Podcast: providing perinatal education during COVID-19 through Baby Steps

Last updated: 30 Nov 2020 Topics: Podcast Type: Podcast
Overview

How we’ve adapted our Baby Steps service during COVID-19 lockdowns and local restrictions

Our Baby Steps service – a perinatal education programme – has been designed to help prepare people for becoming new parents. Our service ensures the mental health and wellbeing of parents, healthy development of the child and that there’s a positive relationship between the child and parents.

We’ve released a new episode that focuses on how we’ve delivered our Baby Steps service with our external partners during the pandemic and what changed. If you're interested in the research we undertook to gather insights and better adapt our services for parents, listen to our bonus episode.

Giving birth during a pandemic: what parents experienced and how we’re helping

We invited one of our partner sites delivering Baby Steps to talk about their experience of providing a virtual service during the pandemic, including the challenges and benefits when working with expectant parents.

Bonus episode: what research tells us about our Baby Steps service

In this additional episode, we discuss Baby Steps with our researchers who are working on developing and improving our services. You’ll hear about the key learning we’ve taken from the research and how it’s helping to develop practice.


About the speakers

Michelle Maybury is a project manager at the NSPCC with a key responsibility for all the services currently within our Scale-Up portfolio, including Baby Steps. She has worked in a variety of roles focussed on supporting our development and delivery of services to children and families across the UK and Channel Islands.

Julia Mayes is the Baby Steps Implementation Manager at the NSPCC and has over 10 years of experience working in services for children and families. She has worked across various roles in the NSPCC’s service development and impact programme, with a particular focus on services designed to support relationships between parents and infants.

Dr Aisling McElearney is Senior Development Researcher and leads research and insights projects within the Development and Impact team at the NSPCC. Before joining the NSPCC 17 years ago, she worked as a teacher and has since then been involved in engaging the voices of children, families and professionals in developing services and evaluating the impact of services.

Meredith Russ is the Programme Lead for Baby Steps in Wiltshire. She has facilitated Baby Steps courses in the past and took on her new role this summer. Previously she has worked as a community midwife and most recently holds a safeguarding caseload.

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Related resources

> Find out how Baby Steps works and who it is for

> Get more information about delivering Baby Steps in your local area

> View the key findings from the implementation evaluation of the service

Transcript

Podcast transcript

Giving birth during a pandemic: what parents experienced and how we’re helping

Introduction:
Welcome to NSPCC Learning, a series of podcasts that cover a range of child protection issues to inform, create debate, and tell you all about the work we do to keep children safe. At the heart of every podcast is the child's voice, and how what they tell us, informs the work we do.

Ali:
Hi and welcome to the latest NSPCC Learning podcast. This is one of two podcasts focusing on how the NSPCC and our external partners have delivered services during the pandemic. The episode you're about to listen to looks at how our Baby Steps service has been run since the lockdown began in March. Baby Steps is a very established face-to-face service that's been designed to help people prepare for becoming parents, not just for the birth itself.

I had a chat with Julia Mayes, who is the NSPCC's Development and Implementation Manager for Baby Steps, and Meredith Russ, who runs the service in one of our nine external sites. We talked about how Baby Steps has been adapted and delivered since March, what's worked well and the benefits and what the challenges have been. We also speak about what lessons have been learnt along the way and how these changes have impacted both families and practitioners.

Can we talk about how we approached working with each site about adapting and adjusting the service in the early stages of lockdown?

Julia:
So when lockdown was first announced, we had no idea what the impact was going to be on Baby Steps in each of the sites. And we knew we needed to allow organisations some time to start activating their local business continuity plans. But then once we felt like people had a little bit of time to do that, we set up an initial call to bring teams together, which we sort of asked, would this be something that's useful? And everyone was really keen to find out what was going on in the other areas. So we set that up to sort of take stock of what people's plans were and identify opportunities for collaboration and support and the kind of coordinating role that we might be able to play in that.

