The 8 optimum conditions for systems change

MAP have been working in three school communities in Norwich for the past five years. They’ve learned a lot about what works and what doesn’t when trying to collaborate with multiple stakeholders to influence systems to act earlier.

These are their reflections on the optimum conditions for system change, but they’ve found it’s not a simple ‘recipe for success’. It’s more like working in an ecosystem - there will be storms and droughts - but if we seek to create these conditions that will help the system to change and grow for the better.

1. Stability

It is impossible to work on influencing without stability. Five years of stable funding gave us the opportunity to have a long term commitment and use the resources flexibly. Charities can provide leadership on early action because they can work long term; working to a stable strategy. Schools and commissioners wanted to work with us when they knew we would be there for five years. The public sector is hampered by short term policy and silo budgets. Often all the public sector can do is respond to crisis: A&E targets, reducing children in care and school exclusions. Their culture is immersed in crisis.

2. Crisis

Crisis actually helped us engage with partners. Both our children’s services and mental health trust were in special measures; under huge pressure to improve and change. As a result they were more open to change, consider new ideas, and improve. This appetite helped open doors. A crisis needs a plan, a change of direction and allies. It meant we could be a part of that, setting shared goals.

3. Goals

To influence strategy and culture you need to be very clear about what you want to change. We explain our goals at all opportunities. Working to change culture in schools required them to sign up to our goals. When looking for partners this made it much easier to find the right allies. A theory of change is important. A simple goal that is central to the organisation and easy to communicate is essential for this to work. It is not simply a project goal but central to our mission as a charity.

4. Organisations not projects

Early action has to be at an organisational level. Investment is for the organisation, not an isolated project within it. MAP’s mission is to equip young people to be ready for adult life. We exist for Early Action. Therefore, when considering who to invest in, it is important to look at the whole organisation – what is their strategy, structure and values? Are they well run? Early action in our DNA.

Not all organisations see themselves as influencers. Being an influencer is a strategic decision for an organisation. A one-off project will not be effective. As an influencer we undertake campaigns, deliver training, take part in national research and talk at conferences.

We strongly encourage funders to support organisations rather than fund short term projects. Foundations usually have investment portfolios. They may move their investments if they want to improve their returns. Foundations should consider funding organisations in the same way; providing funding until they feel they aren’t getting the impact they want; an investment portfolio of organisations. This would lead to longer term and bigger impact.

Early action requires a type of organisation: one that has a local connection; a community they are engaged with and one that is big enough, with the right structure and skills, to be influential. There is a sweet spot: big enough but local enough. We need to be credible.

5. Credibility

Organisations can’t only do influencing. They need to have expertise in their area by delivering services. We have this credibility locally – known for providing excellent, well evaluated services. A good reputation is essential to be an influencer. Service delivery still needs funding as well as influencing work. They go hand in hand. We can develop evidence of success, train others, model behaviours all through the expertise of service delivery. This is why we are the Eastern Region Lead for the Centre for Youth Impact. It is only through our service delivery we engage with young people who are the biggest influencers of all.

6. Lived experience

We have learnt a vital lesson: young people are the biggest influencers. They bring their expertise through experience and are seen by the system as neutral, without vested interest. We didn’t focus on this anywhere near as much as we should have in the beginning. Now we promote young influencers as much as we can and are supporting the development of the Young Activist Network. Young people demand earlier action. It is our relationships with young people through our service delivery that has been one of our major assets.

7. Good Relationships

We had excellent existing relationships with young people and partners when we started this work. We understood their needs, goals, pressures. This helped us develop shared work. With trust in place we can achieve so much more. This became a focus of our work.

To further improve relationships we developed a new way of working: “systemic conversations”, with our fellow mental health providers. This work was published in a public health journal. When common purpose and trust is established change can happen. It led to the development of our Commission that made recommendations that have been adopted for the new model for mental health services in Norfolk. Our Commission was a mixture of professionals (head teacher, psychologist, psychiatrist, social worker, funding manager, chief executive) and young people, independently chaired by a Mental Health Tribunal Judge. We develop relationships by expressing our values.

