Written evidence submitted by the Executive Programme on Paramilitarism and Organised Crime, relating to the effect of the paramilitaries on society in Northern Ireland inquiry (PNI0024)

Contents

Programme Overview

Specific questions posed by NIAC

What the socio-economic effects are of paramilitaries on communities in Northern Ireland?

How effective measures under the Fresh Start Agreement have been in combining police and justice measures and tackling socio-economic issues to eradicate paramilitarism in Northern Ireland?

Whether there should be a dedicated formal process of engagement with paramilitary organisations aimed at their disbandment.

Whether the UK Government, NI Executive and Irish Government are working effectively together to achieve a society free of Paramilitarism.

Whether the approach of the UK Government and NI Executive to tackling paramilitarism is sufficiently sustained, resourced and joined-up.

Programme Investment Profile 2022-23

Programme Overview

1. Recent data from the NI Executive’s Programme on Paramilitarism and Organised Crime (EPPOC) suggests that paramilitarism directly affects between 15 and 30% of the population in Northern Ireland. The EPPOC Programme (the Programme) is an ambitious, innovative cross-Departmental and multi-disciplinary initiative designed to address this complex problem and to create safer communities, resilient to paramilitarism, criminality and coercive control.

2. The Programme has operated since 2016 and is funded jointly by the NI Executive and UK Government. Phase 1, which ran to March 2021, focused on delivering 38 wide-ranging commitments in the original Executive Action Plan on paramilitarism, criminality and organised crime.[1] A comprehensive review of the Programme took place in 2020, leading to a new phase of the Programme (Phase 2) that started in April 2021. The Programme is currently funded until 2024.

3. In the current financial year (2022-23), the Programme is investing approximately £11.5m across nearly 80 projects. (Details of this can be found in the Programme Investment Profile attached at Annex A). Through a mix of innovative local expertise and internationally recognised methods, projects are helping people at risk of paramilitary exploitation through early, preventative interventions, as well as providing bespoke support and signposting for people already suffering harm. The Programme operates throughout Northern Ireland and projects vary in scale, focus, location, target group and methodology depending on assessed need. Projects must offer some form of ‘additionality’.

4. Projects are delivered through a network of 7 NI Civil Service (NICS) Departments, 22 statutory agencies, over 50 public sector and 180 community/voluntary sector organisations. Programme funding is ring-fenced[2]. Cross-Executive governance and scrutiny structures allow oversight from project level through to strategic level (overseen by the Head of the Civil Service). The Programme is also scrutinised externally by the Independent Reporting Commission (IRC), created under the Fresh Start Agreement to monitor progress on tackling paramilitary activity in Northern Ireland.  

5. Phase 2 of the Programme requires individual projects to work together to deliver shared and measurable medium and long term objectives. This approach is explained more fully below. Individual project outcomes are important but so, too, are outcomes that increase collaboration and shared understanding among delivery partners. These relationships and insights should help to ensure that the positive impact of the projects extends beyond the lifecycle of Phase 2 and that any gaps or duplication in service provision are identified and addressed.

6. Some projects have been operating for a number of years, others are pilots or ‘proof of concept’ initiatives. The projects cover a wide spectrum – ranging from early years family support to the rehabilitation of offenders and their reintegration into the community. Projects tend to fall into one of three categories:    

• Primary interventions: projects designed to prevent harm before it occurs. These are generally broad-based – a typical example is the WRAP Project: a wrap-around, flexible education service for children and young people facing significant challenges in four geographical areas.  This initiative focusses on educational under attainment and, in particular, on the impact of socio-economic deprivation on children and young people’s outcomes. Influencing community attitudes to education and raising aspirations is key to reducing educational underachievement which, in turn, helps to address the prevalence and impact of paramilitary activity and organised crime.

• Secondary Interventions: projects that deal with harm immediately – as it is happening – and which help to stabilise the situation and prevent it worsening. These projects apply to a smaller group of people. An example is the  Mid and East Antrim Youth Support Hub: this project involves the creation of a multi-agency youth stream of the Mid and East Antrim Support Hub to support young people (up to 25 years) who are at risk of being involved with, influenced by, or exploited by paramilitary gangs. 

