Whole Family Wellbeing Funding (WFWF) - year 1 process evaluation: final report

7 Progress towards early outcomes

This section discusses the evidence of progress towards early outcomes, as set out in the proposed logic model. It is important to note that achieving outcomes is a longer-term aim of the funding, beyond the first year, so CSPPs were not expected to achieve outcomes within the first year of delivery. Instead, it was hoped that CSPPs would demonstrate initial progress towards these early outcomes at the end of Year 1, and Year 2 would focus more on outcomes being achieved. The findings are based on case study qualitative data and the CSP annual report analysis.

Further detail on outcomes with limited progress and unintended outcomes can be found in Annex 8.

Key findings

• Progress towards outcomes was limited, in part due to data quality, but there was some evidence to suggest CSPPs had made progress towards three of the anticipated early outcomes.
• There was some evidence to suggest CSPPs had begun to shift towards ways of working which were non-siloed and allowed the support to match the scale of need, primarily through alignment of funding streams, establishing governance groups to oversee funding priorities, and scaling existing provision to meet needs.
• The findings showed that some CSPPs had started to re-design delivery of services in terms of how families accessed support through different referral systems, activities to raise awareness of support offers, and ways to provide more choice and control over support options.
• Increased collaborative working between CSPPs and adult services was demonstrated to some extent through governance groups where partners were able to participate in the design of services, and improved, purposeful working between agency partners in delivery of support.

Intended early outcomes

CSPPs were asked by Scottish Government to set out in their initial plan the outcomes from the WFWF logic model they anticipated making progress towards from WFWF Element 1 activities within the first year (see

Table 3 below for early outcomes). The Scottish Government proposed these outcomes as part of the WFWF logic model and refined them in collaboration with stakeholders, including the Family Support Advisory Group (see Annex 4 for the WFWF logic model). Please note that CSPPs were not expected to achieve all 11 outcomes; rather, they could choose which outcomes they would aim to achieve and there was no requirement for a minimum number of outcomes.

In summary, the most common outcomes CSPPs intended to have made progress towards in Year 1 were:

• To embed holistic whole family support;
• (Re)design whole family support; and,
• Improve children, young people, and families’ access to support.

The less common intended outcomes CSPPs made progress towards were to:

• Innovate family support solutions;
• Develop a holistic workforce approach; and,
• Invest locally in planning system change.

Interviewed strategic leads and local WFWF leads highlighted another outcome they intended to measure progress on – that of getting people into post to deliver WFWF activities. This was not explicitly one of the original outcomes in the logic model, but strategic leads and local WFWF leads noted that it was a required activity for delivering several of the related outcomes outlined in the logic model. For example, to increase holistic whole family support service capacity.

The logic model captures early outcomes that relate to systems change and are emergent in nature. Within the CSP annual reports, CSPPs often used different terminology or merged outcomes within the logic model into a single one when providing evidence. It was also evident that CSPP stakeholders considered children, young people and family outcomes to be individual-level social or health outcomes because that is the nature of their day-to-day work. CSPPs may benefit from reassessing the ambition of their Year 1 outcomes of engagement to what can be realistically accomplished within a year, instead of anticipating individual-level social or health outcomes that are much longer-term outcomes. This confusion captures the challenges CSPPs faced with establishing realistic ambitions for whole system change.

Evidence of progress towards early outcomes

Progress towards outcomes varied across CSPPs. Data on outcomes comes primarily from the CSP annual reports provided by 21 of 30 CSPPs. Where relevant, the evidence from case study research is also included in the analysis below. It is important to highlight that while progress towards early outcomes was included in analysis, the focus of this process evaluation was not to capture evidence of this. The Year 2 evaluation will focus more on the outcomes CSPPs have achieved.

Evidence from the CSP annual reports was included in analysis below only if it clearly and explicitly described the action taken to achieve an outcome; claims of achieving outcomes were excluded from the analysis if no evidence was provided to support the claim, or the evidence described intended plans or actions rather than what had been achieved. Outcomes are discussed based on the number of CSPPs indicating they had made progress towards them. This is presented in Table 3. Nine CSPPs did not provide clear evidence of any early outcomes included in the logic model, and four CSPPs included evidence towards only one outcome each, demonstrating the limited progress towards outcomes made by some CSPPs.