8. Values

Our values are at the core of everything. They ensure consistency and focus. They are early action values. We are young person centred; we are led by their ideas. We value each individual; understanding their strengths. We work for social justice; tackling the causes not just the symptoms. We are professional; working to high standards and evidence. Organisations need values that lead them to early action in their delivery and lead them to take on influencing. Values can be shared and aligned with partners.

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About MAP and Early Action in Norwich

MAP opened its doors in 1991 in Norwich as Norfolk’s first Youth Information, Advice and Counselling Centre, and has been growing ever since.

Since 2015 MAP have been funded by the Early Action Neighbourhood Fund for an ambitious programme of ‘Early Action’ services for young people in West Norwich. The West Norwich area has high levels of deprivation across a number of indices, significant risk factors for young people becoming NEET. Many young people in West Norwich do not feel able to access facilities and services based in central Norwich.

We’ve been working in three school communities

Our Early Action programme is based on-site in 3 schools in the area, and in the local community, to ensure our provision is easily accessible to young people. By giving young people access to the right support at the earliest moment we hope to help them improve their social and emotional wellbeing, leading to better attainment and less chance of becoming NEET. Hopefully this will also mean they are less likely to need acute services later.

We have offered a microcosm of MAP’s services directly to students within their schools. Counselling, family mediation, mentoring for students and social opportunities are all available alongside professional Advice relating to subjects ranging from sex, relationships, debt, future education and managing stress.

We’ve also been influencing systems

Our aim throughout has been to use the evidence of the demand for these interventions and the positive outcomes of them to influence and improve the services and funding available for early intervention work of this type in Norfolk.

We have helped to create systems change through professional collaborations, training and consultation. We formed the Early Action Network to bring together local professionals from within this community; to identify training needs, share good practice, collaborate to support children and families and to strengthen the voice of early intervention. We have trained teachers and pastoral staff and advised on policy changes within schools.

We want to improve the quality, quantity and accessibility of wellbeing support for young people in Norfolk. We have used our evidence and position to negotiate increased funding for early action in schools and have begun an ongoing collaboration with our local Mental Health NHS trust. We are using our evidence and experience to better ensure young peoples’ needs are represented whilst they undergo a full re-design of service.

We’ve managed to achieve a lot

Throughout this work we have been successful in:

• Delivering significant wellbeing interventions for 1591 young people

• Training 400 school and community professionals

• Improving schools’ awareness of and policies for student mental health

• Reducing demand for community mental health services

• Reducing local waiting lists for students accessing therapeutic services

• Increasing school’s investment in early intervention wellbeing interventions

• Contributing our evidence and experience to our local NHS Mental Health Trust’s service redesign – ensuring young people are consulted and heard.

If you would like to learn more about our model, impact and learning on this project, please read our 2019 IMPACT Report or contact paulwebb@map.uk.net

Our journey to creating healthier relationships in Hartlepool

Jayne Moules from the Healthy Relationships Partnership shares how they have evolved their approach over five years and what they’ve learned along the way.

Community participative research

What is the Healthy Relationships Partnership?

Healthy Relationships Partnership (HRP) programme started in 2015 with the aspiration to make Hartlepool the place with the healthiest relationships in the country. We wanted to create healthy relationships between organisations, within teams and between practitioners and families. We believed that healthy family relationships would be best fostered and supported by a healthy system.

The problem we wanted to solve

The system wasn’t focusing enough on the quality of the relationship between the parents of a child. There is a lot of evidence that this has a huge impact on children’s welfare, well-being and their life chances. It’s also a critical determinant of how effectively parents can parent (Harold, Acquah, Sellers & Chowdry, 2017).

So, we were curious about why, if the evidence is so compelling, aren’t we responding to it? What are the system conditions that need to be in place in order to act early and intervene to strengthen parental relationships? The Early Action Neighbourhood Funding allowed for the creation of a project team to:

1. Act as 'system stewards', providing support to the organisations with the resources, position and power to make a difference to start to think, behave and deliver differently.

