Social value is important to us because it reflects our commitment to improving lives beyond the delivery of clinical services.
Every day through our work with individuals, families and communities, we aim to make a positive impact which goes beyond our core activities and statutory responsibilities.
You will find on this page a series of case studies which bring to life how our services, aimed at adults and children, go beyond delivering high-quality care to help tackle inequalities, support wellbeing, strengthen communities and use public resources responsibly.
Together, they showcase the difference we make by listening to local needs, working in partnership and focusing on what matters most to the people we serve.
Reaching people experiencing homelessness with vital vaccines
This project aimed to increase vaccination uptake among people experiencing homelessness across Bedfordshire, Luton and Milton Keynes (BLMK). By working in partnership with trusted local organisations such as homeless shelters, day centres and food banks, we delivered vaccinations in familiar, accessible environments. The service provided clear and up-to-date health promotion, flexible clinic times and outreach-based delivery to reduce barriers to access. Through relationship-building and repeated engagement, the project has successfully improved vaccine confidence and uptake within a highly vulnerable population.
The challenge
People experiencing homelessness face multiple barriers to accessing vaccinations, including:
Limited health literacy and lack of up-to-date vaccine information
Vaccine hesitancy, often linked to concerns around COVID-19 vaccines, which impacted acceptance of other essential vaccines
Competing priorities, with vaccinations perceived as low priority
Limited ability to travel to fixed-site vaccination clinics
Low trust in health services, requiring repeated engagement to build confidence
Challenges delivering vaccinations safely and discreetly within public or shared spaces
To better understand these barriers, we engaged with our Off the Grid colleagues in Hertfordshire, who shared learning from similar outreach work. We also built strong relationships with Bedford and Milton Keynes Councils and Public Health colleagues, including Dr Zahid Ullah (Central Bedfordshire), who supported networking with wider BLMK multidisciplinary partners.
Project description
People experiencing homelessness are at increased risk of vaccine-preventable diseases and often have lower vaccination coverage than the general population.
The BLMK Off the Grid vaccination service was established in September 2025. The service is delivered by a small team of three qualified nurses with extensive vaccination experience. Our primary aim is to improve vaccination uptake among people who are homeless or otherwise vulnerable.
A key focus of the project was relationship-building. This involved extensive networking, telephone calls and face-to-face visits with homeless shelters and support services across BLMK. We presented the service to multiple organisations, all of whom were highly supportive and keen to engage.
Vaccination clinics were arranged at times and locations convenient for service users. Simple, clear promotional posters were provided to shelters at least one week in advance. On clinic days, we established small, discreet clinic spaces within the shelters. Using secure access to clinical systems, we reviewed individual vaccination histories and offered any missed or seasonal vaccines where appropriate.
Although some individuals were initially hesitant, we prioritised non-judgemental conversations and health promotion. By allowing time for discussion and repeat visits, many clients chose to return at later sessions to receive vaccinations.
Outcomes and impact
The project has demonstrated clear and measurable social value across the themes of health inequalities, prevention and sustainability.
Reducing health inequalities
Delivered 158 vaccinations to people experiencing homelessness across BLMK since September 2025, a population with historically low vaccine uptake.
Improved access to healthcare for individuals facing barriers such as unstable housing, low health literacy and limited mobility.
Strengthened trust between homeless communities and health services through consistent, relationship-based outreach.
Prevention and early intervention
Increased protection against vaccine-preventable diseases, reducing the risk of outbreaks within homeless settings and the wider community.
Supported informed decision-making through tailored health promotion and repeat engagement, helping to address vaccine hesitancy.
Seeks to identify unmet health needs during vaccination encounters, creating opportunities for earlier intervention and onward referral.
Sustainability and system efficiency
Reduced reliance on urgent and emergency care by preventing avoidable illness.
Delivered care in community settings, minimising non-attendance associated with traditional clinic-based models.
Built sustainable partnerships with local authorities, shelters and voluntary organisations to support ongoing delivery.
Lessons learned
Offering clinics later in the day was more effective, as attendance increased around lunchtime when food services were available.
Out-of-hours and evening sessions were essential for reaching people who sleep rough or attend night shelters.
Providing clear, simple and up-to-date information supports informed decision-making and reduces feelings of pressure.
Repeated engagement and consistency are crucial for building trust and improving uptake.
Working with children and young people on a vaccine awareness campaign
This project was undertaken by East of England Community and School Aged Immunisation Service (CSAIS) with support by NHS England and involved the Clinical Quality Lead, Clinical Lead Team, Project Support, HCT Communications Team, Social Change UK, children and young people who participated, CSAIS teams across Hertfordshire and West Essex, Cambridge, Peterborough, Norfolk and Suffolk and education providers who allowed us to attend and hold the focus groups on premises.
This project is important as it aims to improve vaccination uptake among children and young people, reduce health inequalities, build trust through engagement and supports CSAIS future delivery plans by utilising evidence-based and user informed campaigns.
its aims were:
To facilitate the co-design and production of promotional materials for children and young people, with a particular focus on teenage vaccinations (HPV, Td/IPV and MenACWY) as well as a reminder for the MMR vaccine. This included creating materials or content informed by the focus group outcomes.
To use engagement and co-design activities to inform CSAIS future delivery plans and service approach for promoting and delivering vaccinations to children and young people. The goal was to ensure that the service is shaped by the perspectives of children, their families, education providers and practitioners within the service, making vaccination information more accessible, appealing and effective to the target audiences.
