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Improving prevention for children and families and making change stick

Michael Wyatt

It is well known that providing preventative support earlier, at the right place, to the right people, will improve outcomes for children and families. Yet, the ability for staff to deliver prevention is hindered by policy-driven budgeting, insufficient insight to enable community-based support, and a risk-averse culture that halts interventions prematurely before impact can be assessed.

Whilst the central legislation in adult social care (Care Act 2014) states that local government must “provide or arrange for provision of services, facilities or resources” that contribute towards preventing needs for care and support (referencing prevention 26 times), the Children’s Act 2004 has no dedicated prevention policy, referencing prevention only twice (neither of which refer to preventing needs escalating). This has a natural knock-on effect to the way local government sets its budgets and priorities, and prevention for children’s services is pushed aside to fulfil statutory responsibilities.

We cannot wait for legislative change. There is an opportunity now to build on what we know and provide the right support for children and families. Action must be taken now, by:

1. Providing better insight and evidence to strengthen the case for preventative services

Arguing the case for investment requires clarity on forecasted financial and non-financial benefits. Whilst challenging, services must capture and demonstrate evidence of potential and real impact and outcomes of prevention. The use of primed metrics and trajectory management can achieve this. Primed metrics measure impact by connecting purpose and the need to have information that enables decision-makers to act. Unlike traditional methods, they are drawn across system boundaries in a recognition of complex systems that like prevention exist within. Trajectory management enables primed metrics to be tracked over time, providing an overview of system improvement and benefits realisation. Effective trajectory modelling will demonstrate that costly statutory services can be reduced if emerging needs are identified and supported earlier, which will ultimately improve outcomes. Drawing on this insight, and other best-practice interventions, will strengthen the case to increase internal funding or centralised grants.

2. Improving collaborative working and insight sharing across services, directorates and system partners

Children and families often receive support from different services and organisations at different times, including universal support from health, education and voluntary settings. Frustratingly, the interdependencies of these organisations are not often considered and targeted prevention support is therefore not provided. Each of these organisations understand the challenges that their communities face, and the support that could be most effective. Sharing and combining insight across all services and organisations within the system allows for holistic, insight-led commissioning. This is the best chance for wrap-around prevention support for families.

3. Commissioning and delivering prevention via community-based models

Local authorities often cover diverse and complex geographical spaces, and a range of variables alter the way services can be delivered and accessed. Better understanding local community assets, needs and drivers for statutory support enables community operating models to be tailored towards smaller communities. Delivering the right prevention support, at the right time, to the right people is critical – particularly for deprived areas.

None of this can happen overnight. Political and strategic commitments need to be made. Adequate time, effort and resources must be allocated. Effective use of data and collaborative working across complex systems is essential. But critically, it requires confidence to maintain momentum and delivery at times when it may seem easier to de-prioritise and shift resources further up the system.

Making change stick is never easy, and it certainly isn’t the same as agreeing something should change in principal but not acting on it. Jeff Hiatt’s ADKAR Model of Change distils the five sequential (but often overlapping) building blocks to change. Learn how this model can be applied to increasing prevention services in my next blog.

Written by

Michael Wyatt

Senior Consultant

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