Post on 15-Jul-2020
@theEIFoundation eif.org.uk
Donna Molloy, Director of Implementation, EIF
Early Intervention & the work of EIF
What is early intervention ? “Early Intervention is about targeted activity to respond to emerging signals of risk in child development, before problems become costly and irreversible.”
Programmes, Practices and Systems which promote • Social and emotional well being • Language and communication
skills • Self-management and control • Mental health
• From conception to early adulthood • Not just about children’s services but ‘everybody’s business’.
Examples: • Home visiting • Speech and language therapy • Group based parenting support • Youth mentoring • Intensive therapeutic
approaches • Family support
@theEIFoundation | eif.org.uk
EIF: who & what
An independent charity and a ‘What Works’
Centre
launched on 4th July 2013 with a mission to
promote Early Intervention to:
• Tackle the root causes of social problems
• Improve children’s life-chances,
• Reduce the cost of failure to the taxpayer
Generate knowledge &
evidence
Communicate & disseminate
Secure Adoption
Test & learn
@theEIFoundation | eif.org.uk WHY EARLY INTERVENTION? EXPLORING THE EVIDENCE
• Wide and persistent gaps in children’s wellbeing and development emerge
very early in life.
• These factors have important consequences for future and intergenerational outcomes.
• These factors are not set in stone immediately, and can be influenced by timely intervention.
• Programmes which successfully improve these factors deliver substantial individual and social benefits over time.
Early Intervention can improve long-term outcomes for children & families whilst being more cost-effective
Evidence from economic and social research,
established over many years, supports the following
principles:
@theEIFoundation | eif.org.uk
[CATEGORY NAME] £5.2bn
([PERCENTAGE])
[CATEGORY NAME] £680m
([PERCENTAGE])
[CATEGORY NAME] £6bn
([PERCENTAGE])
[CATEGORY NAME] £610m
([PERCENTAGE])
[CATEGORY NAME] £450m
([PERCENTAGE])
[CATEGORY NAME] £3.7bn
([PERCENTAGE])
Total annual spend on late intervention : £16.6bn (2014-15
prices)
EIF National Conference| 12 February
2015
An example: The Effects of Weaknesses in Oral
Language on Reading Comprehension Growth (Hirsch,
1996)
5 6 7 8 9 10 11 12 13 14 15 16
16
15
14
13
12
11
10
9
8
7
6
5
Readin
g A
ge L
evel
Chronological Age
Low Oral Language
in Kindergarten
High Oral
Language in
Kindergarten
5.2 years difference
@theEIFoundation | eif.org.uk WHY EARLY INTERVENTION? EXPLORING THE EVIDENCE
@theEIFoundation | eif.org.uk WHY EARLY INTERVENTION? EXPLORING THE EVIDENCE
Key elements of an effective EI strategy to reduce demand • Using the evidence about what works • Breaking down silos - integrated public services • Focus on frontline practice • Utilising capacity in wider services & communities
@theEIFoundation | eif.org.uk WHY EARLY INTERVENTION? EXPLORING THE EVIDENCE
Key elements of an effective EI strategy to reduce demand • Using the evidence about what works • Breaking down silos - integrated public services • Focus on frontline practice • Using the reach & contacts of wider services
EIF evidence ratings
@theEIFoundation | eif.org.uk
The EIF Guidebook
@theEIFoundation | eif.org.uk
What works to support parent child interactions in the early years ?
Assessment of cost and strength of evidence for 82 programmes that aim to support the parent child relationship C-5
Key messages:
• Generic and universal programmes seeking to achieve multiple outcomes for diverse groups do not work
• Best evidence of effectiveness is for targeted programmes with a clear target population and rationale
• Good evidence on behaviour e.g group based parenting programmes and communication.
• Evidence on attachment programmes is less strong
• Critical: clear, well defined target group; well trained & supervised workforce
What works to prevent young people being involved in gangs and youth violence
What does the evidence show about what has and hasn’t been shown be effective?
• Seeking to create positive change
• Schools-based or family-
focused • Skilled facilitators • Implementation fidelity
• Programmes specifically designed to prevent gang involvement
• Mentoring and community-based programmes
• Programmes based on deterrence/discipline
• Computer-based programmes
Evidence-based interventions in 13 of EIF’s Pioneering Places (all age ranges)
3%
47%
4%
22%
15%
9%
PROGRAMMES BY EVIDENCE RATING
-1 0 1 2 3 4
• 47% have no known evidence of effectiveness in an established clearing house
• 24% are underpinned by at least one RCT
• 22% have evidence of potentially improving child outcomes from a pre/post evaluation not involving a comparison group
• 4% have a logic model only
• 3% have been proven to be ineffective
@theEIFoundation | eif.org.uk WHY EARLY INTERVENTION? EXPLORING THE EVIDENCE
Key elements of an effective EI strategy to reduce demand • Using the evidence about what works • Breaking down silos - integrated public services • Focus on frontline practice • Using the reach & contacts of wider services
Blackburn with Darwen
LFRS
Police.