Generally, the CSPPs who reported relatively more progress towards outcomes were among those with the highest funding amounts, and those working in urban areas with larger populations. Half were focusing on transforming delivery as opposed to exploratory or scaling up.

The following sections describe the evidence provided for the outcomes outlined in the logic model where there was notable evidence of progress. There were three outcomes for which more than a quarter of CSPPs (who returned CSP annual reports) showed evidence of progress, and eight where evidence of progress was limited (less than a quarter of CSPPs who returned CSP annual reports demonstrated progress). Outcomes with some evidence of progress are discussed below, and a full discussion of the outcomes with limited evidence of progress is presented in Annex 8.

Note: An earlier version of the logic model included the outcome: Delivery partners (including third sector) are integral to service design and delivery of whole family support. Seven CSPPs indicated they aimed to achieve this in their initial plan and two demonstrated some progress towards it in their CSP annual reports. As this outcome was combined with outcome number 3 above due to overlapping meaning, it is not discussed further in this section.

Outcomes with early evidence of progress

1. Early evidence within CSPPs of a shift towards non-siloed and aligned family support funding that matches scale of need

Only five CSPPs stated an ambition to achieve this outcome in their initial plan, but eight were assessed as showing evidence of progress towards this outcome in their CSP annual reports. Evidence largely centred around integration and alignment of WFWF funding with other sources of funding for family support establishing governance groups to oversee funding priorities and scaling existing provision to meet needs (as discussed in Section 3 Scottish Government approach to funding, allocation, distribution and support: Element 1).

"It's not like we're all being precious over one pot of money, and you know we can work together whereas previously an issue... It's all about coming together and being part of the one big project and goal."

Children’s Services Manager

To align funding streams and to ensure that family support matched the scale of need, some CSPPs indicated they were reviewing existing contracts to ensure there was not overlap in how services were being funded, such as where multiple CSPP services were funding third sector organisations. For example, see CSPP Spotlight in Figure 15 below.

Figure 15 CSPP Spotlight: Glasgow City

Integration of WFWF activities and existing mental health funding

Glasgow City's CSPP identified that the WFWF complemented the Community Mental Health and Wellbeing funding they already received from Scottish Government. Due to potential overlaps, they are taking steps to ensure work is not duplicated across the two funding streams.

Interviewees reported better cross-agency working with colleagues in Child and Adolescent Mental Health Services (CAMHS) as the CSPP was working in partnership with them and encouraging CAMHS staff to feed into WFWF design and delivery. This enabled them to demonstrate how their activities were aligned and encourage integration.

A common approach to making progress towards this outcome was CSPPs convening a steering group of relevant stakeholders who were responsible for overseeing funding opportunities and ensuring a collaborative and multi-agency approach to whole family funding.

Informed by needs analysis, some CSPPs were scaling up existing services to meet demand. For example, some were recruiting additional social work assistants and family support workers, or commissioning services currently run by statutory partners to increase capacity.

2. CSPPs start to redesign/design delivery of new whole family support services, including removing barriers for children, young people and families to accessing support

Ten CSPPs stated an ambition to achieve this outcome in their initial plan and seven showed progress towards this in their CSP annual reports. CSPPs who reported in their CSP annual report that they had successfully established or scaled family support hubs, or built new ways of accessing services, tended to have a larger population, were based in urban areas, and had higher than average WFWF funding and a medium level of family need.

Some CSPPs were in the process of re-designing the routes for children, young people and families to access support through different referral systems. For example, some CSPPs were using place-based provision such as having hubs in local communities (as discussed in Section 5: Implementation and delivery of WFWF to date). To provide easier and approachable access to support, South Lanarkshire and Fife reported that this hub approach minimised the need for formal referrals and reduced the time taken by families to identify the correct point of contact for their needs.

Some CSPPs had reviewed and revised referral processes, including how families accessed support, how their requests were processed, how support was allocated, and the process for self-referrals. Similarly, CSPPs reported ensuring that families were directed to support by trusted frontline practitioners, and closer agency working which enabled more effective referrals (see Figure 16).

