Good parent-worker dynamic vital for impact

This year's theme is "How Evidence is Changing our Town", which made me think about what and how we are delivering services on the ground.

Over the past four years, the Blackpool Better Start partnership has developed a place-based approach by bringing together statutory organisations (police, health services, local authority) with a lead national voluntary sector organisation (NSPCC), to work together in a different way. They have worked with some of the best brains in the world to enhance their thinking. One such academic is Professor Frank Oberklaid, Melbourne Centre for Community Child Health, who has been developing thinking around evidence-informed practice. This is not just about using and delivering evidence-based programmes but also using evidence-based processes and drawing upon service users' and professionals' values and beliefs to understand what goals are important and what interventions and programmes are acceptable to families as well as how effective they may be.

Professionals have to ensure that the interventions they use have an evidence base and are used in the right circumstances. Without engagement between practitioner and parent the programme will not produce the impact it could. The parent-worker dynamic is crucial to ensure successful, sustained engagement and is part of an evidence-based process that includes delivering to fidelity and providing a quality assurance framework to support this. Part of the quality assurance should ensure that the right people are receiving the right intervention; all too often stretched services want to find a service for someone and a helpful worker will accept a person/family who does not meet the service specification. This is no help to anyone and the family engaged will be disillusioned when the intervention doesn't work for them and a family who might have benefited may lose out.

This approach has been used in the implementation of the enhanced health visiting service which has now been rolled out across the town. Not only is their practice evidence based but the work is parent-led with health visitors engaging differently with parents and taking their lead. Also the policies around how they work have embedded more relational working including the use of trauma-informed approaches, peer-to-peer supervision, a quality assurance framework and ensuring fidelity to, and quality of, the approach are important. Using evidence-informed practice has started to show early indications of success. Key elements of the approach have been identified as:

1. Co-production of services alongside the community; collaboratively implementing a range of innovative and evidence-based programmes to tackle systemic issues
2. The creation of a common language for professionals and parents to discuss early child development
3. Workforce and systems reform through the implementation of trauma-informed practice.

• Merle Davies is director of the Blackpool Centre for Early Child Development