And at the beginning, there were only a small number of sites who had made the decision to move to online delivery of the groups. And others were just sort of developing emails they were sending out to families and following those up with one-to-one phone calls. So we were wanting to try and identify what were the kinds of resources that we could develop across the whole Baby Steps community that would support people to work in these emerging ways.

The approach was really for teams to just do whatever was going to be feasible within the given constraints in their local areas and the needs of families which were varied hugely across sites. And the key thing was as best as possible to continue delivering the key messages that form the Baby Steps programme and to support parents during this really challenging time, within the ethos of Baby Steps.

Ali:
Meredith, if we can come to you from an external provider's point of view, how was it for you and your colleagues during this time? Did you feel supported by the NSPCC? How did that work?

Meredith:
Yeah, I think we really did feel supported. It was great to have that opportunity to share and collaborate with the other providers across the country. But in the early days, it was a case of running to catch up really and figuring out what we were going to do, how we were going to do it. But I think the NSPCC's coordinating role felt quite nicely 'light touch' which I think at that point we needed. We didn't need sort of very directive “you've got to do it like this” because there were all sorts of figuring out which platform to use, how we were going to condense that and do it online. So it was supportive but just to the right level really for us.

Ali:
Great. So can we talk a little bit about how Baby Steps itself as a service has been adapted? Meredith maybe we can come to you again first. What adaptations did you guys make?

Meredith:
Initially it was a case of we've still got these families that need supporting. We've got a number of groups that we'd started pre-lockdown which we were either half way through or we were in the break where they were having their babies. So we continued supporting them, particularly the families who were in the break for their babies to be born. We really were able to fill a gap there for offering them support which maternity services weren't at that point able to. We focused on that, offering the support on a one-to-one basis. Then we developed our programme and adapted it to be delivered in a shorter time because we had a kind of pause where we weren't delivering anything at all because we were trying to figure out how to do it and finding the right platforms and things. So we condensed it down to a full week of antenatal classes rather than the six which we usually have. And each session was really kind of tailored and focusing on the Baby Steps ethos particularly. We weren't able to do all of the activities we normally would, but we really focused on that supportive ethos and thinking about engaging with the babies and connecting with the babies when they were born.

And then as time went on and we learnt more and became more confident about working online, we were able to take stock of where we'd got to and think, okay well actually, we do feel more confident now. We can develop this further. We can get back to the six weeks of antenatal sessions and the three weeks of post-natal sessions and learning really collaboratively with other providers of Baby Steps across the country through the shared learning for managers and facilitators that they set up. And that meant that we could bring more of the content back into the programme. And we were able to utilise things like the YouTube channel early on. So the YouTube channel was great because it kind of gave us the 'go to' resource for videos and ways to get that content over to the families early on when we were very condensed. But as time has gone on, we've used it less because we kind of developed our own resources and own ways of sharing things remotely, so, electronic links to videos and that kind of thing.

Ali:
Great thanks Meredith. Julia, so Meredith has just mentioned the YouTube channel, could you give us an overview about what that was?

Julia:
We had some teams who just didn't have the organisational infrastructure in place to move to an online delivery of groups. They either didn't have the platforms available to use or they just didn't have the skills and experience of delivering services virtually.

In the initial phases of the adaptation, there were some teams that were just having to make use of emailing out content and following that up with phone calls. So one of the ideas that we came up with was to create a private YouTube channel, put some of the videos that we use in the Baby Steps group delivery on that channel and also create some new films that show some of the role play type activities the facilitators do in Baby Step groups. So we identified what we thought the key videos would be and shared those out across the teams. And people did the sort of selfie style homemade videos of those activities. And then we collated all of those and put these on the YouTube channel. So it just really gave something to add a bit to these emails that we were sending out to families in areas where they weren't able to deliver the groups on a virtual platform.

Ali:
Sure. Bring it to life. And was that quite well received? How did that go down?

Julia:
Yeah, I think so. As Meredith said, it was filling that gap in the initial phase. I think we’re now at this point where most teams are now delivering the programme on a virtual platform. So there's sort of less use for those kind of resources. But at that time, in a lot of areas we had nothing to go with.