Community Step Down
Public Health Blackpool
• Alcohol • Evaluation • Health
Education
Blackpool CCG (NWAS)
• A & E Blackpool
• A & E Lancaster
• GP Surgeries • NHS integrated
teams
Fylde & Wyre CCG
Lancashire North CCG
Blackpool Council
• Fulfilling lives • Springboard • Children's
Social Care • Adult Social
Care • Troubled
families
Public Health Lancashire
• Alcohol • Evaluation • Health • Education
Chorley & South Ribble CCG
• A & E Preston • A & E Chorley • GP Surgeries • NHS Integrated
teams
Preston CCG
West Lancs CCG
Lancashire County Council
• Children's Social Care
• Adult Social Care
• Early Help LCC • WTWF
Public Health Blackburn with Darwen
• Alcohol • Evaluation • Health
Education
Blackburn Darwen CCG (Mental Health)
• A & E Blackpool • A & E Lancaster • GP Surgeries • NHS Integrated
teams East Lancashire CCG
Blackburn with Darwen Council
• Transforming lives
• Child Social Care
• Adult Social Care
• Troubled families
Deprivation Drugs Loneliness / Isolation
Alcohol Mental Health Elderly
Learning Difficulties
Dementia
West South East
Vulnerability
Multi-agency panel targeted interventions
Evaluation
NWAS
LCFT
Crime ASB
Adverse Childhood Experiences
Volunteers Home Start
Befriending Services
Youth Offending
Making every adult matter
Red Rose Recovery
Alco/drug Treatment Services
Troubled Families
Early Help
Mental Health services
Revolution Women's centre
Age UK Group
Help Direct
Blackpool Offender Prevention Team
Early Action Team
NWAS HIU Worker
Adult Social Care Step Down
Children's Social Care Step down
Mental Health Frequent Flyers
Early Response
Police High Intensive Users
Mental Health Triage
Dementia Logs MASH
A&E Frequent Flyers
GP Frequent Flyers
NWAS High Intensive Users
NHS Locality Team Confidential Meeting
Lancashire County Council Blackpool Council
Health & Wellbeing Boards
Locality Teams
NPS & CRC Wicked
problems
“The challenge is now to move away from police, local authority, health, probation interventions to asking the question: “What treatment do we need to apply to reduce offending and vulnerability in this place?” The blueprint requires a shift ….to deliver really integrated public service”.
“So we know this will not be solved through traditional collaboration or multi-agency working. We need integration not collaboration. We can’t afford to keep paying 18 different professionals to sit in the same room and talk to each other. We need one public/community sector asset not 18. Step out of your silo, be prepared to give to receive and start thinking more radical thoughts”.
West Cheshire
Delivered a multi-agency front door – over 20 agencies directly co-locating professionals, data systems and triage /risk assessment
of complex cases below Social Care threshold
Established eight multi-agency teams involving over 180 workers in community settings sequencing and coordinating family-led
service plans directly empowering family independence
Embedded a single family assessment tool (TAF) and ICT solution across over 40 services including all schools,
GPs, NHS providers and criminal justice agencies
Coordinated a menu of multi-agency interventions including personalised budgets and tailored support packages for families
Re-commissioned an evidence based services menu for fast access to meet demand where and when required.
@theEIFoundation | eif.org.uk WHY EARLY INTERVENTION? EXPLORING THE EVIDENCE
Key elements of an effective EI strategy to reduce demand • Using the evidence about what works • Breaking down silos - integrated public services • Focus on frontline practice • Using the reach & contacts of wider services
@theEIFoundation | eif.org.uk
Its not just about programmes – need to think about practice
• Fairly small numbers who actually receive evidence based programmes especially when compared with much larger numbers in contact with professionals, services or volunteers
• Its people who change people!
• What is it about the nature of interactions between a worker or volunteer that leads to behaviour change?
@theEIFoundation | eif.org.uk
Catherine Needham and Catherine Mangan
@theEIFoundation | eif.org.uk WHY EARLY INTERVENTION? EXPLORING THE EVIDENCE
Key elements of an effective EI strategy to reduce demand • Using the evidence about what works • Breaking down silos - integrated public services • Focus on frontline practice • Utilising capacity in wider services & communities
Using the reach & contacts of other services – Early Intervention as everybody’s business
• Delivering effective early Intervention to all who need it, also requires us to
think about the role of wider workforces
• Better use of core public sector workforces through involving them in identifying need and providing basic information has the potential to keep people out of expensive specialist services
• noticing and helping a struggling family as ‘part of the day job’ of anyone who comes into contact with families
@theEIFoundation | eif.org.uk WHY EARLY INTERVENTION? EXPLORING THE EVIDENCE
• Ensuring the first person in the door has the
toolkit they need www.eif.org.uk/early-intervention-
a-guide-for-frontline-police-officers-and-pcsos-3/
West Midlands Fire Service – improving public health Have begun to play a key role in “prevention” and the risk reduction efforts targeted at vulnerable communities at most risk of deprivation and ill health. They remain fully committed to providing the highest standard of emergency incident cover, including the delivery of a risk based 5 minute attendance to incidents. 1322 fire fighters, 58 technical support officers; 61 fire safety officers have at least a million contacts with the public – their mantra is “Prevention, Protection, Response” Workforce time now committed to prevention to tackle: • Anti social behaviour • Preventable ill health and early death • Empowering people to improve wellbeing in communities that with poor health outcomes • Engaging directly with households and neighbourhoods & supporting behaviour change • Healthy neighbourhoods and improvements in community resilience • Improving life chances and equality of opportunity
This work has been endorsed by Professor Sir Michael Marmot, for its work in tackling health inequalities.
@theEIFoundation | eif.org.uk WHY EARLY INTERVENTION? EXPLORING THE EVIDENCE
• Traditional approaches have their limits • The need for strengths based approaches, improving community
resilience and reducing dependency • Models of community based support peer support, co – production,
volunteering, paid community capacity building roles • Growing interest in how councils/others can support and enable these
approaches including sharing evidence and information on what has worked and overcoming challenges
How do we build the capacity of communities to spot risks or individuals & families needing help and provide it?
@theEIFoundation | eif.org.uk
Find out more at: www.EIF.org.uk Contact us at: info@eif.org.uk Follow at: @TheEIFoundation & @donnamolloy_