findings and recommendations of the evaluation, which are helpful for any local government looking to adopt a hub as part of their exercise referral service
Watch a video sharing top tips for public involvement in evaluations
Find out more about PHIRST
Find out more about Community Health Ambassadors