The other thing we did was set up a shared resource bank as teams were rapidly developing new content to enable them to deliver Baby Steps online or through the emails they were sending out. There was lots of good material that was being developed. So we wanted somewhere that we could place that centrally so that people could make use of that, and access that and not have to reinvent the wheel. And there was some really good stuff I think that people were spurred into, for example, creating content that was translated into different languages. So I think we've got some really rich, useful resources that we'll be able to make use of going forward, even beyond this pandemic period.

Ali:
So what have been some of the benefits of moving the service to a more virtual way? What's come out of it that's been really positive?

Meredith:
Well, one of the things that we found is that we've probably been able to engage some of those really hard to reach families, which traditionally would have some barriers around transport or childcare of their other children, things that would hold them back from attending courses, even just anxiety around going into a group in a room and feeling inhibited about that. So because people can join from their kitchen, wherever they might be, even we've had families, women join from their hospital beds - so they've maybe gone in, nothing dramatic is happening but they don't want to miss the opportunity to come to the session. So they've actually joined from a sort of bay on a ward somewhere which is really great and shows how important it can be for families.

I'd say we've also noticed that real benefit in the building of relationships that we do with Baby Steps. The facilitators particularly it was evident with the families who had started the course, were on the break, they were really kind of left a bit high and dry because all home visits were stopped. I mean most areas it was really hard for families in those initial first few days after going home from hospital with their babies and people turned to the Baby Steps facilitators for breastfeeding advice. So I remember doing a few calls about how to breastfeed or they were about to have their baby and they were really worrying and panicking about it. I think the anxiety around lockdown came out in other ways related to their pregnancy. So it was great to be able to reassure people and fill some of those gaps that were inevitably there. And then as time's gone on, again, we've just been able to be that kind of nice, calm, anchor for them through the sort of storm of COVID. And I think that's really valuable.

One of the other benefits for us was the community that was really brought to the fore by the NSPCC input. We're used to meeting with other Baby Steps providers maybe once a year in London which is not easy to access for everybody. But we've met multiple times online. We've really got to know each other. We really shared a lot and collaborated and problem solved with the technology issues and how to adapt activities so that you can do them online. There's been some really great innovation that's come out of it and I'd love to keep that going if we can.

Ali:
Yeah, that sounds great. So Julia from the NSPCC's perspective, that's a really nice list of benefits Meredith has given us. So would you echo that? Is there anything else the NSPCC has thought that's really positive?

Julia:
Absolutely. We ran our first virtual community of practice event last month and we just got so many more people who are able to come along. And I just think it's accelerated people's acceptance of using these virtual platforms and that's brought us together. In addition to running these sort of biannual events, we now have monthly meetings on Zoom or Teams as well. So there's more regular real-time adaptation and sharing that can go on.

Ali:
I guess on the flip side, what have been some of the challenges over the past few months of operating in a more virtual environment?

Meredith:
Well I think connectivity is got to be top of the list really. So you know we're working from home, our home WiFi networks have never been so overloaded. Everybody down the street is all trying to work online and that can be a real challenge. And it's one thing if it's just a team meeting that you're trying to join and something crashes but when you're actually trying to deliver a course content, meet a group of other families who are all a bit anxious about joining as well and you really want it to go well. You've got a lot invested in it and it can be really stressful when it doesn't work. So I think it's the same for everybody, but it is still a challenge there.

We have had some people not being able to join us, who would benefit from the programme, because of connection issues and digital WiFi capabilities. But I would say in general, it's been a lot less than we might have anticipated so that's reassuring to know. I think most people do have some way, whether it's a smartphone or an iPad or whatever it might be, some way to connect in this way. And as the facilitators have become more confident in how to talk people through it and to begin with, they were very anxious about joining. Now that they are confident - they've done it a lot - they can really bring people with them and make them feel that it's going to be okay if they try and join with us.

Ali:
Great thanks Meredith. And Julia, I think Meredith touched on a little bit earlier on in the podcast about midwives and health visitors in the early stages of lockdown, they were redeployed. And so that obviously had an impact on families and those who just had a baby. Can we maybe touch on that as a challenge?