• Tertiary Interventions: projects designed to minimise the long term impact of paramilitarism and organised crime and prevent further victimisation. These are the most narrowly focused and bespoke types of intervention. Examples include the Aspire project: an important initiative targeting marginalised men who are most susceptible to paramilitary / criminal influence and, therefore, most at risk of becoming involved in paramilitary or criminal activity. The project helps them to develop coping mechanisms and increase their resilience. 

7. Project investment is an important way of addressing the complex issue of paramilitarism but wider factors are also critical to success. The Programme has identified six strategic enablers as follows:

• Leadership – demonstrating clear political leadership
• Partnerships & Alignment – consciously aligning with other strategies
• Communications – communicating that violence is preventable and not inevitable and ‘what works’
• Locality working – maximising the use of existing resources in particular areas and drawing on local expertise and connections
• Research & Best Practice – harnessing data/evidence to understand the problem and to  develop solutions that work and provide a sound basis for investment
• Governance – involving cross-sectoral structures that ensure the programme has an impact after the lifecycle of funding

8. At its core, through its two workstreams (encompassing ‘harm in the here and now’ and ‘early, preventative interventions’), its primary, secondary and tertiary-based interventions, and its six strategic enablers, the Programme has adopted a ‘public health’ approach to violence reduction.[3] The Programme exhibits many of the characteristics of violence reduction units that are working across the UK and internationally.[4] Although the Programme draws on national and international best practice, its approach is bespoke to NI and reflects the high levels of trauma within communities as well as the complex social, economic and political context. A system-wide approach like this makes it easier to identify gaps and duplication when it comes to interventions and ensures a more effective use of public funds. 

9. In Phase 2 there is a conscious focus on being data / evidence-driven. Data on performance from the first year of Phase 2 is currently being analysed. This will help to inform future investment decisions by providing a robust basis to identify what is working and what needs to be improved.

10. So far, the emerging Programme data and evidence gathered in 2021-22 confirms the findings of other studies that point to significant levels of trauma in communities where paramilitary activity is prevalent, and among those who are receiving or seeking support from the Programme. For that reason, the Programme is seeking to be trauma informed in all that it does; this means giving due consideration to the impact that trauma has on victims of paramilitarism, as well as those who help and support them. 

11. Of course, the Programme alone cannot solve what is a highly complex problem. Much of Phase 2 activity will be focused on sharing best practice; demonstrating the importance of understanding and proactively addressing paramilitarism beyond the Programme; and understanding ‘what works’ and scaling up that activity beyond the Programme.

Specific questions posed by NIAC

What the socio-economic effects are of paramilitaries on communities in Northern Ireland?

12. For many years, security statistics were used to measure the extent of paramilitarism in NI. However, this provides only a partial glimpse into a complex multi-faceted situation. To better capture and understand the effects of paramilitary groups on individuals and communities, the Programme has adopted a public health model for Phase 2 (2021-24). It invests in action research that helps to shape practice and policy in real time, as well as project evaluations. It also draws on qualitative and quantitative data from multiple sources at project, programme and population level.

13. Through investment in data and research, as well as collaborative working across the Executive, the Programme is developing a more comprehensive understanding of the types of harm caused by paramilitarism and organised crime and what works best to address it. This can range from granular project-level detail about when young people are most likely to present in A&E as a result of paramilitary harm (and, therefore, when statutory services are likely to be in greatest demand), through to strategic discussions about how to ensure that vulnerable individuals access seamless support and the role investment and collaboration plays in that.  

14. The Programme’s most recent data shows that paramilitarism remains a pervasive but relatively localised phenomenon in Northern Ireland, at least in terms of serious, acute harms (violence against the person). While there are very few areas of Northern Ireland which have not seen a paramilitary incident, or the presence of paramilitary groups, our data shows that, over the period June 2019 to date, serious harm has been concentrated in Belfast, Derry/Londonderry, Mid & East Antrim and Ards & North Down.

15. This Programme data is important because it links to emerging evidence from Northern Ireland which suggests that living in areas with elevated rates of violence, and being exposed (even indirectly) to paramilitary related harms, increases mental health issues and risk taking behaviours. It also reduces community connectedness.[5] This evidence points to the systemic impact of exposure to paramilitary related harms; it shows that this exposure, not only increases the risk of involvement with the justice system, but also increases the need for access to healthcare and exacerbates educational under-attainment. Emerging evidence further suggests that systems in NI are not well designed to identify the needs of those traversing between services, or, indeed, to provide a timely and evidence-based response. In addition to this being detrimental to individuals and communities, it also creates increased demand, and places additional pressures on the public and community and voluntary sectors. 