2. Deliver activities to demonstrate evidence-based practice locally.

At first we focused on ‘delivering’ something

In the first phase we introduced an evidence based relationship intervention called ‘Parents as Partners’ (PasP).

We thought we needed to have a tangible ‘thing’ we were delivering. We believed this would help us to win credibility and to be seen to be ‘bringing something to the party’. Especially in the early stages of the progamme, when ‘system change’ was a concept that was not well understood and difficult to translate into activity. We also thought it would help us to demonstrate to the funders and partners that the project had ‘beneficiaries’.

We thought lots of schools and other early help services would be interested in this. Wrong. Despite tireless promotional work, demand was low.

So we changed our approach

As our understanding of the system conditions matured we adopted a different approach.

We created demand for services by raising awareness with parents and community organisations and increasing the supply of accessible support.

To drive up demand for healthy parental relationships we developed community awareness raising campaigns. We used social marketing, social and broadcast media to increase the profile of HRP and of the issue.

This support was delivered either through self-help, training community volunteers or by equipping practitioners in community and universal services with the confidence to have a helpful conversation about the quality of the parental relationship.

This has helped to change the system

Through the support, we’ve helped to build the capacity and skills of individual practitioners and managers within the local authority early help systems. People are now saying that they feel more confident in supporting and helping parents to manage their relationships and to reduce the potential for conflict. This practice is being reinforced by changes to supervision practice, practice standards and job descriptions within the local authority.

Which has benefited families – and fed back into the system

We have been able to collect stories from parents and practitioners across the wider early help workforce. They’ve described how these lower level interventions have improved relationships and children’s well-being and prevented the need for more intrusive interventions from specialist services.

We have fed these back into the system as illustrated by the following quote from a school based practitioner:

“I’m conscious of parental conflict as something that might sit behind some behaviours that we see in school now, where I wouldn’t have been before. I wouldn’t have even thought about it. It’s about trying to look for the signs of it. It’s made me much more comfortable with exploring that with parents. I’m happy to have that conversation.”

— Parent Support Advisor

Early help practitioners receiving training on being able to provide relationship support

Some key things we’ve learned along the way

1. Don’t underestimate the time and energy it takes for organisations to understand and to commit to system change. Not everyone is used to thinking in terms of systems and there needs to be a shared understanding and commitment to ‘going with’ the process.

2. Having a clear identity as a system change programme rather than a project than delivers a service to families was important for us. This helped us to resist the pull from agencies to see us as just another pair of hands within the landscape of local service provision. Although we had the skills to work with families so we could model different ways of working, we had to keep focused on systems change.

3. We had most success when we did the following things:

   • Designed in partnership. We worked with School based Parent Support Advisors to develop and to test out resources that they would find helpful to use with families.

   • Worked with people rather than ‘did to’ or ‘did for’ them. We found it really effective to support workers think through how to help parents to strengthen the couple relationship and reduce conflict. We also learned that in order for practitioners to apply their learning, organisations need to create the right conditions to give their staff permission, support and encouragement to do things differently.

   • Collected and used real people’s stories. We used any opportunity to shine a light on success stories from the workforce and from parents’ perspectives.

   • Were flexible. We used data iteratively to inform the development of the programme and to share with stakeholders to inform their decisions and practice. This meant not always sticking with the original action plan.

   • Recognised that communities have strengths and are a real resource. We worked with and trained parents to support other parents to promote healthy relationships. They can reach people practitioners often can’t.

Co-producing a parents-led project with community members

Reference: Harold et al. ‘What Works to Enhance Inter-Parental Relationships and Improve Outcomes for Children,’ 2017 (. Early Intervention Foundation Briefing)

It's not about having the answers it's about learning to ask the right questions

In the first of a new series of blogs, Emma Bates and Clare Wightman from Ignite share their advice for funders of this kind of work.