Julia:
So in the initial phases of the lockdown, there was lots of redeployment of midwives and health visitors. Some of the Baby Steps teams were disbanded altogether because staff were all deployed to the front line. And it also had an impact in some areas on the referrals coming into Baby Steps’ teams because many of the teams rely on maternity services to refer families into their Baby Steps service - so that sort of broke down.

Ali:
And how did that impact you Meredith as an external site delivering this? How was that an impact for you?

Meredith:
We have unfortunately seen a drop in referrals in most areas, although it isn't all areas, so it's difficult to know whether it's to do with how the changes have been managed in certain Trusts versus others, or whether it's a combination of factors. As in there are difficulties for midwives referring, but also perhaps difficulties in families buying into wanting to attend something virtually. I think that may be becoming a factor as we get that sort of Zoom fatigue of just “does it have to be online? I just want to do something face-to-face”.

Ali:
Of course.

Meredith:
A combination of things there. But I think as time has gone on and we've worked hard to explain what we're offering and how accessible it is, I think we will see those referrals coming back up again in certain areas.

Julia:
But I think in some other areas there was an increase in referrals and an increase in the needs that families were bringing. I mean, having a new baby is hard at the best of the time, but having a new baby in a pandemic where all of your usual support has fallen away is even harder. So we had some teams who were having to start to triage families into more intensive and lighter touch versions of Baby Steps or just spend a lot more time working more intensively with families.

Ali:
Are there any more challenges that we encountered?

Julia:
Yeah so I think access and digital exclusion was a big one and Baby Steps really was developed in light of this evidence that there is about those families that don't engage in traditional antenatal education and that the families who would benefit most from additional support at this time are the ones that tend to be excluded from services. And so there was just a real concern that in some areas where digital exclusion was a really big challenge, that this was just further compounding the vulnerability of these families.

Meredith:
Yes, some of the challenges we've had around delivering virtually are, it is hard to keep a group of people engaged on a screen, much more difficult than if you're meeting face-to-face. So we've really worked hard at developing new ways of working and new ways of delivering activities.

And I think also another challenge for us was the evaluation of the programme which traditionally was done with paper forms of all the questionnaires that we use and the different points. Three times throughout the programme, we would in the face-to-face world give out these paper forms and get them filled out and handed back to us personally. Obviously we weren't able to do that so we kind of scrambled to catch up and developed and brought in an electronic evaluation system which is great. I think it's a challenge but one of those benefits is that actually the innovations that we've made with technology have really made great in-roads and made things more accessible and actually provided big, positive impacts on our service. And those are things that we can keep going for the future too.

Ali:
Can we maybe touch on some of the ways in which you did work to engage the families that were more reluctant to engage remotely?

Meredith:
Yes so we have been more flexible and we've offered one-to-one support for a few families who were either reluctant to join in a group or really reluctant to have their camera turned on for example. So really, I think in a group situation, it's really important that everyone's camera is on because it's kind of fair then to all members of the group there and they will feel happy to share and take part in the session. If people are really unkeen to do that, then we have offered one-to-one. And we've also done that for those families where English isn't their first language, they might need an interpreter. That's a lot more difficult to do in a group. So we've offered more one-to-one than we otherwise would have.

Julia:
A really important part of Baby Steps is having the baby in the room and when you're delivering over a format that's just a head and shoulders and you can't see bumps and then it's much harder to see babies once babies have arrived. It's just finding ways to keep that alive throughout the delivery of the group. Facilitators reported this as a challenge.

Meredith:
One of my facilitators said that they've tried doing a sort of jokey “oh show us your bump!” so everybody stands up and shows their bump. And I think if people are willing, it's quite a fun way to do it. So we are trying these different ways to keep families engaged and feel connected and Julia's right about how we just aren't able to see people in the same way.

Another thing that has been a restriction is that usually talk and listen time which is a really crucial part of Baby Steps at the end of every session. This moment where you can really teach communication skills and develop people's active listening skills and things like that, so they do it in pairs and in a group in a room but we can't on Microsoft Teams which is the platform we're using in our area. You can't very easily put people into pairs in breakout rooms. It's supposed to be a development coming soon but that's been quite a restriction.

