In March, FNP National Unit Director Ailsa Swarbrick was invited to give evidence to the House of Commons Science and Technology Committee’s inquiry into evidence-based early-years intervention.
Matt Buttery from Triple P, Jen Lexmond from EasyPeasy and Professor Edward Melhuish from the University of Oxford also gave evidence on the impact and importance of early intervention.
Chaired by Norman Lamb MP, the Committee focused on the impact these programmes have in both the short and long-term, how they know what they are doing is working, how they collect and use data to improve, and the ways in which they are having to develop and evolve in a sector where demand is growing but resources are becoming more scarce.
Professor Edward Melhuish described how his extensive research in this area has shown the long-term benefits delivered by good early intervention practice for parents, their children and also on wider society. He highlighted that currently in the UK 20% of children begin their school journey inadequately prepared to benefit from school. He explained that the trajectories children are on when they start school are difficult to change as they move through the academic system; if children start from a disadvantaged position it becomes more difficult for them to achieve the same outcomes as those not considered disadvantaged. “We need to change our culture with regard to how we view parenting. We need to realise that day-to-day activities with children make a real difference to children’s long-term outcomes. Those long-term outcomes for children have consequences for the economic development of the country.”
Professor Melhuish advised that in order to see both social and economic benefits, investment in early years is imperative. He explained the growing disparity between resources available to fund and evaluate services and those available to develop and create a service. He was clear that FNP and the other programmes discussed deliver real benefits for clients and commissioners.
Responding to a question about how FNP provides appropriate support that reaches those who need it, Ailsa described how user-centred design within FNP is a fundamental aspect in shaping work on developing and responding to change in the FNP programme. Accelerated Design and Programme Testing (ADAPT) is one strand of this and seeks to bring more flexibility into the programme to ensure that the interventions nurses deliver fit as much as possible with individual client’s needs (agenda matching) with the aim to achieve better outcomes for both clients and their babies. Ailsa stated that we are moving towards a programme that is: “Tailored to the local context—and tailored to individual clients, because they are all very different. We wanted to introduce much more flexibility and direct responsiveness to individual and local circumstances, while retaining the very good evidence base that we have.”
Asked by Damien Moore MP, if early intervention was an industry, Ailsa said: “It’s not an industry, it’s not owned by one sector – it’s a rich, diverse and very well informed community.” Both Matt and Jen agreed and discussed the importance of working together to create robust practices that provide good quality interventions.
Matt Buttery talked about how critical it is to involve service users at all levels to generate good outcomes and alluded to Ailsa’s previous point about involving clients in the service design:“We have shown that a population approach to parenting, allowing parents to choose what level and intensity of intervention they want to access, is one of the most powerful ways of getting out there.”
Topics also discussed included the importance of the Early Intervention Foundation’s Guidebook, which reviews and rates early intervention programmes. The panel were in agreement about how valuable it is to have an external body providing un-biased reviews and recommendations about such programmes.
Bill Grant MP, asked about the evidence behind FNP and what barriers and constraints such a robustly evidenced programme works across geographical and culturally diverse settings. Ailsa explained that it is in fact the strength of the evidence base and the theories that underpin FNP that have allowed the programme to adapt, develop and remain successful for the last decade in England and other parts of the UK.
Closing the session, Norman Lamb asked the witnesses about their vision for early intervention in the future. All of the panel expressed a need for leadership at a local and national level, more resources, and a collaborative and cooperative movement that allows the current community to continue to grow and reach those in need. Despite varying programme dynamics, all have the same principle: to ensure high quality early intervention services are available to improve the lives of families.
There will be further evidence sessions so please keep an eye on the Committee webpages.
The full inquiry can be viewed here.