Sally Cowling is the Director of Research, Innovation and Advocacy for UnitingCare Children, Young People and Families. Sally was the joint leader of UnitingCare’s Newpin Social Benefit Bond project with a focus on outcomes measurement and analysis.
It’s really important to explain what the culture around measurement was for the first 12 (self-funded) years of Newpin’s existence. It was pretty ‘anti-measurement’ because of the imperative of building a strengths-based environment where families are supported to make profound changes without being judged. We have really fine and long-serving practitioners with a deep commitment to the Newpin program. Talking to families about scores and scales was the antithesis of their way of working. So one of our big fears with the focus on measurement, introduced as an essential component of the Social Benefit Bond, was about losing staff. (Social Benefit Bond is the New South Wales Government’s name for a social impact bond.). It is a credit to our staff and Newpin’s leader Liz Sanders that we didn’t lose anyone. They’re all still there.
I’m not going to pretend all the staff have fallen in love with measurement. I’m sure some preferred a world without reporting requirements, but we’ve come a long way. It’s important to reflect on the process of driving cultural change. It requires time, focus and trust.
The first thing we did in the 12 month joint development phase (of the Bond) with the NSW Government was to introduce reporting and build staff capacity to understand the reports that our management accounting team fed back to them.
The second thing related to the introduction of program eligibility criteria. It was really hard for a program like Newpin to turn anyone away because they don’t fit the criteria. So we had to reassure staff that there were other services to refer to; that the focus on families with the highest need was true to our social justice ethos, and that families could come back for support if their situation worsened.
Our eligibility criteria mean that we are now working with families with very complex needs. The fundamental tenets of Newpin are unchanged but practice innovation started flowing from the need to support and train staff to work with a higher risk group. More training on trauma. A new focus on clinical supervision.
Practice change relies on trust in the agents of change. The economist (that’s me) or the accountant in our team couldn’t have introduced these shifts. We needed the social worker who had set up the program and built the practice model to start talking to staff about measurement and why it mattered.
One of the measurement changes that met with a fair degree of scepticism and the odd sigh was the introduction of a formal assessment tool, the North Carolina Family Assessment Scale. It helped when Newpin staff knew it was used in our other Intensive Family Services programs. Practitioners communicating with other practitioners and sharing expertise was essential to create this shift in practice culture.
A big lesson from me (after more than the odd failed attempt) is that if you choose measures that are both assessment tools that can support practitioners to identify priority needs and define goals AND capture outcome changes then it CAN become part of people’s way of working. Useful measures aligned to practice are the ones that fly. Getting compliance on data collection that is less integrated into daily practice is a much harder gig.
It doesn’t matter whether the data is on paper or electronic files. If it’s not being looked at and responded to, what is the purpose of collecting it?
As we build a Performance Improvement system for a large organisation, we are conscious that it’s not the job of non-practitioners to specify what the outcomes for each program are. One of our lessons from Newpin was that if our practitioners are going to have responsibility for outcomes and their measurement, and if they’re going to collect the data, they need to see those outcomes measures as relevant. You don’t want to develop outcomes and build them into your systems and then spend your life haranguing people to collect the stuff. Our practitioners make the call on which measures. Our research team advises on valid and accessible ways to measure.
The practice innovation that happened in the first 12 months of Newpin’s operation under the Social Benefit Bond compared with what happened in the previous 12 years has been something to behold.
- We now we have mothers’ centres and fathers’ centres connected for the first time and do work with partners.
- We’re do work in school holidays with older siblings to rebuild relationships and attachment across the family.
- We do more intensive work to sustain restoration outcomes.
One change that’s staggering, more on the part of government, is to do with our Newpin Fathers’ program. This was one of our first innovations in the early years of Newpin and was driven by Dads saying ‘you’re helping my Missus why aren’t you helping me”. Most of our referrals came from GPs and lawyers where Dads wanted their children to come home from foster care or to prevent their children being removed.
As we started the Social Benefit Bond most of our referrals now came from government child protection workers and getting any referrals for the Dads’ program was tough. Child protection workers often see men at their worst. See them perpetrating violence that is as unacceptable as it is harmful. But what can get lost in this narrative is that some men are victims of DV or have grown up with violence as their only model for our families operate. Some men are willing and able to change. We kept pushing for referrals, and slowly they started. As this happened, FaCS staff could see the changes that Dads were making in their parenting abilities and the referrals began to increase. And as we were getting referrals to the Newpin Dads’ program, the Dads’ restoration outcomes soared!
When we opened our first new Newpin mothers’ centre in Wyong, FaCS asked us to run a father’s outreach program from that centre. If you’d told any of us that would happen a few years ago we wouldn’t have believed you.
Part of innovation (the key part) was building a program that worked for men and enabled children to be safely restored to their Dads. But innovation is also a process of ‘persuading by proving’ and getting government to understand how and why change is possible for men.
Developing, implementing and monitoring the Newpin Social Benefit Bond has been as complex as the practice innovation has been exciting. The question that has intrigued me was why didn’t we drive practice changes that improved outcomes when we funded the program ourselves? There was nothing that stopped us but ourselves. My own conclusion is that an explicit focus on measurement has created the environment for change.