And I think another thing which we're missing is the video-enhanced, reflective practice, so looking at the minute body language and interaction with the baby, which we would go into a lot of detail with them at their postnatal home visit, sadly we don't really do that in the same way.

But we're developing ways that we can still give feedback. We're seeing families on screens with their babies at their postnatal home visit. And because the mother and father are able to see themselves on the screen which you don't normally do when you're just sitting in a room, we can draw their attention, “look at how you're holding your baby” or “I love the way... have you noticed how you're doing this?”, and we can draw their attention to lovely little things that they're doing which is that really strengths-based approach of promoting their self-esteem as parents. So there are ways aroundb but it's frustrating as well.

Ali:
What have we learnt over the past few months and how are we putting that into practice? Or have we put some of that already into practice?

Julia:
I think the importance of face-to-face has really come through as a strong message. And whilst there's been some real benefits from the virtual delivery and it definitely has a place going forward, I think it's really highlighted just how important face-to-face is for doing this kind of work.

Meredith:
Absolutely. It's so hard to make those connections for the participants of Baby Steps. A big part of why they're there is to build their own support network with other friends that they might make on the group, with the children's centre or other workers that they can come into contact with by going into a building. And understanding “oh these are groups and they're really friendly so actually I do feel more confident to go along to that” or whatever it might be. And we've developed ways of trying to overcome that.

So, for example, starting our WhatsApp groups for the families on a course earlier than we otherwise would have. So usually we do at the end of the antenatal sessions, now we're doing it right at the start. They're getting the opportunity to connect with each other right from the beginning. But yes as Julia says, face-to-face is so important and I think we're really plugging away at the hospital trusts and the children's centres and making sure that they know that. And that we don't want anyone thinking, “well this is a lot cheaper and easier than it was when we had to hire a room and we had to make sure that there are tea and coffee available. It's easier to do”. It is in some ways easier but we're missing a huge amount there.

And I think particularly from a safeguarding point of view, so much is missed when you can't actually see people and their body language and how they're interacting with others or not. So to get back face-to-face is just a big kind of priority for us.

Ali:
Great and what about the facilitators themselves? What have we learnt about the way that they've been delivering the programme? Can we talk a little bit about that?

Meredith:
Well I'm a lead for the facilitators in Wiltshire and I have to say hats off to them. They have adapted and developed the new content and ways of working so brilliantly. But I've really needed to support them more. So usually we wouldn't have met as a Wiltshire team all that often, maybe three or four times a year. We started doing weekly online team meetings which had really offered a place for them to just let off steam about how this doesn't work or that is annoying, also of course share resources, share ways of delivering content online which they're really developing all the time. So we're all going through this and I think it's just really important that not only are we there for the families, but we're there for each other as facilitators. They're supporting really vulnerable people going through a very challenging time but they're also struggling sometimes too, so having time and space for them has been really important.

Julia:
I just wanted to echo what Meredith's saying. It's been a real reminder about the importance of looking after our practitioners because they are the intervention. If we're not looking after the practitioners, it's really a lot to expect them to be able to look after families.

But I guess just linking back to our earlier discussion about the way that we as NSPCC can play this national coordination and support role, there's been some big learning for us about using these platforms, how we might make our community events more accessible and how we might take those forward, post-pandemic, I think is definitely something we would want to be doing.

Ali:
Julia, Meredith, thank you for joining me to talk about Baby Steps. It's been really interesting to hear how you've run it. And thank you also to the practitioners that have been facilitating this and working really hard and to the families that have taken part. It all sounds brilliant. So thank you both very much.

Julia and Meredith:
Thank you.

(Outro)

"Thank you for listening to this NSPCC Learning Podcast. If you're looking for more safeguarding and child protection training, information or resources, please visit our website for professionals at nspcc.org.uk/learning."

