Introduction
This chapter sets out a call for What Works Centres to devote more attention and resources to supporting the scaling up of effective approaches – policies, services, practices, programmes and so on – to extend their reach and impact. We pick up the story of interventions at the point where an approach has been shown to have enough evidence behind it to justify its wider use – it has been shown to be effective, usable and implementable. Scaling up is then about expanding the reach and impact of an innovation to foster the greatest possible positive change for diverse groups, including the most marginalised and those with the greatest support needs. (We use the term ‘innovation’ throughout this chapter, recognising that what is being scaled up might be a policy, programme, service or practice but that it is by definition new to the scale-up setting.)
Of course, not everything should be scaled, even if it has been shown to be effective. McLean and Gargani introduce the concept of ‘judicious scaling’ and make the point that ‘scaling is a choice that must be justified’ (2019, p 34) and that involves trade-offs. Scaling up an innovation involves opportunity costs and compromises (List, 2022), for example between overall reach, focus on more marginalised groups, quality and cost. It would be very ambitious to scale up very widely, without losing touch with the needs of more marginalised groups, and to sustain quality of delivery, and to keep costs sufficiently low that demand is not reduced – and in practice choices and compromise are needed. But scaling up is clearly central to the ambitions of What Works Centres: there seems little point in identifying ‘what works’ without paying at least as much attention to how to achieve levels of reach and impact that are socially significant.
It is, however, a particularly challenging area of work, and in practice few effective innovations reach populations at scale (Fagan et al, 2019; Milat et al, 2020). It is easy to assume that a programme proven to be effective will be taken up by organisations and embraced by the wider system.