An independent evaluation and a 17-point roadmap to secure long-term provision for CSA survivors in South West London
| Outcomes at a glance |
|---|
| Outcomes |
| • 78% of therapy outcomes survey respondents recorded a positive change in scores over time |
| • Boys and young men accounted for 7% of referrals, against national estimates that they represent around a quarter of victims. This shaped a recommendation to strengthen referral routes so that more boys and young men can access support |
| • A 17-point roadmap delivered to commissioners, prioritised by impact and feasibility, to inform the business case for a long-term commissioned service |
| Reach and delivery |
| • Fourfold increase in access compared to previous provision, engaging 335 children and young people over 22 months |
The challenge
Around 500,000 children are sexually abused every year in England and Wales. Children who have experienced sexual abuse can suffer a range of psychological and behavioural issues from mild to severe, in both the short and long term. The effects depend on the circumstances of abuse, the child’s developmental stage, and how the adults around the child respond.
South West London faced a critical gap and historical fragmentation in provision for children and young people affected by child sexual abuse across six boroughs. A pilot service had been commissioned and funded jointly by SWL ICB, NHS England, and the Mayor’s Office for Policing and Crime (MOPAC) to begin addressing this gap. Commissioners then required a definitive evidence base to navigate a complex multi-agency landscape, prove the true impact of the pilot, and establish a clear plan for long-term provision. TPHC was appointed to independently evaluate the pilot’s impact and deliver an action plan for sustainable, equitable care.
Our approach
No logic model or theory of change existed for the pilot, so we built one, establishing the causal pathways the evaluation would test. We then designed a mixed-methods framework drawing on RE-AIM, realist evaluation and process evaluation, combining service data, stakeholder insight and market analysis with the lived experiences of young people and families. This captured outcomes that had previously gone unmeasured, including psychological distress and parental isolation.
To gather lived experience safely and ethically, we worked with a specialist survivor-led partner to conduct qualitative work with 17 young people and nine parents and carers, under protocols covering informed consent, anonymity and safeguarding. What participants told us shaped the findings directly, rather than illustrating conclusions reached by other means.
We translated service data into actionable insight. Referral analysis showed that boys and young men made up 7% of referrals, and that over half of all referrals came from two of the six boroughs. Benchmarked against national prevalence estimates and local 0-19 population data, both became concrete recommendations: targeted work with referrers to reach boys and young men, and a community-based delivery model to address geographical inequity. This culminated in a 17-point action plan, prioritised by impact and feasibility, setting out a transition aligned with international best practice including the Child House (Barnahus) model.
The impact
The pilot supported 335 children and young people over 22 months. The provision it replaced had received 60 referrals over 15.5 months. Of the 45 therapy clients who completed outcome measures more than once, 35 (78%) showed improvement in their scores. Completion rates across the wider cohort were low, and we recommended a mandated, resourced performance framework so that any future service can evidence its impact consistently.
The evaluation profiled a cohort with high and overlapping needs. Over three quarters of service users had at least one recorded disability, 19% were neurodiverse and 13% had learning difficulties. Referrals for Black (20%) and Mixed-heritage (16%) children exceeded their share of the local 0-19 population (13% for each), evidence that the pilot was reaching communities the previous provision had not, and a basis for formalising culturally competent practice in any future contract.
Our recommendations set out a strengthened model for the future service. This included a broader therapeutic offer covering embodied, non-verbal and creative therapies, and a whole-family approach that recognises the role of non-offending parents and carers.
Children and young people who used the pilot consistently described the support as validating and safe.
The evaluation gave commissioners the evidence base to move beyond short-term pilot funding and plan a stable, long-term service. Commissioners are using the findings and the roadmap to develop a multi-partner business case and inform recommissioning, working towards more consistent and equitable provision across South West London.
What our clients say
“I recommend TPHC as a suitable provider for independent evaluations. They have demonstrated strong experience in working across health and community projects, using robust and ethical evaluation methods, and worked well with diverse stakeholders. Their report on the evaluation of our child sexual abuse commissioned work across SWL has been of high quality, and provided clear, actionable insights.”
SWL ICB Mental Health Transformation Project Manager
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