Transcript: bonus episode

Podcast transcript

Bonus episode: what research tells us about our Baby Steps service

Introduction:
Welcome to NSPCC Learning, a series of podcasts that cover a range of child protection issues to inform, create debate, and tell you all about the work we do to keep children safe. At the heart of every podcast is the child's voice, and how what they tell us, informs the work we do.

Ali:
Hi and welcome to the latest NSPCC Learning podcast. This is one of two podcasts focusing on how the NSPCC and our external partners have delivered services during the pandemic. The episode you're about to listen to looks at how we undertook research in order to gather insights about how our Baby Steps service has been run since the lockdown began in March. Baby Steps is a very established face-to-face service that's been designed to help prepare people for becoming parents, not just for the birth itself.

I had a chat with Aisling McElearney and Michelle Maybury, who have both been researching what we can learn from working with children and families, and developing this into a series of service delivery insights. We talked about how Aisling and Michelle undertook the research, about how our service delivery models have been adapted and how this has been received by families, practitioners, teams and delivery partners. In addition, we also discussed what we could understand and learn from this work.

Ali:
Aisling, can we come to you first and can you give an overview of the service delivery insights series?

Aisling:
Yes, Ali. Well this is something that in the Development and Impact team that we are working on at the moment. Essentially what we're trying to do is to create an ongoing flow of learning back into the service development processes, that we're always learning and feeding that back into improve our services.

And I guess as we all know, across all organisations, we collect so much data and information on our services all of the time, but sometimes we don't make effective use of that and that's what we're seeking to do. This insights series is really about looking at the data that we have available to us that we routinely collect so that we can learn and improve our services. So I guess our primary focus is feeding it back into colleagues within our team about insights for developing the services that we're working on, but also I think if there's value in sharing that more widely with other organisations to help them learn about developing and implementing services. I guess that's why we're pulling together this as a series.

Ali:
Michelle, can I come to you? This particular service delivery insight is about our Baby Steps service. Could you give us an overview about that service?

Michelle:
Certainly. Our Baby Steps service is a perinatal and antenatal education and support programme.

It focuses on the normal antenatal education programme that is offered quite widely through the UK. But there is some additional topics that we bring in, which is quite unique to Baby Steps, which includes areas around the infant-parent relationship, couple relationships, emotional wellbeing and baby's development. And these areas have been seen to have a hugely beneficial impact on the parents' relationships with their babies and reducing levels of anxiety and depression.

Ali:
Great thanks Michelle. Can you talk us through what this insights project involved? So what were you researching in relation to Baby Steps?

Aisling:
I suppose just picking up on what Michelle has said, we know that the research would tell us clearly that pregnancy is a stressful time for some parents. And between ten and twenty percent of mothers and up to ten percent of dads will experience mental health issues or challenges at this time. That has only been what we know from what's been going on around us over the last six months or eight months. That has only been exacerbated or added to by COVID, where there has been a gap in services, provided midwifery services, health visiting services, and people have been facing into birth and labour without the support of family and friends.

So we know that our service is being adapted, so for us it was really important that we try and learn from that experience as much as possible. What we wanted to do was to describe and understand the process that was followed in terms of adapting the programme during the COVID restrictions. How that came about, what were the adaptions that were made and how they worked. We wanted to identify some of the key challenges and the enablers, not just for ourselves as an organisation supporting the scale up of this programme, but also for external partner delivery sites. And we wanted to identify any key learning that we could take more widely into other services in our early years work or wider again just into service development across the NSPCC.

Ali:
Aisling and Michelle, going on from that, could you talk us through some of the barriers and challenges and issues that the research insights project threw up?

Aisling:
Some of the key challenges really were around technology, not only for organisations like ourselves and the delivery partners and having access first of all to platforms such as video-conferencing platforms where we could engage in virtual delivery. I think that took a couple of months and the research has shown that in the beginning there was almost like a scramble where people or practitioners and teams are trying to respond to meet the needs of people on the ground, but didn't have essentially the tech capability and the hardware to have them do that. So it took a process basically of learning and trying to build that capability and skills in the early days.

