Child poverty pathfinders - early implementation process: evaluation

Chapter 7: Conclusions and recommendations

In this chapter, we set out the conclusions from the early process evaluation, along with suggested recommendations for future delivery of the existing Pathfinders, as well as for any potential future Pathfinders.

7.1 Conclusions

Partner and stakeholder views were relatively consistent when it came to defining the overarching aim of the Pathfinders. All suggested that the overarching aim was to tackle child poverty. The understanding of how this aim would be achieved was relatively consistent across both sites, with almost all partners and stakeholders asserting the view that system change was required to address child poverty. Most suggested that there were early signs of progress being made toward achieving this aim, as there was evidence of enhanced referral routes through the 'system' being provided by partners and stakeholders who were developing new ways of working including providing triage and holistic needs assessments during initial contact with parents/carers.

The emphasis placed on partnership work throughout chapters 4 and 5, however, reflects a key finding, in which systems change was being achieved by people from different organisations and/or departments getting to know each other and committing to working together. The vehicle for change tended to be the relationships that were developing between people. This raises some questions about how sustainable change may be in the longer term, as it appeared that some of the early indicators of the system becoming more 'joined-up' was reliant upon relationships and personal commitment rather than structural, or formal change. It is likely, however, that some of the informality of the changing approaches relates to the early stage of implementation and that some of the learning will be able to be mobilised to create more formal changes at a later stage.

The findings of the early process evaluation suggest that both Pathfinders are operating slightly different models of delivery so far, but that both are underpinned by shared objectives, such as the provision of person-centred, holistic support. Although the models of delivery differ, partners and stakeholders in both discussed efforts being made to establish a 'no wrong door' policy (in both sites) where parents/carers could enter any service locally and receive triage to identify multiple needs, and keyworker-style support to navigate the 'system'. In both approaches we heard examples of this where the initial keyworker would remain with the family, approach relevant services on their behalf and remain involved until they had begun to engage with the support offered, or until their needs had been met. Examples of support received ranged from help to access fuel grants, clothing grants, free school meals, transport, housing, benefit income maximisation, mental health support, education and employment.

In Dundee, co-location of services within the drop-in hub appeared to be supporting relationships between staff from multiple services who described beginning to understand each other's roles more. This appeared to be supporting the development of a more 'joined-up' approach because staff knew where to refer people to, and tended to be able to draw upon the relationships they'd established, which was acting as bridging capital.

Although all local stakeholders described feeling motivated to contribute to systems change, a few third sector organisations noted that operating in this person-centred way was time consuming and not sustainable in the longer term because it was taking staff away from their core business, which meant that they were able to evidence less towards their key performance indicators (KPI) which in turn had implications for their funding arrangements beyond the Pathfinder. For these services to continue operating in this way, they noted that there would be a requirement for core funding to be allocated via the Pathfinders to allow more staff time to be allocated. This was described as being an issue that many third sector organisations may face.

In both Pathfinders, partners and stakeholders suggested that there should be increased involvement of the third sector at a strategic level and so it is recommended that consideration is given to funding arrangements to enable activity to be sustainable for organisations whose funding is dependent on the achievement of KPIs that are not demonstrable when conducting triage and supporting parents/carers to access other services.

When it came to identifying and targeting those most in need of support, several partners who had involvement at a strategic level suggested that targeting priority groups was challenging due to the constraints of data sharing. Many noted that certain organisations who were involved in the Pathfinder held key demographic and income data that could be used to provide targeted offers of support to priority groups. Getting data sharing agreements in place for this purpose remained an ongoing task for those involved in both Pathfinders.

In the Glasgow Pathfinder, several partners and stakeholders noted that they had had some success in targeting young mothers with children under 2, who had been identified as a group experiencing high levels of poverty. Campaigns in early years establishments had helped to target this priority group. Several parents/carers who had received support by ticking a box on the registration form for their child's early years childcare placement noted that they felt as though they'd heard about the support available by chance. These findings suggest that targeted promotional campaigns had begun to have some success in helping the Pathfinder to reach priority groups, but further awareness raising campaigns would potentially be helpful. This may help to provide an additional route to reach those in need, while the work to address data sharing remains ongoing.

