Listening hard for ourNCTservices

People involved = >220

Number of small group and one-to-ones discussions = 70

Regions of the UK = 12

Sheer volume of learning = awesome

Wow, February and March proved to be a very busy time for the ourNCTservices team. Caroline, Annie and I have been travelling the length and breadth of the UK to meet with more than 200 practitioners, alongside discussions with volunteer coordinators and PSAs. What have we been doing? Listening; listening hard.

Building on #ourNCTstory so far, the ourNCTservices project asks how, over the decade ahead, do we ensure our services are as accessible and impactful for parents as possible. What should we just keep doing the way we currently do? What should we adapt? Is there anything we should stop doing? And what should we consider starting to do?

Learning from your practical expertise and experience of delivering services for parents is absolutely key, alongside listening to parents directly. And so we’ve hosted a series of structured small group and one-to-one discussions, in person or by phone, speaking in depth with over 220 individuals – many of whom you can spot in this montage of photos from our travels!

It has been a truly brilliant experience and we have gained so much from the discussions – what you think are the most important times and ways in which we can support parents, what the barriers are to this locally for you, when and how we should be providing and promoting services, where you think we need to make improvements, and your ideas for better ways of working. Whilst not a quantitative exercise, speaking to so many of you means that we have been able to capture the strength and consistency of feeling to a certain extent, as well as the views expressed.

This beautifully complements the in-depth research we have been doing with parents across the UK, including those who have accessed NCT support and those who haven’t. I’d like to thank everyone involved for your commitment, honesty, enthusiasm and healthy dose of challenge. It’s really going to help us make much better decisions if we continue to work together on this.

It hasn’t all felt easy of course; it was never going to. There are understandably deep-seated frustrations about some of our current ways of working or the pace of change. There is some suspicion that we might already have the answers up our sleeve (we haven’t by the way – this whole exercise is nothing, if not open to listening, learning and analysis, ahead of any decision making). There is both desperation for change and weariness of change – sometimes expressed by the same person in the same conversation. But there remains remarkable consistency in what we’re all here to do (all parents, first one thousand days), and enthusiasm for working together more effectively as an organisation and across specialisms.

What are the next steps? We’re heading into a very busy period of analysis through late April and May, pulling together the evidence from across the workstreams – what we’ve heard from parents, what you’ve told us, what we’ve found from NCT data (e.g. impact, feedback, cost) and what we know from external evidence. We’ll then be sharing initial findings with you all at the #ourNCTstory workshops in June – dates will be shared very soon.

Thank you again to everybody who has contributed and everyone who continues to welcome us along to observe your services. Mother and Baby Yoga (with a willing doll) on a Friday morning was the perfect antidote to a week on the rail network – I may be back very soon!

If you haven’t registered already to be kept up to date with the project via email updates from the ourNCTservices team, please do so here. And we look forward to seeing you lots of you at the next stage!

You can read more about the background to the project in our first blog hereAnd you can catch up on Annie, Nick and Juliet’s reflections from partway through our discussions with parents and practitioners.

A little less conversation, a little more action?

Back in the heady days when Dad-dancing was still happily for other people (my Dad, for example), popular-beat-combo JXL, you may remember, remastered the old Presley classic, A Little Less Conversation, A Little More Action. Mingling floor-filling big beats with deeper tones from Memphis, ‘JXL vs Elvis’ pepped-up the summer of 2002. And though clearly not a song written about early parenting, I’ve found myself wondering this week whether its central injunction is really right? And if it’s not, what that’s got to do with NCT?

We’re in the middle of hundreds of conversations ourselves just now with parents, practitioners and volunteers about the future of ourNCTservices – itself a central chapter in #ourNCTstory. How, in the decade ahead, do we make sure that what we deliver for and with parents stays relevant, accessible and impactful?

We are still very much at the investigation stage and will be sharing emerging findings in the now-annual summer roadshows. In the meantime, I’ve personally really enjoyed and taken much from four events I’ve been part of in Belfast, Birmingham, London and Manchester, including some specific conversations with practitioners on how we can encourage more parents to take up our Early Days courses. Early Days evaluates consistently well. Selling it is persistently hard.

A number of themes have surfaced as we explore with parents and practitioners why this is and I won’t attempt to summarise here. Yet one that keeps coming up is that parents will spend on their babies sooner than themselves. I get this. We all do. But it’s a problem, right? Because we also know how hard these early days are. How bewildering, isolating, daunting, doubtful. And we know from our insight work how parents so often feel they are uniquely failing. This in itself points to the importance of making space to talk. So does wider evidence.

