We know that parenting programmes can make a real difference in improving children’s lives and futures. There’s a strong, established track record and an ever-growing evidence base about what works.

Programmes such as Empowering Parents, Empowering Communities (EPEC), Triple P and Family Foundations have proven positive impacts on children’s social and emotional development, while programmes like Incredible Years Preschool, Family Nurse Partnership and Preparing for Life have demonstrated positive effects on children’s early language skills and literacy.

But despite this knowledge, there is still huge inconsistency about what’s on offer to parents around the UK.

When we previously spoke to 27 local authorities, we found over 60 different parenting programmes on offer and between one to eight different programmes being delivered in each local area.

This patchwork approach, with considerable diversity in what is being offered, means that some of the most effective interventions are not being rolled out nationally, and parents across the country are missing out on vital help that could make them feel more supported and confident in their parenting and improve their children’s life chances.

Though there are some high-profile examples of widely adopted programmes - such as Triple P and EPEC - most parenting interventions will never reach anything like their level of scale, in no small part due to a crowded and fragmented market place where the most high-quality interventions can struggle to communicate their comparative benefits.

To find out why some parenting interventions successfully achieve implementation at a large scale and others don’t, Nesta and the Behavioural Insights Team (BIT) interviewed parenting programme developers, local authority commissioners, academics and policy experts.

These conversations taught us valuable lessons about the enablers and barriers to establishing parenting interventions at a national scale.

Here are seven areas where national early-years policymakers, funders and programme developers can work together to take action to help spread effective parenting interventions.

Where interventions such as Family Nurse Partnership, Triple P or Video Interaction Guidance have achieved widespread delivery, it’s often because there has been national government investment to support coordinated training and delivery at a national scale.

This has happened previously through the National Academy of Parenting Practitioners, Sure Start and, more recently, Family Hubs and Start for Life funding.

Without this centralised coordination, it is very difficult for individual intervention providers to get established in a fragmented market, especially if they are a small organisation or academic team with limited capacity for marketing.

Intervention developers told us that it’s a long and challenging process to attract the investment needed to reach scale.

While academic teams can obtain funding for initial development work and small-scale trials to establish impact, they find it difficult to attract follow-on funding.

Further investment is often required to iterate and refine the intervention, understand how to successfully implement it and then develop the infrastructure needed to maintain quality whilst delivering in a large number of locations.

Though we increasingly know what types of interventions work (thanks to the Early Intervention Foundation Guidebook) we still don’t know enough about how to use this evidence to build sustainable services that deliver positive outcomes over time.

Ultimately, there is a lack of knowledge about how to effectively implement interventions at scale. We need more investment in research about how the actual process of scaling up itself.

At present, intervention developers trying to break into the UK are faced with a highly fragmented market with a bewildering number of potential customers - there are over 200 local authorities commissioning early-years services across the UK, as well as NHS trusts and others. Each of these customers has different requirements, processes and funding constraints.

From the commissioners’ side it’s an equally complex picture. In any geographical area there will be considerations of population need, workforce and cost to factor into deciding which parenting interventions might be the best fit.

Commissioners are also faced with a confusing array of choice. In the Early Intervention Foundation Guidebook, there are 76 different interventions available for parents of children aged four and under, each targeting different groups of parents, different child outcomes and with varying requirements and levels of supporting evidence. This makes it a complex task for commissioners deciding how to focus the limited resources they have available.

With so many stakeholders involved in this picture at a local and a national level we need a better mechanism for focusing on parenting interventions that have a proven track record of improving child outcomes.

Local commissioners need more support with interpreting the evidence base and understanding how to apply it to their context, their population of families and the outcomes they are seeking to achieve.

While there is a growing number of interventions that have been found effective in small-scale trials, both in the UK and internationally, many of these interventions would be difficult to put into practice in this country unless additional ringfenced funding is provided by national government.

For example, parenting interventions that require a highly-qualified workforce (eg, teachers, clinical psychologists, midwives) are currently very challenging to implement in local early years systems where these professionals are expensive to employ and in very short supply.

Some of the interventions that have scaled more successfully in the UK are those that can be delivered by practitioners from a much broader range of professional backgrounds (eg, parenting practitioners, family support workers, early education practitioners). In the case of EPEC, parents are also trained to be parent-group facilitators, which helps support parent engagement if facilitators share common backgrounds and experiences with them.

Developers of parenting interventions need to consider the delivery context where they will be operating very carefully and design their interventions to be as cost-effective as possible.

It is important to local commissioners of services and the facilitators who deliver them that they’re able to tailor the delivery of parenting interventions to the needs and interests of the parents they’re trying to support. If parenting interventions are too rigid and don’t allow for this tailoring, then it will be hard to recruit and retain parents, and sustain delivery over time.

Our interviews taught us that modular interventions can help increase local ownership, giving service providers the opportunity to select the most relevant components for the parents they’re supporting.

It’s also really helpful if facilitators are supported and encouraged to tailor activities for the parents they are working with, so that they can make them as relevant as possible, without compromising the fidelity of the intervention.

Programme developers talked about how scaling up a parenting intervention, even from small-scale implementation (eg, in 4-5 locations) to medium-scale implementation (eg, 15-20 locations), requires a delivery infrastructure that is up to this task. Small academic teams and start-ups can struggle to make this transition without adequate support and funding.

One of the key conditions of success to make this transition is the existence of a central unit to drive wider scale adoption and support high-quality implementation. These central units can take many forms; they may be located in a central government department, an NHS trust, a university, a voluntary sector organisation or a company.

The central unit will be responsible for driving the adoption of the parenting intervention (including establishing local partnerships and providing training and delivery manuals) as well as providing infrastructure to support and monitor the quality of delivery and evaluate impact.

Without the existence of a sustainably-funded central unit in some form to support implementation in multiple locations, scale up is likely to be slow and challenging.

We learned that parents themselves are an overlooked and undervalued component of scaling strategies. Parents themselves are active agents in deciding whether it is worth their time to engage with parenting interventions and this can be a key factor in deciding whether an intervention will succeed. If parents are not considered sufficiently then the result may be low engagement, causing local implementation to fail.

One of the most important ingredients for success includes involving parents in designing and planning parenting support from the outset, so that central teams and local implementers can work together to carefully consider parents’ needs and preferences.

We have a growing evidence base about ‘what works’ in the UK - both to achieve impact for families in the early years and to enable successful implementation.

In order to drive up the delivery of effective parenting support in the UK, this will require more collaboration between research funders, policymakers, funders, local commissioners, delivery organisations and intervention developers.

Some important key elements of this include:

1. ensuring that national government funding for parenting support incentivises the adoption of evidence-based interventions with a proven track record
2. giving local commissioners more support to interpret this evidence base and apply it to their context; Foundations’ Changemakers programme is a great example of work to help local authorities drive implementation of evidence-based interventions
3. better coordination between funding bodies to help tackle barriers for parenting intervention developers so that they can grow their evidence base. As well as knowing which interventions work, we need to know how to scale and sustain them and engage parents effectively in different delivery contexts
4. more sustainable funding for the central teams who are needed to develop and scale effective parenting interventions. This will enable them to develop the infrastructure needed to support high quality delivery in multiple locations simultaneously.

At Nesta’s fairer start mission we want to work with the many influential stakeholders in the early-years sector to help overcome the barriers highlighted in this blog and drive up the delivery of effective parenting interventions at scale. We hope that this new report will be a contribution toward building this collaborative community.

We are also planning a stakeholder event in the autumn to discuss how we can work together as a sector to support wider delivery of effective parenting programmes. If you would be interested in attending, please get in touch.