Several partners and stakeholders also felt that the Pathfinder partnerships required more detailed information about household income according to demographic group to allow further priority groups to be identified and targeted. Some felt that they had only begun to scratch the surface of knowing who was in the most need during this early stage of Pathfinder development. This affirms the importance of data and being able to use data to inform future Pathfinder development. Most partners and stakeholders were of the view that there was no robust empirical evidence that they were aware of concerning what works to tackle child poverty. Several considered that local data was key to understanding what would work where, for whom and in what circumstances.

Partners and stakeholders in the Glasgow Pathfinder considered that all Pathfinder activity to date had been informed by the detailed data that had been gathered by Glasgow City Council over several years related to child poverty in the area and what had been tried and tested to improve it over time. Partners and stakeholders in Dundee felt similarly about empirical evidence, but were less clear as to whether local data and evidence had been used to inform Pathfinder development. Most expressed that data had been used to identify the area of Dundee to target, and stated that this decision had been based on evidence that families within this particular locality were facing some of the highest levels of deprivation in the country. In Dundee, most partners and stakeholders held the view that the Pathfinder was in a process of learning and establishing the evidence base for future activity to reduce child poverty, and asserted that there was a need to collect and share robust data about progress made over time.

As such, it is possible to conclude that both Pathfinders were at a slightly different point when it came to developing and/or using evidence. This points to the importance of sharing learning between Pathfinders, and also points to the importance of working through data sharing agreements to enable further data to be used, relating to priority groups.

Some informal arrangements for sharing learning between Pathfinders were described by a few partners, but findings suggest that this could be further strengthened via more formal processes as the Pathfinder develops.

The pace of change appeared to differ between the Pathfinder sites at the beginning of the early implementation, and this may relate to the different stages the two partnerships were at strategically. In Glasgow, the Pathfinder partnership appeared to align with existing strategic activity which meant that it could 'slot in' and benefit from existing working groups, which also appeared to make it easier to use existing evidence on what had worked previously.

In Dundee, partners described feeling a need to 'rush to action' which had caused some tensions in the early stage of relationship building within the partnership, which was described by one partner as a process of working through the 'norming, storming, forming' phases of team development (in that order). The 'rush to action' had also left limited time to scope out local services, which meant that some key local organisations had been missed from being invited to the table at the early stage. Despite these challenges, all partners and stakeholders in the Dundee Pathfinder described a sense of hope and optimism and shared that although the partnerships had felt challenging at the start, they were now beginning to form in a positive way.

Partners and stakeholders in both Pathfinders described Pathfinder meetings as places that had gradually started to feel like 'safe spaces' to discuss views, including those that challenged the status quo. This gradual creation of 'safe spaces' to share learning and discuss progress was linked to a growing awareness of each other's roles, values, experiences and perspectives. Working in partnerships across multiple sectors was still described as having 'sticky moments', but most felt that there was now a sense of shared aims and shared commitment to enacting change, no matter how challenging that could be at times. This played into a theme that came through strongly of 'we are getting there now'.

The key learning from these experiences is that relationships appeared to be what was driving change. This includes relationships at an individual level, as well as relationships between services. Developing those relationships was a core component of arriving at shared aims and achieving a shared vision, and so it is suggested that if future Pathfinders are considered, time should be allocated for the formation of effective relationships and partnerships. Where this time is available, it should be viewed as being part of creating the right conditions and foundations for change, and it should be communicated clearly to partnerships that time is available, to reduce the risk of actions occurring before comprehensive planning and team formation has occurred.

Although the process evaluation was conducted at a very early stage in Pathfinder development, it is possible to conclude that there was some evidence that changes were beginning to occur to align services to facilitate the holistic approach to service provision.