16. Many of the projects delivered under the Programme are aimed at addressing these known socio-economic harms and significant steps forward have been made in developing a robust evidence base to understand acute, overt harm. However, much more work needs to be done to understand the extent of wider, and potentially more widespread, ‘hidden harms’; paramilitary-related coercion, for example, is less overt but can, nevertheless, have a devastating impact on individuals and communities.

17. Better understanding of these more hidden harms involves looking more closely at the bottom two-thirds of the ‘Harm Triangle’ depicted below. This includes a range of activity including:

• Physical harm (which is not reported in security statistics)
• Intimidation and extortion (data for which is limited)
• Individual coercive control
• Community coercive control / ‘gatekeeping’ (including, for example, controlling access to social housing, funding, local services)
• Organised criminal activity
• Malign influence on young people
• Effects on community cohesion and access to services

18. Early analysis of Programme data from Phase 2 suggests that there are specific evidence gaps that need to be addressed in relation to:

• the nature and extent of child criminal exploitation (including through recruitment into proscribed organisations);
• the manifestation and impact of paramilitarism in rural communities; and
• particular cohorts, including women and older people, where there has been, to date (with some exceptions),[6] far less discussion and research.

How effective measures under the Fresh Start Agreement have been in combining police and justice measures and tackling socio-economic issues to eradicate paramilitarism in Northern Ireland?

19. Paramilitarism is a vast, complex, intergenerational problem. The Independent Reporting Commission has consistently stressed that addressing paramilitarism means transformation of the social and economic conditions within affected communities. This work needs to be underpinned by a whole of government, whole of society approach, and as a priority in the Programme for Government.

20. A comprehensive Review of Phase 1 of the Programme in 2020 offered insights into what had been achieved.[7] It noted that the vast majority of the 38 original Executive Action Plan commitments had been addressed in full or in part, although some were delayed due to the absence of an Executive. In each of its four annual reports, the Independent Reporting Commission has pointed to the significant progress the Programme has made in addressing the needs of victims and addressing the causes of paramilitarism. It is clear that having a dedicated programme of activity has helped to ensure a continued focus on paramilitarism, to understand ‘what works’, and to increase the number of organisations consciously addressing the problem.

21. Since the start of the Programme, significant numbers of people, including thousands of young people, have been supported, reducing their short and longer-term vulnerability to paramilitary harm. Capacity is being built in communities and within particularly vulnerable groups; and wider systems change is helping to ensure that existing supports are more joined up and better able to address the many manifestations of paramilitary harm. Research and data on the issues and potential solutions have been significantly enhanced. The number and mix of partners and organisations actively engaging in addressing paramilitary harm has increased significantly, although some organisations remain wary about involvement or promoting their involvement publicly. 

22. Extensive trauma-training (including on Adverse Childhood Experiences - ACEs) is helping frontline delivery partners manage complex challenges in new, innovative and more effective ways. Early interventions are reducing pressures and cost elsewhere in the system. The Programme’s public awareness campaigns[8] are playing their part in addressing attitudinal change (independent research has shown that, as a result of the campaign on paramilitary style assaults, there was a reduction in the percentage of people who think that such assaults are justified/justified in certain circumstances, from 35% in 2017 to 19% in 2019.) 

23. Despite Phase 1’s successes, significant challenges remain. Measuring effectiveness in this context is inherently challenging and not unique to Northern Ireland or the Programme. For Phase 2, the Programme is using an outcomes based methodology called Benefits Realisation. This is the recognised standard for measuring change in programmes that involve not only project delivery but also attitudinal and behavioural change (at system, community and societal level). This approach is used in many peace-building scenarios.

24. Programme Projects are subject to independent evaluation and progress is measured by collecting and analysing short and longer-term project-level and population-level data. Continuous improvement across all activity is critical. Over time this will ensure that there is a robust evidence base showing what is working and what still needs to change.

