The need for evidence-informed services and practice has never been greater. Public services are facing unprecedented challenges; now more than ever we need to use public resources on the things that are more likely to work.
One implication of this, preoccupying both our organisations (the Early Intervention Foundation and Research in Practice) is that evidence-informed practice needs to be a core business for the children and early help sector. The development and use of evidence must not be the preserve of academics or research institutions, and this demands that we think differently about it.
Naturally, RiP and EIF are both committed to robust evidence; EIF and other centres have developed standards that provide information about the reliability of different types of evidence. The relevance of evidence matters too: it needs to be fit for purpose as well as scientifically robust. Randomised controlled trials (RCTs) are excellent at determining the impact of an intervention. But the questions that practitioners ask, particularly in relation to early help, are often not about impact. Instead, they ask: how do you get the right intervention to the right person at the right time? How do you assess need or risk? Some questions are better asked – and answered – in other ways. It is not all about RCTs.
Nor is it only about manualised programmes – interventions delivered according to prescribed steps, with clear guidance that practitioners must follow. These are an important part of the jigsaw, and the EIF has a guidebook on the strength of evidence for many early intervention programmes. But as the local areas we work with often testify, programmes are only a part of early intervention.
The standards for using evidence to inform wider practice questions that do not relate to impact are less well established. If we are asking questions that are not about whether something works, but about how it works, how best to do something or what children feel about support they receive, there aren’t clear standards of evidence we can use to answer them. Vital support is provided day in, day out by children centre workers, health visitors, early help teams, family and parenting workers and a whole host of other professionals and volunteers. We need to develop a body of accessible evidence to inform their work and provide better support for them to access and apply the evidence that exists.
So how do you define and apply rigorous evidenced approaches in response to questions in children’s services that are not about impact? And how do you help practitioners use evidence confidently, and see it not as a straitjacket – a set of rules that must always be followed allowing no room for professional judgment or the child’s perspective – but as scaffolding for their practice? This requires us to be creative and combine multiple types of evidence, recognising that various sources of knowledge need to be used to answer different questions.
RiP uses the concept of evidence-informed practice – a combination of evidence from professional researchers, the experience of service users and practitioner wisdom. Other types of evidence may be relevant too. While single sources of information by themselves can be misleading, scaffolding knowledge by bringing together multiple sources of information can help distinguish myths, ideologies and preferences from things that have some basis in evidence. For example, baby massage is practised widely and is well-liked by practitioners and parents, but there is little convincing evidence that it improves outcomes for children.
This approach is also about supporting practitioners and commissioners to become more confident in using evidence. We need to develop a sector in which practitioners are research literate, critically curious, hungry for knowledge and supported to produce new evidence themselves. This requires organisational leadership, role modelling from management, support for practitioners to engage with evidence as part of the day job, and for their knowledge – and that of families – to be respected. Evidence really is everybody’s business.
Dez Holmes is the director of Research in Practice and Research in Practice for Adults. Donna Molloy is the director of implementation at the Early Intervention Foundation