The findings showed that the models being used in each Pathfinder differed. However, it appeared that both were underpinned by what we refer to as a 'triage and navigation' approach. What we mean by this is that, motivated by an attempt to align services, many partners and stakeholders described moves to ensure that the first person a parent/carer approached for support would see the case through. Descriptions of this varied, and were dependent on the situation, but it meant that in both Pathfinders, people from a variety of services were describing conducting calls and appointments in a way that facilitated a holistic, yet brief, assessment of needs. Once needs were identified, the staff member would either address those needs during the call, where possible, or they would walk alongside the parent/carer, link them in to the right services and remain involved until engagement with another service began. This was occurring formally, with the two new key workers in Dundee and via the Glasgow Helps telephone line. However, several partners and stakeholders in both sites expressed that since becoming part of the Pathfinder(s) they had begun thinking about support in new ways and were taking opportunities to link parent/carers into other services. Often, the partnerships within the Pathfinders appeared to be making this easier. In Dundee, the drop-in hub model appeared to hand several stakeholders described the collegiate relationships that were forming between staff from different organisations. This led to informal 'warm' introductions to other services being possible. Several parents/carers conveyed that this made them feel cared about, and it differed from previous experiences of seeking support where interactions had been more process rather than people driven, and where they often described having felt stigmatised.

In both Pathfinders, some of the early indicators of systems change, however, appeared to be reliant on the commitment of the individual staff involved and their relationship to the Pathfinder. Much of the change appeared to have been stimulated by the development of relationships between people. While this is positive, it raises some questions about sustainability, and points to a need to create formal processes at an operational level to support the new referral routes and working practices that are emerging.

Despite the different models of service delivery being used in each Pathfinder, the findings suggest that both could be described as 'outreach'. In Dundee, the outreach activities were more overt, and included door knocking within the community to identify families most in need, to raise awareness of the Pathfinder and to consult with the community regarding what interventions might help. In Glasgow, the outreach component was less overt, but still present. This was evident in the awareness raising campaigns in children's early years establishments and nurseries, and the new 'tick box' on early years childcare registration forms that families could select that would trigger a call from the Glasgow Helps team, leading to a holistic needs assessment. Once needs had been identified via this triage approach, the Glasgow Helps team would provide informal navigation to other services by remaining involved until the family's needs had been met.

This outreach approach was valued by families in both Pathfinders. What appeared to make the biggest difference to the uptake of support, however, was feeling fully listened to and not judged. It was this humanistic, empathetic, understanding approach that parents/carers described as being different to any support they had received in the past.

Having one keyworker that would help them enter other services was also a factor that several parents/carers valued because it made them feel less vulnerable as they did not have to keep re-telling their story and re-asserting their needs. This approach was described by parents/carers who had received support via both Pathfinders, and these findings suggest that there may be early indicators of cultural change being created by those involved in the Pathfinders. Cultural change tends to be gradual and non-linear, and so, it is crucial that the perspectives of parents/carers continue to be used to inform Pathfinder development.

One of the aims of this early evaluation of the process of change was to identify the effects that the Pathfinders were having on community capacity. The early stage has meant that it is not possible to assert clear or stable findings in relation to this. What the findings do show, however, is that the parents/carers who took part in the interviews were able to feel more confident about seeking help and articulating their needs. It is possible, therefore, that over time, parents/carer's ability to engage in self-advocacy may increase, particularly when systems change fully takes hold and the 'system' becomes easier to navigate. For this to occur, however, the early indicators of cultural change will need to continue alongside systems change, as a key change for parents/carers was being able to access support without feeling judged.

7.2 Recommendations

During the interviews, partners and stakeholders were asked to reflect on how things might be done in the future, to ensure that other Pathfinders can be mobilised quickly and efficiently and have maximum impact on child poverty targets locally. This section sets out recommendations and considers next steps for the future of the current Pathfinders, as well as recommendations on for future Pathfinders.

