Overview of project

Baby Steps is an evidence-based perinatal education programme targeted at vulnerable families. Developed by the NSPCC working with Warwick University, it is designed to help vulnerable parents cope with the pressures of having a new baby. A strong focus of the programme is on improving the relationship between partners and developing positive parent-infant relationships.

Baby Steps covers six themes:

  • the development of my unborn baby
  • changes for me and us
  • our/my health and wellbeing
  • giving birth and meeting our baby
  • caring for my/our baby
  • who is there for us – people and services.

The programme is delivered jointly by a health professional and a family support worker and starts at between 26 and 30 weeks of pregnancy. It includes: a home visit at the outset to explain the programme, engage the family and gather some key information; 6 antenatal group sessions; a postnatal home visit; and 3 postnatal group sessions. In Wiltshire Baby Steps is delivered in 6 children’s centre sites.

How was the need for this project identified?

Wiltshire Council’s decision to work with the NSPCC as an early adopter site and implement Baby Steps came at a time when early intervention, particularly for vulnerable families, was identified as a local priority. Early intervention was a key theme of Wiltshire’s Children and Young People’s Trust Plan. The Early Help Strategy that followed outline the vision and strategic intent to achieve this and stressed the importance of providing early years support to ensure the best outcomes for vulnerable children.  There was a lack of evidence based antenatal education locally with little focus on the wider transition to parenthood.   It was recognised that Baby Steps had the potential to contribute to the early help agenda and to other local priorities around child poverty and health inequalities.

Please give an overview of the project’s benefits, and the aspects of public health it addresses.

Baby Steps is a health improvement programme that focuses on improving the lifelong chances of vulnerable children and families through early intervention and prevention. It recognises pregnancy and infancy (the first 1001 days) as a period of rapid brain development, a time when parent-child interaction and parent-parent relationships are critically important in laying the foundations for a child’s learning, behaviour and health.

Wiltshire has a robust evaluation framework in place for Baby Steps. Referrals, engagement and attrition are closely monitored; parent feedback is sought routinely after the antenatal group sessions and at the end of the programme; and data is being gathered to measure parent-infant attachment, relationship quality and mental health. Due to the protracted nature of the programme outcome data is not yet available; there are plans to report fully in early 2017.

Parent feedback has been positive to date. Over 94% of 148 parents who have completed the end of programme survey responded agreed or strongly agreed with the following statements:

  • The course has helped me feel positive about being a parent
  • It has helped me prepare for giving birth to my baby
  • It has made me feel secure and supported
  • It has helped me feel better to prepare to look after my baby
  • It helped me feel more confident

Key findings from the NSPCC 2 year pilot of Baby Steps in various sites across the country suggested that parents will be better equipped to provide sensitive, responsive care to their babies. However, there is insufficient evidence to know if changes were a direct result of the programme.

Other positive spin-offs of Baby Steps in Wiltshire include: improved joint working between health professionals and children’s centre staff, and more parents being introduced to children’s centres earlier as all are invited to register at the initial home visit.

What was the biggest challenge faced by your project? How was this overcome?

The two biggest challenges have been:

  • ensuring a steady flow of referrals for Baby Steps in all six sites locally; and
  • maintaining staffing levels, particularly given the complexity of the local delivery model and the wide geographical area that the programme covers. Some services have also been recommissioned and transferred to new providers during this time.

The following elements of the local structure have been important in addressing these issues:

  • Programme lead role – critical to promoting the programme, managing staffing and ensuring programme continuity. Key functions include: maintaining an oversight of staffing levels, supporting and supervising staff, creating a sense of team, building good relationships with managers of facilitators and identifying back up staff where possible.
  • Local Baby Steps Project Group – important multi-agency forum to monitor progress (referrals, engagement etc.) and to maintain dialogue and engagement among key stakeholders. Recent agreement for members of the Baby Steps team to work across organisational boundaries to help with staffing gaps is evidence of improved relationships and growing commitment to the programme.
  • Contract and commissioning processes – a more formal mechanism to escalate and address concerns where required.

What advice would you give to a team managing a similar project?

Don’t underestimate the time it takes to implement a new project and achieve a steady flow of referrals, particularly when it crosses a range of organisational and professional boundaries. Utilise existing mechanisms and forums from the outset to engage stakeholders in the process, to raise the profile of the programme and to encourage buy in – from senior management through to frontline practitioners.

Identify a dedicated lead role to maintain day to day management and oversight of the programme.

Spend time developing a robust evaluation framework and effective data collection mechanisms at the outset considering both short and long-term outcomes.

What’s next for this project?

To complete a full evaluation of the programme in early 2017 to inform future developments.

Have you had any feedback (e.g. from colleagues, third-sector partners, members of the public)?

Feedback from participants has been overwhelmingly positive as mentioned above. Anecdotally children’s centre colleagues have noticed positive changes among families who have attended. We aim to gather wider feedback from colleagues to feed into the evaluation report.

Which aspect of this project makes you most proud?

The robust evaluation framework – a mix of qualitative and quantitative measures – that will enable us to make informed decisions about the future of the programme.

How can your public health colleagues get more information about this project?

Go to NSPCC website for information on the programme content and see evaluation reports from the 2 year pilot.

Contact Sally Johnson for more information on implementing and commissioning Baby Steps in Wiltshire.

Is there anything else about this project you would like to share with your colleagues across AGW?

Happy to share an information sharing and storage agreement that was developed and recently signed off by all local partners after many months of debate.