25. In Phase 2 the Programme’s effectiveness is being measured against its ability to achieve measurable long term changes (or benefits) at population level, using baseline markers. These are:

• A decrease in levels of paramilitary activity
• An increase in people feeling safe
• An increase in people feeling protected by the criminal justice system
• An increase in community resilience
• A reduction in membership of paramilitary groups
• Attitudinal change towards paramilitary groups

26. Realising these outcomes at population level will require time and sustained investment over the longer term. As a result, 18 intermediary indicators of progress have been developed to show whether progress is being made towards these longer-term changes, and to help evidence whether the Programme’s investments and focus are effective. All Programme projects have to contribute to at least one of these benefits and work with other projects to do this. The more indicators that are met, the more quickly short and long-term benefits and positive changes will be achieved. These intermediary indicators are also positive changes in themselves. These are:

1. Reduction in paramilitary intimidations
2. Victims receive effective help
3. Reduction in public order issues
4. Increase in significant disruption to paramilitary groups
5. Increase in individual protective factors
6. Reduction in recidivism
7. Improvement in front line workers efficacy
8. Increase in ex-prisoner (re)integration
9. Improvement in availability and visibility of exit routes
10. Improvement in relations between PSNI and communities
11. Get more people involved
12. Strengthen local networks
13. Increase local skills and expertise
14. Attitude to change
15. Connect with resource and influence
16. Get help from other communities
17. Increase in community voice
18. Tap into existing support services

Further information on the measurable indicators the Programme uses can be found in a diagram in Annex B.

27. Throughout 2021, data at project, Programme and population level has been gathered to help with understanding the Programme’s impact. This data is currently being considered but initial analysis provides a sense of the scale of the support provided at project level during 2021/22. Some examples are set out below.

• Over 7,000 people were assisted through 4 place-based projects to support young people and their families in education.
• 3,282 young people were supported through youth work based diversionary or wider support projects, including 425 at acute risk and 244 young people diverted from involvement in bonfires.
• 491 young men who were vulnerable to paramilitary involvement or harm were supported through social work and community mentoring.
• 18 young people at acute risk of paramilitary harm, or who were under threat from paramilitaries, were supported by a multi-agency project in one geographical area.
• 354 victims of paramilitary violence were supported. This includes 21 children referred by the Paramilitary Crime Task Force (PCTF) to statutory services; as well as 128 young people supported in one hospital emergency department, and 205 through a project to support those under threat. (It is anticipated that an additional 75 victims of paramilitary style attacks will to be provided with bespoke support in 2022/23).
• 254 women were supported to develop their skills in community leadership, and 117 women in the criminal justice system to develop their life and social skills and help them reduce their vulnerability to paramilitary exploitation.
• Hundreds of young people were supported through community projects and sport; these are currently finalising their evaluations.
• Hundreds of people were supported through community projects to increase community resilience; these projects will be reporting over the summer of 2022.

Projects are also capturing information on the scale of the issue and the level and type of assessed need. For example:

• At a population level, Programme data suggests that between 15 and 30% of the population in Northern Ireland live in an area which experiences paramilitary fear and intimidation. There is a slightly higher proportion of young people who report that paramilitaries create fear and intimidation in their area than adults.
• Projects are reporting levels of exposure to paramilitary violence among participants that is higher than the population level trends would suggest we should expect. This could be that a participant has been the victim of such violence, has witnessed violence, or has a family member who is the victim.
• The level of trauma and adversity amongst the participants on projects under the Programme is higher than would be expected in the general population. 
• Some projects are also evidencing large numbers of participants with probable Post Traumatic Stress Disorder (PTSD) because of exposure to paramilitary violence.
• Projects are working with individuals with highly complex needs, including mental health issues, addiction issues, experience of trauma, and poor family, community, and peer support.
• Paramilitary activity and violence is concentrated in specific localities across Northern Ireland.

While the long-term population level measures have not changed significantly, projects are delivering outcomes that will have positive impacts on individuals and communities and will reduce the ability of paramilitary groups to cause harm in the long term. For example:

• There is a downward trend (seen in multiple data sources) in the number of intimidations and in the types of paramilitary activity that cause the highest harm, including murder and violent assaults and shootings.
• The Engage project, has seen a reduction in the levels of probable PTSD among participants, and a reduction in the risk taking behaviours of young people, including those intending or expecting to be involved in violence, from 43% to 3%. The project supports young people using youth work methodologies run by the Education Authority. It promotes life and social skills development for participants, as well as positive change in their aspirations for their own lives and for their community and peer groups. It also promotes improvement in the mental health of participants.
• There has been an increase in the ability of Aspire clients to live a crime free life. Aspire is a project, run by the Probation Board Aspire in conjunction with its Community and Voluntary Sector partners, to support young men between 16 and 30 at risk of paramilitary involvement. The project promotes life and social skills development, as well as substance misuse/wellbeing. Clients find improvements in their mental health, wellbeing, drugs, alcohol, use of time and offending behaviours.
• The Developing Women in the Community project has seen improvements in self efficacy and the locus of control, as well as a reduction in anxiety, depression, and probable PTSD.
• There have been significant developments in learning and best practice in relation to support for people at risk.