Recommendation 1: The Pathfinder aims and objectives should be co-designed early on and with the right partners and stakeholders locally

Some partners and stakeholders felt that having clear aims and objectives from the outset would have enabled the branding of the Pathfinders, which would have been helpful for encouraging partnership and stakeholder engagement. Others felt that the earliest phase of the Pathfinders had been about working together to arrive at these aims and objectives.

Having clear aims and objectives in place is critical to enable data sharing agreements to be put in place effectively, and a monitoring and evaluation framework to be developed and implemented. If future Pathfinders are to be developed, a suggested recommendation would be to ensure that suitable time is built into the planning stage for the co-design and co-development of the overarching aims and objectives for the Pathfinder, with the right partners and stakeholders involved locally.

Findings indicate that planning time before the 'action' phase is required to also ensure that local scoping work has been done to ensure that the right stakeholders and partners are involved at this early stage. This would ensure that the Pathfinders face fewer early challenges when forming local partnerships, thereby ensuring that they are able to become embedded locally. Time allocated to planning and visioning is likely to reduce duplication of efforts, build ownership, and support with data sharing requests. Following on from having agreed aims and objectives, a locally co-designed action plan would also support data sharing as well as monitoring and evaluation activities. Within this, agreeing definitions of key terms, such as 'systems change' and 'person-centred', would also ensure clarity of the action plan.

Recommendation 2: Data sharing challenges should be worked through from the outset to allow data to be shared and used to identify and reach target families consistently

Partners and stakeholders were asked to reflect on how things might be done in the future, to ensure that other Pathfinders can be mobilised quickly and efficiently. One specific example given was ensuring data sharing agreements were in place prior to the Pathfinder beginning delivery, so that priority groups could be identified and targeted more effectively from the outset. This would also ensure that delays in the Pathfinder 'going live' are not experienced. It is recognised that often getting data sharing agreements in place can be a slow process, to ensure all partners and stakeholders information governance requirements are satisfied, so this should be a key priority during early project mobilisation.

This recommendation is that, for future Pathfinders, data sharing agreements are in place in the early stages of Pathfinder planning and mobilisation. This should include mapping out the data sharing requirements including: understanding what data is needed and for what purpose; the key partners and stakeholders involved in data sharing; the timeframes; and information governance requirements for each of the partners and stakeholders. A challenge here is that an operating model that is sufficiently detailed is required, before a data protection impact assessment (DPIA) can be completed. If possible, partners and stakeholders should undertake a joint DPIA which will support the development of a data sharing agreement. It may be beneficial for Scottish Government to put a series of templates in place, for example data sharing agreements and DPIA templates, that have been agreed by Scottish Government, DWP, and COSLA to reduce duplication and streamline the process.

A further suggested recommendation that could be used to create systems change would be to implement a joint case management system. This would enable streamlining of services, enable targeting of parents/carers and referral pathways, while providing opportunities to feed into monitoring and evaluation.

Recommendation 3: Clear project planning and project management structures should be in place to ensure that there is effective communication, clarity and shared understanding of partnership goals and clear strategic direction

Translating the overarching aim of addressing child poverty into practical workstreams, services and tasks that could be delivered locally was described as a challenging task in both sites, albeit for different reasons. The early phase of inception, planning and implementation was experienced as challenging in both sites, for different reasons.

In Glasgow, challenges were experienced in relation to keeping staff motivated and involved during the period where the strategic direction was being refined and while work was being done to envision what change would look like. Staff retention and turnover played into this. In Dundee, there was a 'rush to action'.

Partners and stakeholders in both Pathfinders stated that they would have benefited from very clear project plans, workstreams, workplans, monitoring frameworks and risk registers. Partners and stakeholders in Glasgow reported that the appointment of an independent project manager had been a key turning point where everything became much clearer.