Catching up on reading as trains wind slowly through the snow and its remnants, the ever-green International Journal of Birth and Parent Education (a brilliant publication edited by our own Mary Nolan and Shona Gore) draws me to Sutton Trust research on parenting and attachment and a meta-analysis exploring the link between parenting style and cognitive and emotional development. The links are well-known of course. Though one specific finding particularly struck home – that children with more stimulating home environments but less secure attachment have lower language competence aged two than those in less educationally stimulating home environments with more secure attachments. In other words, in nurturing vs. activity, nurturing wins.

We know this already of course. Not least because facilitation, conversation, connectedness are our thing. And spending a lot of time with practitioners in the past ten days reminds me of this powerfully. Of course baby activities, done well, can be very much about developing a nurturing relationship – eye contact, responsiveness, touch, singing, knowing how to play. And in the sidelines, quiet conversations take place which are about mum. They also play into the ‘low pressure to socialise’ theme. So the route to developing nurturing environments might be via activities which are (seemingly) focused on baby.

All further evidence that ‘spending on my baby, or spending on me’ shouldn’t be a zero-sum. Finding space to talk and be, matters more than filling early days with stuff. A little more conversation, a little less action. It’s best sung loud.

Really listening to parents

Why don’t I listen more? This question was ringing in my ears all the way home from Exeter last week, having spent four hours doing nothing but listen to new parents.  As part of ourNCTservices NCT is hosting a series of ways to hear what today’s parents have to say, so that we can best understand what they want and need, as we consider the future of our services. I saw ten parents in two focus groups – the group in the morning were parents like those we traditionally work with and the group in the afternoon was made up of those parents we don’t currently reach.

It’s no surprise that the word listen contains the same letters as the word silent. If you know me, you will recognise that it’s rare for me not to have an opinion, for me not to comment, for me not to try and have the last word. So, to sit and truly listen to parents – to not intervene, lead, probe or ask, but to have the gift of time to absorb and reflect on their discussion – was both refreshing and revealing. I learnt so much more than talking.

Much of what I heard that day resonated with what we are learning elsewhere in the project – through listening to practitioners and volunteers, observing classes and courses as well as looking at the feedback from parents who use our services. I heard the depth of the value new mothers gave to new friendships that many had gained from our work, but also the concern and worry when those networks and friendships don’t emerge – feelings of isolation and isolation. I heard how trawling through Google is a near universal habit for new parents, even when they can’t find what they are looking for. I heard about the utter confusion and overwhelming anxiety that can result from well meaning advice from friends and family that wouldn’t pass our test for evidence-based information.

When asked to reflect on what they wished they knew before the baby was born I was surprised not to hear about practical baby care, but about mental health. The mothers in Exeter reflected on how unprepared they were for this experience, either when their own mental health was put under pressure, or the health of their partner or friends. I heard the pain of difficulties accessing basic support and the guilt felt by many parents when they felt they weren’t able to do the best for their baby. I heard how the women felt about changes in their partner and in their relationship. The prominence of sleep issues surprised me as did the low priority these parents gave to self care in the early days.

Hearing and truly listening to the highs and lows of parents – both those we currently serve and those we want to reach out to – was a privilege. There truly is so much to learn. I need to listen more often.

ourNCTservices is now in full flow

For a reminder about the project see Sarah’s blog here.

Annie Raff, Parent Insight Manager
Annie Raff, Parent Insight Manager

In the past eight weeks we’ve heard from 48 parents, over 50 practitioners and more than 20 volunteers, all about their experiences of becoming or supporting new parents. All of this, alongside analysis of our evaluation and operational data, will help us understand how best we can reach more parents and deliver the best support for all across the first 1,000 days.

 

Parents

During this time, I’ve been travelling around the UK, from Pudsey to Peckham, with researchers from Good Innovation, visiting new and expectant first-time parents in their homes. I’ve got to know Birmingham and Leeds train stations very well, particularly the Pret a Mangers! We’ll also be in Belfast, Exeter, Glasgow and Cardiff hearing from parents over the next month.

The purpose of the interviews is to uncover deep behavioural insight – to get under the skin of why people act and feel the way they do. Unsurprisingly, interviews with new and expectant parents elicit a lot of raw emotion; some have struggled to conceive and talked us through their IVF journey, others have had traumatic births, and many are still navigating the minefield of sleep deprivation and a new baby.