Mapping local strengths at the Hagard Centre in Willenhall, Coventry

Ignite has been a unique blend of two very different interventions –

a community focused one seeing answers to problems in networks of healthy relationships and connections as well as stimulating the agency of local people to come together for mutual help and support in groups.

And an advice approach that wanted to not just correct every day law related problems but to transfer capability to resolve those issues if they happened again – to change knowledge and behaviour

That combined approach has been placed for the last 4 years inside two service systems – children’s and housing management in one Coventry neighbourhood - as a catalyser of wider systems change.

Right now in our final six months we’re translating Ignite into system wide action via a plan being implemented across all family hubs

Looking back, if we had to nail some key messages for funders of work like this they would be:

Be flexible. For this work it was important not to deliver to a proposal but to respond to the constantly changing context and to what we were learning. We were free to follow ideas and threads of energy and land in a place with people we could explore Early Action.

Persistence pays off – in terms of a churning context – the churn can churn back in your favour – but real resilience is needed over a 5 year time frame.

Voluntary sector led system change?

Runs the risk of being peripheral to the wider system. We wonder if sharing grant monies inside the public sector system would have enhanced their stake and their shared accountability back to the funder? That might have mitigated the effect on us of a churning context too. On the other hand, it gave us a unique lens. Unlike the public sector system, we were able to encounter people in a different way. We were not trying to determine our statutory duty or responsibility and that meant we could work out what was required to solve the problem at individual and system level.

One big take away

For all the work we’ve done, the personalities and relationships are the most significant factor in if something lands and when.

And finally… what do we know now about Early Action that we didn’t before? Poverty and inequality are at the root of the problems experienced by people children’s early help services are trying to help. We can’t provide one without tackling the other.

You can find more learning like this in our latest output from the evaluation - a briefing for funders.

A Day in the LifeZone at City Academy Norwich

My shopping list reads: cherry tomatoes, grapes, blueberries, carrot sticks, celery, pitta bread and hummous. I’ll need to get two packs of everything because the students at City Academy devour the lunchtime LifeZone snacks before they’ve hit the table. Especially the cherry tomatoes, which Daniel*, a year 7 student, has discovered a mild obsession with. This, I think, is definitely progress. At the beginning of the term the hummous was given a wide berth by everyone. “What is THAT?!” people cried, holding their noses. “It looks like sick!” But after some gentle coaxing by the youth workers and tentative ‘dipping’ the students at City Academy now dive into the hummous as if it were going out of fashion.

Food is a great leveller and conversation starter, and MAP’s youth and advice workers see it as a way of sparking good relationships with young people. The LifeZone is not all about bringing hummous into the lives of young people however—although healthy eating and familiarity with fresh fruit and veg is a bonus. The LifeZones are spaces where young people can self-refer into any of the Early Action interventions that MAP currently offers across three Norwich high schools: counselling, advice and youth work.

Before the bell goes for lunch, Youth Worker Paul bounds into the kitchen and greets the lunch staff with a big smile and a bunch of celery that needs chopping. They are more than happy to oblige. Meanwhile Georgie, the Advice Worker, and I scoot into the library to borrow two round tables for the snacks and one for flipchart paper and set ourselves up in the atrium.

“Our questions for the day are: ‘What makes a school student happy?’ ‘What makes them anxious?’ ”

I write them up on the flipchart paper and Georgie gets the pens ready. Paul’s back with a plate piled high with yummy celery; I get the referral forms ready Georgie tears open the hummous and puts her sign up: ‘ask me for advice’. We’re ready to go.  Just in time, the bell rings and the familiar roll of thunder signalling feet on stairs sounds.  

Our first LifeZone guests are a group of year 7s who like to hang out while the queue for lunch dies down. “Hey, it’s MAP!” one of them shouts and they plonk themselves in front of the snacks. In exchange for a handful of blueberries they write down their answers to our question of the day. Their thoughts are interesting, some facetious: it doesn’t take long for someone to write ‘no school’. One student however writes ‘proper support and help with issues,’ another, ‘exam stress’. Simple activities like this show us what’s really going on in schools and how the students are feeling.  