It is recommended that dedicated project managers are appointed early in the process of implementation of any future Pathfinders, with a remit creating clear project plans, workstreams, workplans, monitoring frameworks and risk registers, as well as leading on communication.

Recommendation 4: Monitoring and evaluation processes should be built into Pathfinder models to support the early identification of delivery issues, improve opportunities for ongoing learning and allow an assessment of impact

Linked to the recommendation on data sharing, some stakeholders told us that they found it difficult to know if the Pathfinders were on track and working effectively without monitoring and performance data agreed in advance, and available and accessible to stakeholders. While monitoring via Key Performance Indicators (KPIs) can constrain creativity and innovation, monitoring is an important tool for understanding whether a Pathfinder is achieving its objectives. As such, monitoring processes should be a key discussion point during future Pathfinder inception discussions at the earliest possible time point. This would enable Pathfinder partners to be able to track progress and begin collecting data to use as evidence to inform the gradual development of the workstreams.

Additionally, by tracking progress and collecting data, stakeholders will be able to identify issues early and make necessary course corrections. Data collected through a monitoring framework will support in future evaluation and impact assessment.

In future in Glasgow and Dundee, and for any further Pathfinders, having a locally agreed monitoring and evaluation framework in place at the beginning will give better transparency on what is being achieved, help Pathfinders to stay on track and perform well, enable Pathfinders to identify what has worked less well and to learn from that, enable data and evidence lead decision making. This will help to ensure that future Pathfinders are evidence-based. Ideally monitoring tools, and data collection methods, will be embedded within the delivery of the Pathfinder, to minimise the burden on staff and parents/carers.

Several partners and stakeholders who were consulted during this early process evaluation were of the view that it would take a long time before impacts and outcomes would begin to emerge. Some considered that change on the scale required would take 5 to 7 years to evidence. While monitoring the process of change, and early indicators of success will be important going forward, a suggested recommendation would be that consideration is given to the amount of time that it may take to fully embed systems change and tackle child poverty. A suggested recommendation would be that once the Pathfinders are established in each area, shared outcome frameworks should be developed. This will help in progress monitoring.

Recommendation 5: Strategic and operational commitments to allowing different ways of working and creating spaces for people to build relationships and work collaboratively should be ensured to enable the operational culture for system change

Stakeholders and partners told us that new ways of working at partnership and stakeholder levels have been established across both Pathfinders. There was recognition that this has been a journey, but most partners and stakeholders felt that it had been worthwhile and that both partnerships were in the right place, at the time of interview, to deliver the Pathfinders.

It should be recognised that building successful partnerships takes time and effort. It is not a quick process. In recognition that Pathfinders have been on an intensive journey to build partnerships that work together differently, there are recommendations on partnership development and partnership working for future Pathfinders.

Pathfinders must be willing and committed to develop partnerships that work differently and that are robust enough to handle and resolve difficult discussions locally. For Pathfinders to be successful, all partners need to need to recognise that the child poverty targets are critical and commit their organisations to working together to tackle this.

Structures and processes are very important, but the culture and values are equally important, and it is recognised that cultural change is a gradual, non-linear process that requires considerable time investment. All stakeholders and partners have different ways of working and different objectives. Strong relationships based on trust are critical. This commitment to collaboration needs to take place at strategic as well as operational levels, and at senior as well as front line staffing levels. Having shared aims and objectives, that are co-designed, will support this. A memorandum of understanding between the stakeholders and partners may be an effective way to formalise this commitment to partnership working and set out the expectations of each partner and stakeholder.

Some partners and stakeholders told us that a collaborative approach can make progress faster, with partners and stakeholders having autonomy. Key to enabling this, is operational staff feeling that they have 'permission' to work outside their normal roles and not feeling restricted by their employer's organisational boundaries. A memorandum of understanding would clearly set out the organisational buy-in to operate differently, recognising what this means for each organisation locally, and empowering staff to participate in the new ways of working to achieve the shared objectives. This would mean that operational staff would explicitly have permission to work 'beyond' their daily roles.

