Leadership: Scaling up interventions


Once the value of an innovative intervention for children and families has been recognised, the next step is to effectively implement and replicate it on a scale that can benefit even more people.

The UK has some of the most impressive and innovative organisations researching, developing and testing programmes to achieve better outcomes for vulnerable children and families. Yet replication of these interventions at scale continues to be a slow, laborious process.

Significantly more funding is aimed at developing and testing new innovations rather than the end goal - implementation and replication of effective services. In a world of declining resources, greater emphasis needs to be put on the use of evidence in practice, encouraging commissioners to actively seek out opportunities to replicate evidence-based programmes that already have proven outcomes. Innovating organisations need to consider how they can actively support this to happen by investing in implementation support.

The NSPCC's Scale-up Unit is a new initiative attempting to break down some of the barriers to using evidence at scale by supporting organisations to put evidence generated by the NSPCC into practice. Our approach to scaling-up draws on learning from our own research, implementation and behavioural science and an ongoing commitment to learning more about what works for successful scale-up.

Implementing evidence-based services can be hard and painstaking and we continue to learn a lot about how it can best be done in social care. It is also a critically important and hugely rewarding task in our work to improve outcomes for children and families in the long-term.

1. Scaling up takes time and resources. Successful replication of evidence-based programmes requires investment in resources and infrastructure from both the innovating organisation and the adopting organisation to be successful. Implementation takes time. Evidence suggests it takes two to four years before an intervention can be classed as being fully implemented.

2. Know your market and your product. The term "market" and the use of sales language is not something charities and social care tend to use in their daily practice. However, developing insights into who might use the programme and an understanding of the context in which they are working are critical when considering how you might take a programme to scale. You may need to consider how you prime your market, develop a marketing plan or develop a community of engagement before you "launch" your innovation.

Before you pilot the replication of your programme, you also need to consider how it is teachable, learnable and doable by other organisations, and ensure that the evidence can actually be translated into practice. To aid this you need to have developed any materials, guides and manuals that support the adopting organisation to put it into practice. As future phases roll out you will learn and adapt and add to these materials, but it is important to have them from the start.

3. Be clear on what scale-up model you will use. A decision also needs to be made about the replication model you will use for the programme you are scaling up. How critical is it that it is delivered to the fidelity of the model? Will you licence the adopting organisation to use the programme or will you provide it through free dissemination? You need to articulate clearly the areas that are non-negotiable and the areas where there is flexibility to adapt the programme locally without compromising model integrity.

4. Think data and evidence from the outset. There is an increasing drive for organisations to capture evidence of reach and impact. Consider from the start of any pilot what data you want to collect as the innovating organisation and what the implications of this are for the adopting organisation, then build data collection into the system from the start. Don't over-engineer or over-complicate data collection.

5. Supporting leaders and staff is key to sustainability. Evidence on outcomes does not help you successfully implement programmes, people do. It is critical to nurture leaders and champions at all levels within the adopting organisation, preventing a "single point of failure" should there be staff turnover or a restructure. Your leaders do not have to be the most senior person within an organisation, but they do have to have a passion for the programme.

Implementation support for adopting organisations should incorporate methods to improve and sustain use of innovations and to develop competence and confidence. Systems and processes need to be put in place for this to happen, for example opportunities for further learning or to join a community of practice so that successful implementation can be shared between a network of organisations.

Consider what ongoing support you will provide to the adopting organisation - it needs to be proportionate to the service you are scaling up and the model you have decided upon. Are there ways you can support sustainability? This could be through a "train the trainer" model, enabling organisations to train their own staff, or support around accessing ongoing funding.

Hayley Clark is senior business development manager at NSPCC

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