About half way through lunch a year ten girl approaches the area, she’s hanging back a bit, assessing the scene. She looks nervous. I smile and offer her tomato. “Would you like to chat?” I ask. She nods and comes over. “Can I talk to someone about counselling?”

“Definitely,” I say. “How about somewhere private, away from all the hummous and chaos?” She manages a laugh.

The school has given us a couple of rooms we can use at lunchtimes—to have private conversations in. I take a referral form and appointment card with me. “I think I could do with some counselling,” the girl says. But I’m not sure how to do it.

“You’ve definitely come to the right place” I say.

 I explain how the referrals work:  we fill in a simple form together and I pass it to Joyce, the lead counsellor with Early Action, who does the initial assessment with all new young people. I go over what confidentiality means and how counselling works. Then she tells me what’s prompted her coming to speak to us and I make a few notes on the form. I’m so glad she’s reached out to us.

“This is the first time I’ve talked about any of this,” the girl says. She seems visibly lighter.

There’s no waiting around for appointments with our referral system and I’m able to give the girl a card with a time and date on it for her initial assessment. It’s like handing someone a lifeline just when they need it.

“Come and see us at the LifeZone anytime,” I say as we part ways.

The bell will soon go for form time; 50 minutes has whizzed by. I get back to Paul and Georgie who are both surrounded by young people. Georgie is explaining the advice work she offers, and writing down appointment times for students who want some CV help. Paul is having some kind of debate about the merits of celery. I’m glad there’s three of us on LifeZone duty, we can connect with as many people as possible that way.

There’s the bell, the atrium clears in a matter of seconds.  All we are left with is an empty tub where the cherry tomatoes once were, and a few blobs of hummous on the table.

Re-framing self-harm in Norwich

As part of the Early Action Neighbourhood Fund, Mancroft Advice Project (MAP) has started delivering training and CPD work to teachers in the three academies and schools attached to the project. The first event was for staff at City Academy Norwich, where MAP delivered Self Harm training to 20 members of the academy team. This was identified as a training need by the teachers, when MAP conducted a staff survey around emotion wellbeing and mental health late in 2015.

The course covers background information regarding self harm, signs and symptoms, why young people self harm and tools to support young people around this issue. The staff gave excellent feedback on the training, with one participant commenting “There was excellent information given, in a sensitive and engaging way. Advice was also given on supporting young people and dealing with self harm”. Another in attendance said “It was useful to reframe self harm as a normalised event, not just a reaction to a crisis event”

We asked the teachers to rate their confidence in supporting young people around self harm on a scale of 1-5. Before the training the average score was 2.3/5, however once the training finished this rose significantly to 4.1/5. The same training will also be delivered within CNS and Notre Dame within the coming months. 

UK funders come together to launch the £5.3m Early Action Neighbourhood Fund

The Fund was launched in February 2015.

Commenting, Dawn Austwick, Chief Executive of the Big Lottery Fund, said:

“This is an exciting moment, building on 12 months’ work but with aspirations to change the way early action is approached long into the future. It is also a great way of working together as funders, drawing in best practice, learning and experience from all the partners. Our collective funding can enable people in Hartlepool, Norwich and Coventry to identify and solve problems early; experiences we can all learn from.”

Commenting, Judith McNeill, Grants Director of Comic Relief, said:

“Early action makes sense. Why wait until problems are entrenched and harder to solve? By targeting funding early, we will see better outcomes for individuals, families, and communities and hopefully show that by using limited resources in a different way we can stretch them further and help more people .”

Commenting, Caroline Mason, Chief Executive of Esmée Fairbairn Foundation, said:

“Acting early to help people become more able to deal with life’s challenges is common sense, but far from common practice. Foundations like Esmée Fairbairn can do this because we can fund and think over the long-term. We hope that this fund will demonstrate the value of early action to other funders, commissioners and to the voluntary sector.”