Evaluation of the 'You First' Programme for Young Parents

9 WHAT IMPACT HAS THE PROGRAMME HAD ON OTHER RELATED SERVICES?

Fitting in with relevant local strategies and plans

9.1 The strategic involvement of NHS Lothian in the project review board acted as a starting point for You First to link into the relevant local strategies in each of East, West and Midlothian. The link to local strategy was provided by the Chief Nurses from each of the three programme areas, who were also members of the project review board. They linked the You First facilitators with the relevant health visitors and co-ordinated with them when selecting the areas for the programme.

9.2 While the programme was linked in to local strategy for the health visiting team, it seemed that this happened to a lesser extent with the local multi-agency parenting strategy as a whole. This is highlighted by the fact that some stakeholders felt that the project had been 'parachuted' in with little consultation. This was particularly the case in one of the three areas. The You First management were aware of this and efforts were made to try to improve the links. They tried to engage with different groups and services to explain what the You First programme was aiming to do and how it differed from existing provision. In addition, by the end of Phase 3, there was a You First representative at parenting strategy groups for each of the three areas. Stakeholders did concede that once they understood the programme, and what it set out to achieve, they were reassured that it did link sufficiently with local plans. However, they still felt that the way in which the programme was originally introduced in their area could have been better.

Taking account of the local context and particular local needs

9.3 In advance of the pilot phase, informal scoping exercises were carried out in each local authority in order to get an idea of the local context and what provisions were available to parents in the area. You First management felt that their representation on the aforementioned parenting strategy groups did provide them with a view of the local context and need. However, this representation did not happen in all three areas until the later stages of the programme.

9.4 In terms of selecting the pilot areas, the You First team liaised with the Chief Nurses and the health visiting team to take into account local context. This meant that detailed local knowledge was used during the process of choosing particular areas (for more details see section 6.7). However, the facilitators selected the venues.

9.5 There were still concerns from some stakeholders that the facilitators did not know enough about local geography or the transport links available to parents. This may be down to the practicalities of finding a venue that is suitable for every parent in a group. However, it did cause one parent to stop attending the group altogether.

9.6 In working with local service providers, the co-ordination of provision is key; in the test phase, one of the programmes ran on the same day as a local young mothers group. At the time, this caused some tension between You First and other local services as those from the local services felt that the facilitators should have taken into account the timing of other local groups. Lessons were taken from this and the tension has been resolved.

Linking in to other initiatives/services in the area

9.7 You First linked in to a number of initiatives and services in the three areas in which it was operating. The majority of these have been used to provide inputs during the sessions but others have been identified as services that parents can go on to use once they have completed You First.

9.8 Throughout the three phases, facilitators have attempted to build upon their available contacts and find new ways of working with other initiatives. A good example of this was that, in one of the programmes, You First was co-facilitated with a member of the local Sure Start team. This ran smoothly and the parents at that particular group were as happy with the facilitation as those in the other areas. It was a good opportunity to share best practice between Sure Start and You First. Working with an established local service was also beneficial in providing the facilitators with further links to other services in the area.

9.9 There were two main things that hindered the programme in terms of joint working. Firstly, as previously discussed, there was a feeling from some stakeholders at the start of the programme that the group was simply 'parachuted' into areas without much consultation. Secondly, stakeholders had reservations about the use of a financial incentive. While some simply disagreed with paying parents to attend a group such as You First from an ethical standpoint, others felt that other services might be put at a disadvantage. They felt that, as the You First parents were offered money and were therefore more likely to attend, any comparison of service uptake would be unfair. Once stakeholders had more information about You First and what it involved or saw it in practice, they became much more positive about what it was trying to achieve.

9.10 As with any programme of this type, in order to improve joint working, facilitators must communicate with local stakeholders as much as possible and as early in the process as possible.

Child protection requirements

9.11 You First established appropriate procedures in relation to child protection requirements. In order to ensure consistency of approach with local procedures, it followed the protocols set out in the Edinburgh and Lothians Inter-Agency Child Protection Procedures. It was agreed that the health visitor would act as the liaison point for facilitators if they had any child protection concerns. At the first home visit, facilitators informed parents of their responsibility to report to the health visitor anything that caused them concern. They also explained that they would try to make this process as open as possible and let the parents know that they were going to speak to the health visitor.