To facilitate this, further consideration may have to be given to the involvement of the third sector and charitable organisations who often have to demonstrate their staff member's use of time against the generation of KPIs for external funders. If more time is to be allocated to involvement in the Pathfinders, then funding rules may need to be considered, if staff need to be released from their normal duties to facilitate participation in Pathfinder activities and the new ways of working that are required when delivering holistic, person-centred care, such as triaging and supporting people to access other services when the service they first approach is a third sector organisation.

Delivering system level change requires innovation, and courage to question the status quo. Several partners and stakeholders noted that challenging the way things were currently being done took courage. Many noted that partnership meetings needed to be 'safe spaces' where change could be envisioned and barriers to change could be openly discussed. It is recommended that if future Pathfinders are to be developed, memoranda of understanding are developed at the very earliest point of inception, and within these, people are given the permission to question the status quo and to share ideas. This recommendation, however, should be considered alongside the requirement to build in time for relationships of trust to form, since trust is required in order for people to feel safe entering into discussions about change and innovation.

Recommendation 6: Local knowledge should be embedded and shared in the Pathfinder delivery and development process so that support can be tailored effectively to local need

All partners and stakeholders, as well as parents/carers, mentioned that a critical factor to a Pathfinder's success was having local knowledge in both designing and delivering the service. There are several important operational strands to this. One of these that came through very strongly in the process evaluation was the importance of local knowledge, as this helps in building trust with parents/carers, if they feel that the member of staff understands the geography and challenges locally, as well as helping with signposting and practical issues, such as local public transport routes.

Several partners and stakeholders told us that it was essential that local delivery staff were given some autonomy and flexibility in terms of how they deliver services, and how they interact with people accessing their service, to make sure that their approach was tailored to local need and informed by local knowledge.

A recommendation here is to continue to recruit local staff into the Pathfinders where possible, and to share knowledge and intelligence between staff and across organisations, to ensure that learning is not lost or dependent on key members of staff. A mechanism to do this would be to create an online 'information store' for all Pathfinder partners to use, to capture, share and update information locally. It is acknowledged, however, that due to the local nature of the Pathfinders, some people may be concerned that their data may be accessed by someone who knows them, thereby compromising anonymity. Protocols for use to manage this risk should be agreed as part of information sharing agreements.

Recommendation 7: Ensuring that a 'No wrong door' model with multiple access points and delivery channels is key to providing support that families feel is easier to navigate and non-judgemental and should continue to be built on as a central part of the Pathfinder model

Parent/carers reported valuing easy access to the Pathfinders locally. Parent/carers told us that they appreciated the ease of access of both Pathfinder models. Several parents/carers conveyed that this had helped them to feel listened to, and less like they were being taken through a process that they did not understand, which had been the case in previous experiences of seeking support.

Many told us that this made them feel as though they were being responded to in non-judgemental ways which lessened the experience of stigma. Rapid navigation through multiple services, however, requires that staff have local connections, and local knowledge related to what is available, for whom, where and how to access it. Local faces that people could get to know and visit whenever seeking support also appeared to help reduce barriers that people described having experienced before.

In future, Pathfinders should maintain and continue to deliver support through the 'no wrong door' principle, whether in-person via drop-in hubs, or via telephone helplines. Pathfinder models which are flexible enough to accommodate varied access points and delivery channels including face-to-face via telephone and online will give parents/carers choice and can be adapted to meet the needs of local contexts.

Pathfinders should continue to adapt and evolve in future, to ensure access points and delivery channels respond to the needs of parents/carers. For example, this may include being able to use platforms such as WhatsApp, which can be accessed via public WiFi for those who do not have access to call plans on mobile telephones. Consultation on accessibility should be conducted and reviewed on an ongoing basis to ensure that no assumptions are made about accessibility.