Further data will be forthcoming as a number of projects are finalising evaluations and end of year reporting.

Whether there should be a dedicated formal process of engagement with paramilitary organisations aimed at their disbandment. 

28. The NI Executive has noted the Independent Reporting Commission’s latest recommendation from 2021 that there should be a formal process of engagement with paramilitary groups aimed at their disbandment, overseen by a body established by the UK Government and the Irish Government in consultation with the Executive.

29. The concept of ‘transition’ is a complex issue. It was one of the underpinning concepts highlighted by the Fresh Start Independent Panel appointed by the Executive (May 2016)[9].  Although group transition was mentioned by the ‘Three Person Panel’ in 2016, the Executive Action Plan that formed the basis of Phase 1 of the Programme did not include any specific actions on ‘group transition’.

30. The focus of the Action Plan and the first phase of Programme delivery was, rather, on personal and societal transition – ensuring that “support is available for those who wish to move away from paramilitary activity and structures”. In other words, the Programme’s focus is on supporting individuals who want to transition and creating capacity within communities to move away from the influence of paramilitarism, including coercive control. Work was undertaken in Phase 1 to better understand perspectives on the issue of transition; this concluded that transition needs to happen at three interconnected levels:

• within society as a whole;
• within neighbourhoods and places; and,
• for individuals or specific groups of people.

31. A number of activities under the Programme continue to seek to deliver these outcomes. These include building community resilience and cohesion; helping people feel safe (including through effective policing); and addressing a range of socio-economic issues that impact on individuals and communities vulnerable to paramilitary influence.

32. There are many complexities and sensitivities in relation to the suggestion of a formal process of engagement with paramilitary groups regarding group transition. Developing a dedicated formal process of engagement with paramilitary organisations aimed at their disbandment would require significant and careful consideration. From this Programme’s perspective, it is essential that, in giving consideration to the IRC’s recommendations, nothing is done that would compromise or undermine the Programme by, for example, inadvertently reinforcing the status of people or groups who seek to exercise coercive control over communities, or lead to the creation of legacy structures or organisations which, even if not engaged in illegal activity, would continue to be able to bring undue influence to bear on communities.

Whether the UK Government, NI Executive and Irish Government are working effectively together to achieve a society free of Paramilitarism.

33. Action C8 of the original Executive Action Plan committed the UK Government, the Executive and law enforcement agencies, working with their partners in Ireland, to ensure that tackling organised criminal activity is an integral part of their efforts to deal with Northern Ireland related terrorism. The New Decade, New Approach (NDNA) Agreement in 2020 reaffirmed the commitment of the UK Government, the Irish Government, and Northern Ireland’s political parties to continuing this work. The Programme’s review of Phase 1 noted the importance of a joined up approach to the issue, which extends beyond the Programme.

34. The Programme uses its collaborative working model to share best practice across the statutory sector and among delivery partners. It also shares its learning to help others enhance related policies and strategies and to facilitate wider system change. The Programme has an important role to play in showing the benefits of a whole of government / whole of society approach and the benefits of shared outcomes and collaboration.

35. There are a number of areas which would, from a Programme perspective, deepen collaborative working and help the Programme realise medium and longer term benefits. These are:

• A common framework for law enforcement partners in Northern Ireland to identify and prioritise threat, risk and harm across crime types in Northern Ireland (i.e. common to proscribed groups on ceasefire, proscribed groups not on ceasefire and organised crime groups).

• The common adoption across all crime types of a ‘public health’ approach to violence reduction. This places an emphasis on understanding the nature of the problem, puts in place bespoke and early interventions (to increase protective and reduce risk factors), and refines the response based on evidence of what works.  
• A system /government wide commitment to trauma-informed practice.
• A strategic understanding of how UK and Irish Government funding beyond the Programme is addressing paramilitarism and how this aligns to NI Executive priorities. This is a congested funding space and there is a lack of a single agreed set of behaviours that those in receipt of funding ought to be able to commit to.
• A strategic, joined-up approach to investment to ensure the greatest possible impact. This includes understanding how wider government funding is being provided in local areas, and how the Programme can add value where Government funding is already being provided or planned.
• A wider roll-out of place-based funding working, drawing on existing resources and models of best practice across the Executive and beyond. 
• There is often an inconsistent approach to engagement across Government, including the UK and Irish Governments, that can undermine the purpose of the programme, namely to undermine any credibility or status that paramilitaries have in the community.