And also I guess, technology proved a challenge. We talk about the concepts of 'IT poverty', but for some for some parents and families having access to tablets and laptops to actually engage in an online programme is a challenge and having access to the affordability of mobile data.

What the insights has really shown is that through dedication, commitment and really being creative, that practitioners have across a range of sites, have pulled together and collaborated, produced a set of videos, where the NSPCC then led on pulling that together into a private YouTube channel so that could be accessed by all of the sites and also by the parents doing the programme.

Those challenges are really overcome by leadership and commitment and being really creative and innovative in providing some technical solutions. I think the NSPCC also led in developing SharePoint sites where different teams took the lead on developing and adapting specific resources, whether they were resources for parents whose first language wasn't English, language other than English, which could be used by other sites then in trying to engage some of those communities as well. So while the challenges were there, I think what really comes out of this piece of work is really strong collaboration and strong working together and a real strong sense of sharing resources to really help meet the needs of people at this uncertain and difficult time.

Ali:
Michelle if I can come to you? Obviously all our work is centred around the voice of the child and capturing that. This would have been incredibly difficult for this insight series for many reasons. Most of the time the children weren’t born yet and when they were, they were very young, but the added pressures of the service completely changing during lockdown. How was that for you as a team to try and capture that voice of the child?

Michelle:
I think within the scope of this work, we weren't in a place to be able to do that work. Even though it would have been ideal to have understood the real impact of the work that was undertaken. We did have some wonderful hearsay evidence from parents through our sites about the positive impact that that service had had and the fact that we'd been able to provide support in a time where they weren't getting support elsewhere was hugely beneficial to them.

At the time, most of our sites were dealing with the COVID impact which meant a number of their staff were being furloughed or redirected into frontline health care services to support the impact. And so trying to do any kind of formal evaluation process just wasn't an option for them at the time - as for us. So sadly that hasn't been able to happen but like I say, we had some really good support from the sites that the impact has been incredibly positive.

Aisling:
Just to add, we did have some exploratory calls with a couple of sites early on just to see what was possible in that regard and what learning could we capture. And it became very clear, as Michelle has suggested in terms of capacity, that it just wasn't going to be possible to engage service users directly at that time in light of all that was going on for service users themselves, but also for the sites in terms of what they could contribute to. So on the back of that, what we did decide to do was look at what data we had and try and make best an effective use of that for learning.

But going forward, if we were thinking about using a virtual or even a blended model of delivery for Baby Steps and other services, I think it would be really important that we do include the voice of the service user and what their experience has been of receiving services this way before any formal decisions are made about a programme delivery model.

Ali:
What's worked well? Out of the insights that you discovered, what were the positives?

Aisling:
Well I suppose there's three key things that have come out. First of all, we looked at a range of types of data. We looked at the minutes. There was eleven project call meetings with managers or facilitators over a five-month period. And they were all hosted and facilitated by the NSPCC Scale-up Unit. We looked at reach data that they kept to themselves in terms of how many parents were using their programme, how many included fathers and supportive carers, as well as mums. We looked at YouTube data from the YouTube channel. We looked at the data about who was using the site, how they were using it, how many videos they watched, how long those videos were watched, all of that sort of material. We also interviewed two implementation managers.

And right across all of that data when we analysed it, there's a very strong theme coming through about feeling supported and in some cases, people have talked about been inspired. So there was something there about a really strong sense of community ethos across the sites and strong leadership from the NSPCC Scale-up Unit in terms of coordinating the sharing of resources, building a real sense of shared purpose and community around delivery at that time.

Now the community of practice is something that the Scale-up Unit provides on an ongoing basis. So it was about building on that and also providing a space for practitioners who were providing a service to families in a challenging circumstance, who were working at a very fast pace to adapt and meet the needs and respond to the needs on the ground, but also themselves living through the COVID pandemic and working remotely. The community of practice was highlighted as also providing almost a safe space for them to reflect and take a bit of time to think about all that was going on and look at how they themselves were coping and able to respond. So I know that that was valued right across by practitioners.