Recommendation 8: Pathfinders should continue to be built around and commit to providing person-centred support providing the right level and type of support that each family needs at the right time

An overarching finding is that Pathfinders need to be shaped around principles of person-centred support, while having the flexibility to be delivered in ways that are appropriate to and reflect and respond to the local context.

Parent/carers reported receiving help for immediate crises, and reported feeling more positive about the future after an immediate crisis was resolved. Many parents/carers had received support with multiple issues or concerns. A key point is that parents/carers need support to resolve immediate crises before they are able to commit to engaging with support that might lead to longer term benefit for the families, such as advice around routes back to employment, training and education. There were several examples of people returning to the service that had provided them with crisis support, seeking support to address other issues once the immediate crisis was resolved.

Parent/carers reported trusting the services at Dundee drop-in and Glasgow Helps and said they would use it again and would recommend it to friends and family. Pathfinders embed the principles of person-centred and place-based support and have delivered high quality support, that has been valued by parents/carers. It is an important recommendation that this commitment to quality continues.

There are two, linked, recommendations:

Firstly, the Pathfinders have an obvious commitment to high quality delivery. This could be captured in some delivery principles, that clearly articulate these values, are agreed locally, guide staff – particularly when working across organisational boundaries - and embedded in the memorandum of understanding and monitoring and evaluation framework. These could include, for example, delivery being high quality, trust-based, person-centred, non-judgemental and trauma-informed. The trauma-informed component of this relates to a commitment to offer choice, to respond to people where they are at without expectation and to empower people to discuss what their needs are. Clearly articulating these values and developing them locally will ensure that the Pathfinders continue building trust with parents/carers through support delivered in person-centred way, which is of most value and is how parents/carers have experienced the Pathfinders as being different to other support they have accessed in the past.

Linked to this, parents/carers should continue to have the opportunity to engage in brief interventions. As the reason they first contact the Pathfinder may be linked to a crisis, it should be made clear to them that they are welcome to come back for a more holistic needs assessment and further support to address wider needs, once the crisis is resolved.

Recommendation 9: Pathfinders should ensure they are delivering support using appropriate delivery models and locations, that are accessible and have privacy

The drop-in hub model being used as part of the Dundee Pathfinder is a good example of integration and co-location of services. There were some early indicators of this enhancing relationships between staff and members of the local community and of collegiate relationships between services. This can be conceptualized as having had benefits in terms of both creating community bonds and enhancing bridging capital, which, taken together were understood to be facilitating the joining-up of services.

The environment selected for the drop-in hub had initially been suitable, but when word about the services offered had begun to spread, the setting became busier, leading to waiting times. To accommodate the numbers of people accessing the hub, additional tables had been added and some parents/carers felt that there was now less privacy.

It is recommended that careful attention is paid to the environment selected for any future drop-in hubs and that steps are taken to ensure that parents/carers can be afforded privacy to discuss the issues that matter to them. This is likely to enhance engagement and is required as part of a sensitive, trauma-informed approach to service delivery. It is also recommended that the feedback of parents/carers is continually sought to ensure that issues such as this can be raised and responded to promptly. This may take the form of a parent/carer feedback or steering committee.

Recommendation 10: The support offered by the Pathfinders should be more effectively communicated in the areas it is available through a variety of routes

Parents/carers who took part in the interviews described being grateful for having been offered wider support than what they'd originally reached out for. Partners and stakeholders, however, conveyed that in their experience, some parents/carers had expressed feeling suspicious about the broad offer of support and were initially wary about discussing their needs.

It is recommended that a communication strategy is in place, including public awareness campaigns being undertaken so that parents/carers feel less surprised by this. Public awareness campaigns are also recommended as a way to ensure that priority groups are aware of what's on offer and know how to get in touch and benefit from the new approaches that are emerging. A communications strategy will also ensure that key terms, definitions and criteria are used consistently across partners and stakeholders.