Figure 16 CSPP Spotlight: South Lanarkshire

Closer agency working enabling direct ‘warm’ referrals

A family support programme called ‘Pathfinders’ in South Lanarkshire is working with secondary schools and social workers to engage with families who are disengaged from school with a focus on preventing the child or young person being taken into care. Attention was paid to how to communicate to parents and families to inform them about the Family Support Hubs.

'Pathfinders' were utilised to promote the hubs in schools and in discussion with families following referrals from social work or the school. The multi-agency nature of this programme has meant that the hubs have been able to make links with families more easily. For example, pathfinders will give families a number to call or can take them to show them where to go to access support.

“It just seems so much more open for them to access the support than it's ever been. So, a lot of our young people on our case files have now got that intervention in place just because it became so much easier to access.”

Practitioner – Family support worker

Lack of awareness of support available was also a barrier for children, young people and families identified in the CSP annual reports and by partners in interviews. CSPPs reported awareness raising activities such as local advertisements and trying to improve communications and signposting in the community through more accessible materials. CSPPs also recognised that a key barrier to accessing support was the perception of family support among children, young people and families. For example, scepticism about social workers among some families acted as a barrier for these families because they tended to have negative associations with social work that would discourage them from getting involved in support that was offered (see further discussion in Section 5: Implementation and delivery of WFWF to date).

Some CSPPs were planning or actively making changes to service design and delivery to provide children, young people and families with more choice and control about the services they accessed. For example, a new parenting pathway which will provide more choice and control for parents accessing services was being designed in one CSPP. Another CSPP was recruiting more Health Visitors and Nurses to provide children, young people and families with choice between in-person and virtual services.

Children, young people and families expressed appreciation towards the trustworthy and friendly attitudes of frontline practitioners which encouraged them to engage with support. Most children and young people who were interviewed reported that they found activities and support enjoyable which helped with the implementation of WFWF because it meant that families had ongoing engagement with the support provision.

“My favourite bit was the fact hunting bit, that was fun because I remembered the facts and they were actually really fascinating.”

Child

Frontline practitioners were seen by families as being distinct from social workers. This was important to note as some parents often associated social workers with the possibility of their children being removed from their care, so it was important to these parents that the frontline practitioners they received WFWF support from were not social workers. As such, this had supported with the implementation of WFWF as families were more able to engage fully and openly with support provided.

3. Early evidence that CSPPs, including third sector partners, are working more collaboratively and with adult services

WFWF seeks to bring about whole system change to family services, so Scottish Government expected CSPPs would work collaboratively with adult services and third sector partners to design and deliver support. Nearly all CSPPs who set out in their initial plan to work more collaboratively with adult services provided evidence of doing so in their CSP annual report; six of the seven CSPPs evidenced progress towards this outcome in their CSP annual reports. CSPPs who reported progress towards this outcome tended to have medium-high family needs and lower deprivation ranking than average.

CSPPs reported in their CSP annual reports that they were working with partners through governance groups to enable them to participate in the design of services. One CSPP reported they had updated the membership and remit of their CSPP governance board to ensure more collaborative, joined up and efficient partnership working. This included creating two new senior posts to ensure a collaborative approach across GIRFEC, Promise and WFWF. Another CSPP that had broadened membership of their stakeholder groups stated that this had led to more aligned proposals that better meet the needs in their area.

“Third sector practitioners' voices are more heard then previously and your inputs valued with it...Previously statutory and third sector organisations did work together, but not to the intensity that we do now so anything involving the third sector used to take more of a backseat...We were seen as more on the periphery before."

Frontline practitioner – third sector support worker

Greater collaboration among CSPPs was demonstrated through active, purposeful working between agency partners to support the same families in different ways (as discussed in Section 5: Implementation and delivery of WFWF to date: Enablers of WFWF implementation). For example, one CSPP reported in their CSP annual report better support for parents with substance misuse, through closer integration between drug and alcohol services. Another CSPP reported the development of a project for neuro-diverse young people, which brought together partners from education, social work and mental health.