One of the other things that has come out really has been about the reach that a virtual model can make in terms of engaging people who don't live close to a centre where a face-to-face service was offered. It's all about new geographies, new locations, but also reaching people who would have faced other barriers to being included in a face-to-face group. And there's huge potential there for reaching excluded people who have great need but are excluded for all sorts of reasons.

And I suppose the other key learning is about technology and what innovative, creative solutions we can put in place and what doors that opens for how we deliver services, but also how we learn from that. Like the example of using the analytics very simply from the YouTube channel. But what that can tell us in terms of how people are using our service and then how we can improve that service.

For example, what we noted was that most parents were watching up to two to three minutes of the videos, even though many of the videos were longer. What we noted was that the next time we're making videos, let's make sure that they're short and let's make sure that we have the key messages in the early part of the video. So simple things like that just from really what technology provides in terms of how we use data and how we learn.

Ali:
That's a really interesting point about what we've learnt and how that's going to help us shape and possibly change the Baby Steps service going forward. Michelle or Aisling, are there any more examples like that about how either this has affected practice already or how it might affect practice and how we deliver Baby Steps in the future?

Michelle:
I think there is some clear learning about how technological engagement has changed some of the ways that people have been involved with us. And I think we've seen a wider group of people potentially joining some of these sessions and engaging with services that potentially wouldn't have before, which has been hugely positive.

In reality there is a nervousness, I think, that people see the cost savings of using technology as a long term saving. And I think what's really important to highlight here is that there was a continued message that face-to-face contact can never really be replaced and building those relationships. And peer support offered through that face-to-face contact should never completely be replaced. But there's definitely a lot of learning that can be taken.

Aisling:
Yeah, I suppose one of the things that really emerged was that Baby Steps and programmes of this nature are about building relationships and relationship skills and the physical presence of either bumps or babies in a group and the importance of that and that that's missing in a virtual context. So certainly, while there are huge benefits as Michelle said and we said earlier, I mean there's also significant challenges in terms of the way the programme is delivered, the types of activities that can be approached, that can be done in a virtual context.

Certainly from the data that we've analysed, there would be a clear sense or consensus amongst practitioners on the ground that they shouldn't replace face-to-face. Maybe there's an opportunity for blending elements of it where we use technology, but that the face-to-face would be very important.

Ali:
Michelle and Aisling, could you talk us through how it's been for you guys researching all of this, especially with the limitations that the lockdown and other restrictions have bought?

Aisling:
Absolutely. I think it has been a really worthwhile process for us because we have taken some really good learning I think for how we work and potentially for how the sites themselves would work in terms of delivering the programme.

This is a relatively new way. It's great to be working in this way where we're making effective use of data that we collect. I suppose one of the key things is about recognising the limitations of what routine data can give you, what we can learn from it. First and foremost, we have to remember that it was collected for a different reason. It was collected and for monitoring who's using services or to track service delivery. But when you start to try and use it for learning, there are obvious things that are going to come up in terms of the recording and how complete that data is when you're using it for another purpose, such as research and insights and learning.

And I suppose that the other most important thing really is that we don't have the direct voice of the service user. So we don't know from the data that we have available to us, we don't know what their experience and their response has been to using the Baby Steps when it was delivered virtually.

Michelle:
I think mainly the learning for me is very much that while we've always captured information, it's been used for certain purposes as Aisling identified. And I think it's certainly made us look at how we collect data and the way we ask questions and gather that sort of information to be a bit smarter, I suppose, about how we ask the questions and gather that data to be able to use it in multiple ways and to make it a more meaningful reporting process with the ability to actually feedback to our sites themselves rather than just gathering things for our own purposes. So there's a lot of learning that has been taken from it.

Aisling:
This is a gap that we all face in our work in terms of how do we make good use of what we collect on an ongoing basis to learn. And I think there's an appetite for that. So certainly, it's good to be beginning to do this and to build our own capability around it.

Ali:
Well Aisling, Michelle, thanks very much for speaking to us today about your service delivery insights series. We'll look forward to hearing about the next one.

(Outro)

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