To have materials available for services to use at the end of the project, translated into the most popular languages across the East of England.
The challenge
Vaccination uptake among children and young people for school-aged vaccinations such as HPV/Td/IPV and MenACWY and also MMR was not optimal. National and local data trends showed variation in vaccination uptake particularly in certain communities.
Focus groups identified that there was limited awareness and understanding among young people and their families when it came to these immunisations. Existing materials were described as boring, too wordy and hard to understand by children and young people. We also identified that between areas, there was inconsistent engagement between CSAIS practitioners, schools and families as well as a lack of presence online by our service.
We also appreciate that there are health inequalities across different socio-economic areas within our region that all require tailored approaches. This was identified through focus groups with CSAIS practitioners, education providers and young people.
Early discussions with NHSE and CSAIS highlighted the need for co-designed, youth-friendly materials to improve trust, relatability and accessibility.
Project description
Planning and set up:
We held preliminary meetings with NHSE and CSAIS leads to agree on engagement methods. We developed co-design templates and identified target schools in differing socio-economic areas (areas of deprivation, affluence and mid range). Established engagement questions and methods (interviews and email surveys).
Engagement:
We held engagement focus groups with secondary school pupils in year 8, 9, 10 and 11 ensuring all our CSAIS regions were covered. We sent email questionnaires to education providers and CSAIS staff.
Design and verification:
We analysed engagement findings to inform design, we worked with Social Change UK and HCT Comms to create draft materials and verified these with NHS and CSAIS senior leadership and then tested these out with young people. We incorporated feedback and produced the final materials (video and written/social media materials).
Key contributors were CSAIS clinical quality lead, clinical leads, project managers and communications partners, HCT Comms and Social Change UK as well as the children and young people, education providers and CSAIS practitioners across HCT regions.
Innovative approaches from this project include:
Co-design methodology meant we had direct involvement of young people in shaping content, making materials more relevant and appealing.
We used multi-channel engagement which combined traditional methods such as leaflets and posters with digital strategies such as videos and social media assets based on youth feedback.
Inclusive design to consider accessibility by making the materials accessible to other languages (we selected the most popular languages reported within East of England according to local and national data).
We also took a cross-sector collaboration approach by working with creative agencies and NHS communications teams to ensure professional, impactful outputs.
Outcomes and impact:
Final deliverables included a video and social media/written assets co-designed with input from young people, education and service providers.
This project is yet to be launched so evidence of post-implementation impact is limited at the present time. However, we can assume from the engagement process that the following differences have been made:
Children and young people reported existing materials were boring and hard to understand. Through co-design they suggested improvements which have been translated into the materials produced. This has made materials more appealing and accessible including those with a first language that is not English.
The broad participation we gained ensured that outputs reflected real user needs and were not based on assumptions.
The themes from responses show clear shifts in what would make them more likely to get vaccinated. These included visual and interactive formats such as videos and assemblies, a desire for practical information on side effects, what the vaccines are for, how it feels and how many they need to be protected. They also highlighted the importance of trusted messengers such as parents, teachers and community figures. Education providers echoed the need for timely, clear communication and supported the idea of assemblies and parent engagement.
CSAIS staff and educators confirmed that the new approach would improve communication and reduce confusion.
Lessons learned
What went well:
Strong engagement from children and young people:over 80 respondents provided detailed feedback, giving clear direction on preferred styles and content. We also saw many CYP volunteer to participate in the production of the video, with timely returns of the consents for filming.
Clear consensus on digital approach: 70% of CYP preferred the use of a video for delivery of information on vaccinations, which aligns with current trends in youth engagement.
Collaborative planning: frequent meetings between the Clinical Lead team, NHSE and the projects team ensured alignment and quick decision-making on deliverables and timelines.
Consolidating service understanding of what already works: 91% of CYP and 100% of education providers and staff agreed that parental involvement is helpful which reinforces the dual target approach for materials.
Challenges included:
Complex stakeholder engagement: coordinating input from three distinct groups (CYP, education providers and CSAIS staff) across 5 geographical locations was logistically complex and took time to plan. It was also challenging to gain participation from schools that were representative of the population we serve (in that they included areas of affluence and deprivation). All filming was planned to take place on the same day for logistical and budget reasons. We faced time constraints and pressures created some errors and oversights in content. We therefore needed to reshoot some content following the original filming date.
Balancing priorities: Children and young people asked for bright, digital, video-based content while staff and education providers emphasised assemblies and written materials. Aligning these preferences into a single coherent strategy was challenging.
Time constraints: The engagement phase overlapped with the many different commissioned programmes that run and there was the addition of Covid-19 vaccination delivery to many teams. This extended timelines and increased resource pressures as there were conflicting priorities.
Data synthesis: The choice to use semi-structured interviews and free text MS forms responses meant that there was a lot of qualitative feedback to collate. This was time consuming and complex.
7. Next steps
We will be launching the campaign shortly, and seeking to gain post-production feedback from children and young people, staff and education providers.
This project aimed to increase vaccination uptake among people experiencing homelessness across Bedfordshire, Luton and Milton Keynes (BLMK). By working in partnership with trusted local organisations such as homeless shelters, day centres and food banks, we delivered vaccinations in familiar, accessible environments. The service provided clear and up-to-date health promotion, flexible clinic times and outreach-based delivery to reduce barriers to access. Through relationship-building and repeated engagement, the project has successfully improved vaccine confidence and uptake within a highly vulnerable population. 