Whether the approach of the UK Government and NI Executive to tackling paramilitarism is sufficiently sustained, resourced and joined-up.

36.      The 2015 Fresh Start Agreement was a conscious acknowledgement that a far-reaching and comprehensive framework was required to address the challenging and intractable issues of paramilitary control in Northern Ireland.  The Executive’s original Action Plan, published in 2016, was designed to respond to 38 recommendations made by an independent panel. The plan subsequently evolved into the Tackling Paramilitary Activity, Criminality and Organised Crime Programme, which became operational in June 2016. Phase 1 ran until March 2021. £50m (jointly funded by the NI Executive and UK Government) was committed in Phase 1. 

37. In 2020, following an extensive review of the Programme, the Executive agreed to a three-year extension (Phase 2) of the Programme to 2024, with an associated investment of £8m p.a. This is being match funded by the UK Government, which is providing £5m p.a. for the wider Programme, together with c£3m (ring-fenced from NDNA funds) for the Executive Office-led Communities in Transition Projects (as already highlighted, the NDNA reaffirmed the commitment of the UK Government, the Irish Government, and Northern Ireland’s political parties to addressing paramilitarism). Funding has yet to be finalised for 2024/25.

38. The data elsewhere in this paper demonstrates the very significant outcomes that have been achieved through the Programme in a relatively short period of time. Qualitative information, including stories of the impact that support has had on people who would otherwise remain vulnerable to paramilitaries provides a powerful marker of impact. In addition, work is underway to quantify the financial savings this support has generated on a ‘spend to save’ basis.  Building on this work in the coming years, by identifying what works and upscaling this, will be critical if the gains made across the Programme and the learning that has come from this are not to be lost.

39. The focus in Phase 2 of the Programme is very much about developing sustainable solutions and systems change. Through the Programme’s governance structures, the aim is to start discussions about what is needed to continue to make progress after the end of Phase 2 in 2024. These discussions will be informed by the data being collated and analysed to help us better understand the impact of the Programme to date – including what is working and where the gaps are. In planning the next steps, it will also be important to be mindful of wider work in this area, as well as Executive priorities and funding availability. For example, work in the rehabilitation of offenders and tackling paramilitarism within custodial settings is complex and sensitive work that often suffers from lack of resource despite being an essential part of ending paramilitary activity.

40. Ultimately there needs to be a common approach to engagement and funding, without this it can lead to duplication or worse, conflicting approaches.

August 2022

Annex A: Programme Investment Profile 2022-23

Work stream 1:               Investment: £6.1m - People and communities are safe from the harm caused by paramilitarism (this primarily addresses harm in the here and now).

Work stream 2:               Investment: c£5.4m - People and communities are more resilient to paramilitary influence and involvement in paramilitarism, criminality and organised crime (this is primarily about reducing risk, increasing protective factors and early interventions to break the cycle of harm).

Summary of Projects investment 2022-23

Projects Supporting Work Stream 1:

‘People and communities are safe from the harm caused by paramilitarism­.’

Projects Supporting Work Steam 2:

People and communities are more resilient to paramilitary influence and involvement in paramilitarism, criminality and organised crime

Annex B: EPPOC – End and Intermediary Benefits

The diagram below shows the Programme's strategic objective and the changes that need to happen if this objective is to be realised. This work starts with the projects, which all contribute to at least one of the 18 intermediary benefits listed. The collective impact of the Programme's projects, if they are delivered well, are focused on the right issues, and based on robust data, should help realise the intermediary benefits. This work is overseen by the four Benefits Realisation Groups and a Programme Board. The more intermediary benefits are realised by the Programme, the more it will be able to influence change at a population level - these are the 6 End Benefits identified in the diagram.

Success at population level is not, however, wholly within the gift or control of the Programme. Project outcomes have a role to play but there is also a need to address wider strategic risks, dependencies and opportunities that extend beyond the Programme.