Scale-up: making sure our services work for other organisations

We’ve been scaling up our services so we can reach more children and families. Emma Belton explains how and why we’re evaluating the process

Boy and girl dancing Over the last 5 years the NSPCC has been developing, delivering and testing a wide range of services for children and families. We’ve identified several programmes so far which have a strong evidence base, including:

We want to work with partner organisations so that more children and families can benefit from these services. We are calling this process “scale-up”.

We also want to know whether other organisations are able to successfully adopt and deliver these services. I’m going to discuss why it’s so important to evaluate scale-up, how we’ve done this and what we’ve learnt so far.

We plan to scale up more programmes during the next 5 years so we’re always working to improve the process.

Methods to scale up services

We’ve used a range of methods to scale up our services, depending on the needs of the organisation that’s taking on each programme. We work with our partners to develop the skills and knowledge they’ll need.

This usually involves face-to-face training and providing manuals and guides but different organisations need different levels of preparation before they’re ready to receive any training. We’ve also given different levels of support after the training is complete.

We’ve developed and tested some services which we decided not to scale-up. Either the evaluation results showed they were not effective or they were too costly or resource intensive for other organisations to take on and deliver.

Evaluating scale-up

Successful scale-up involves organisations committing to taking on a service and completing the training required to deliver or use the programme and tools.

But it's what happens once the initial training and input is finished that really matters.

  • Do organisations go on to implement the programmes? What helps them do this?
  • Do they deliver the programme as planned or do they make changes?
  • Does the delivery of the programme or use of the tool become embedded in their day-to-day practice?

These factors affect how the service benefits children and families, which is our ultimate goal.

That’s why we decided to carry out an implementation evaluation for all services we’re scaling up. We wanted to understand how the scale-up process was working in practice.

Implementation evaluation

The implementation evaluation focuses on issues including:

  • the level of organisational commitment and motivation to deliver the service
  • how people feel about the training and whether it leaves them feeling equipped to deliver the service
  • barriers and facilitators to delivering the service
  • how the service is being delivered in practice and whether it differs to the planned scale-up model
  • the reasons for any changes to delivery of the service
  • the impact of local contextual issues on scale-up
  • any evidence the service is being embedded into local practice
  • the future for delivery of the service.

The evaluations explore our partner organisations’ early views of the programme and the training before going back after a period of time to see what’s happened in practice.

We use surveys to get an overall picture and interviews to explore people’s views in more detail.

Outcomes for children and families

Before commissioning a service our partners need to know what difference it’s going to make to the lives of the children and families receiving it.

They want to know if the outcomes achieved by the wide range of organisations taking on the service are likely to be the same as those found when the service was delivered by the NSPCC.

To find out about this we felt a staged approach to evaluation was important: if a service can’t be implemented as planned, it’s unlikely to achieve expected outcomes.

The challenge of evaluation

Outcome evaluations are resource intensive so we don’t want to waste resources on evaluating a service that hasn’t yet opened or hasn’t been delivered for long enough. Similarly, if an organisation hasn’t been able to train up enough staff to deliver the service it won’t have reached the right place for us to carry out an evaluation.

Initially we focused on measuring the reach of our scaled up programmes by asking for data on how many children and families it was being used with: this is a challenge because it means we’re asking other organisations to collect data for us. Their own case management systems don’t always support this. They might know for example, how many children are on their caseload for neglect but not necessarily how many were assessed using the Graded Care Profile 2 assessment tool. This can result in manual data collection systems and low data returns.

The future of scale-up evaluation

Ideally we’d like to conduct one outcomes evaluation for all organisations delivering a service: once it appears to be fully implemented. However, this could be tricky: for any service in scale-up we’d be asking a number of organisations to collect and submit outcome data.

These organisations might have limited experience of evaluation or limited data collection capacity. So we may first need to increase the evaluation capacity of the organisations taking on our services.

As well as providing us with the data we need this exercise will (hopefully!) help us learn how feasible it is to collect outcomes data across a number of organisations. It could also help the organisations taking on our scaled up services to build their own capacity and be able to carry out and learn from their own evaluations.

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