Archive for January, 2014

January 30, 2014

Scaling Good Ideas – The Family Nurse Partnership and Domestic Abuse

Following the research from the Early Intervention Foundation yesterday, with its recommendations regarding the Family Nurse Partnership as a means of intervening early in domestic abuse, I then received a blogpost from the wonderful Bridgespan series.  (http://www.bridgespan.org/Blogs/Transformative-Scale-Pathways-to-Greater-Impact/January-2014/Scale-That-Transforms-Society.aspx#.Uuq8sXmuL-A from @jeffbradach ) It highlights that even the FNP (or NFP as they call it in the US just so I can never remember which way around it is….) which is about the best evaluated model out there, only is available to 2% – yes 2% of people who are eligible for it.  They write:

“The Nurse-Family Partnership (NFP), launched in Denver in 1970, currently serves 26,000 low-income, first-time mothers in 43 states by partnering them with a registered nurse who provides ongoing home visits from pregnancy through the child’s second birthday. The program has been shown to dramatically improve life outcomes for both the mother and child, and provides $5.70 in benefits to society for every dollar spent. Yet, even after successfully securing in 2010 a $1.5 billion federal funding stream that supports this type of work, NFP reaches less than 2 percent of the total number of mothers that qualify for its services, and all home visitation programs (which are of mixed quality) reach less than one in five of those that might benefit.”

How is that possible?

How much more evidence does one need?

January 29, 2014

The Early Intervention Foundation Review – Our First Thoughts – and a chance to discuss with the authors at our conference

The Early Intervention Foundation published its Domestic Violence and Abuse Review today with a number of interesting recommendations and some pretty strongly worded views – all based on really thorough research.  Early Intervention is such a crucial topic in our field and so we welcome their work very warmly.  It also referenced our Children’s Insights service which is gathering terrific data on the experience of domestic abuse for children (including a lot of direct feedback from children themselves) and the impact of the Children’s IDVA on their safety and well being.  

Anyway, there will be lots more information about the findings from Children’s Insights at our conference on the 26th February and the EIF are kindly leading a workshop to explore their findings in more detail.  (For more info about our conference go to http://www.caada.org.uk/events )

Thought 1: Thank you for being so blunt.  

In the opening section of the Recommendations (p 91), the authors write about domestic violence and abuse in the following terms: “Its scale is such that it is vital that concerted action is taken across a very wide range of agencies at national and local levels.” We can only agree.

Thought 2: Yes! Please do proper evaluation of new approaches.  

There is a clear call for new approaches to have robust evaluation whether this be in relation to perpetrator work, or the revised Family Nurse Partnership with the IPV (inter-personal violence) intervention. We are really interested in both – but especially drawn to the FNP + IPV (apart from the prospect of another acronym…) with the potential to work with both young parents and their child.  Having spent this morning looking at cases of domestic abuse involving teenagers aged 16 and 17, these sorts of interventions can’t come soon enough.

Thought 3: We welcome the challenge of working with the whole family.  

The report focuses on the need to include an awareness of DV within all support for families, couples and relationships.  As a sector, we often side-step the need to work with the whole family – leaving women and their children with little support if they decide to stay in a relationship.  If we can’t make this work – whether at an early intervention stage – or later on in an abusive relationship – we will be failing many women, men and children.  

Thought 4: The voluntary sector and grant making foundations have an important role to play.  

The report understandably focuses on the role of Government in leading change.  We would also highlight the potential for the charities in the field – both operational and funders – to do the same.  We are close to the experience of victims and children and perpetrators of domestic abuse and should use this to build on the evidence provided in the EIF report to lead the improvement in services.

Thought 5: We can overcome the barriers to professional confidence to act among Early Intervention practitioners.

I was very struck recently at a meeting where an Early Intervention practitioner stated: “we have the best training, and best procedures but no one has the confidence to act.”  The report confirms this, citing Brandon’s research on the implementation of the Common Assessment Framework and other interviews.  We firmly believe that training helps, procedures help but without a named and known person who you can refer on to, referrals won’t happen. Hence our focus on co-location of IDVAs in maternity and A&E wards, and now I hear in one or two places linked to schools.  This clear ‘care pathway’ is the difference between a sound response in theory and a sound response in practice.