The economic contribution of third sector initiatives for older people: a systematic review and development of a framework for evaluation

An ageing population has placed strains on health and social care systems. Innovative solutions have been sought to inject capacity and capability in order to deliver services to older people more efficiently and effectively. Over the last two decades, governments have actively encouraged third sector organisations to deliver public services on the assumption that they exhibit higher levels of innovation, efficiency and responsiveness. The evidence base, particularly for whether they provide better value for money, remains poor. We present the results of a systematic literature review on the costs and outcomes of services for older people delivered by third sector organisations. We combine this evidence with a framework for analysing the benefits and costs of third sector-led initiatives, and test this out empirically with a group of initiatives delivered for older people in an urban context. We find that our method may hold considerable promise for the evaluation of third sector initiatives.