Key themes have started to emerge from these interviews and some of these are below. Many of them mirror what we have heard from practitioners and volunteers who are supporting parents all the time, and we’ve also gained lots of new insights into the experiences and support needs of expectant and new parents through this process.

People rarely have the time/opportunity to reflect on their journey to parenthood

One of the exercises we get parents to do as homework before we meet them is a ‘journey map’; we ask them to map out their journey to parenthood so far – the highs and lows, where they have got support and information along the way. Almost all of the parents we spoke to, especially those in the throes of early parenthood, told us that doing this exercise was actually one of the first times they had reflected on becoming a parent since they had had their baby. For many, it felt quite a therapeutic process. It really brought the reality of their experiences to life and helped us understand the real pressure points and opportunities for support.

The highs and lows are different for mums and partners

Another interesting aspect of this was the variation between mothers’ and partners’ journeys. For one expectant father, finding out his partner was pregnant was a high. She counted it as a low though, because of all the decisions it meant she had to make about her career. She said she felt guilty for not being happy when she found out. Guilt around not being the perfect mother was another theme that came up again and again.

Mind the postnatal gap

We know from other research and anecdotally that the early days with a new baby can be the most difficult period. But the strength of emotion when people spoke about the early days really brought home the depth of it too. Parents told us that they felt ‘dropped’ by services, sometimes even by NCT which had provided such a solid source of support but didn’t feel relevant once they had had their baby. Other parents who had to stay in hospital due to complications with the birth said that had they not had that time to learn about how to feed and change their baby, they don’t know what they would have done.

Parents as partners

Mums and partners are very much in it together, and it has been great to dig into their respective roles and support needs as they welcome a new baby to the family. Many couples talked about both their efforts to adopt more healthy lifestyles since finding out they will become parents.

Practitioners and volunteers

We had a great response to our call for interest in the project with over 200 people signing up. If you want to there’s still time to sign up and get involved with ourNCTservices – just email Caroline Star.

As well as getting out and about to observe services, we have various workshops and calls coming up – check out Babble for more info.

We will also be talking about the project and hearing from you at the upcoming Regional Practitioner Forums in Edinburgh, London and Manchester – see you there!

And if you can’t make any of these times, feel free to email me, Caroline, Sarah to continue the discussions.

ourNCTservices – Caroline’s story

Caroline Star, Portfolio Manager for ourNCTservices

I started working at NCT in November 2017 to lead the ourNCTservices project, back when my NCT story was only just starting. Yes, I confess that I was one of those people who didn’t book an NCT antenatal course because I just didn’t think I was the NCT type. An assumption that has turned out to be quite unfounded given how much I’ve loved my first few months working here. I also thought it was going to be a big enough challenge to get my husband to sit through an NHS antenatal class let alone several weeks of group exercises. He has recently informed me that he would have loved a properly evidence-based course, so it turns out I’ve been wrong on many fronts!

Caroline Star's daughterThe tragedy in my case was that this wasn’t just a missed revenue generation opportunity for NCT, it could have made the world of difference to my eldest daughter’s very difficult start in life. Parisa (who is now aged 8 ) was diagnosed profoundly deaf when she was just a few weeks old. I’d survived the slightly traumatic birth but I didn’t have the networks or the knowledge to help me cope in the first few months and I struggled immensely. I did look into doing an early days course on a friend’s recommendation but there wasn’t one starting near me so I forgot about it and soldiered on.

So what does #myNCTstory have to do with the ourNCTservices project? We have just finished getting to the next level of detail on what the project will focus on in the first year. We have said that it is about strengthening core services first, then expanding reach and increasing the scope of postnatal services. But what will this look like in practice?

Initially, we are going to focus on increasing the benefit of NCT core services to three groups:

  1. Parents who already engage with our services: we need to ensure that our services are future-proofed and that we are not missing opportunities to signpost these families on to other NCT services.
  2. Parents like me who fit NCT’s core demographic but who haven’t engaged: we need to understand why and what it would take to change their behaviour.  There is a huge opportunity here to increase the number of people who benefit from existing services and to generate more income to invest in expanding reach and scope in future.
  3. Parents who fall within a ‘stretch’ demographic: they might have a slightly lower family income, work in an administrative rather than a managerial role or have left education before your ‘typical’ NCT antenatal parent – we’re talking the middle income families rather than refugees and the socially excluded. We need to understand what it would take to adapt core services to meet the needs of these families and what they are prepared to pay for.

This initial focus will put us in a great position to increase reach and expand scope in future.

We have already finished our first wave of new insight research with parents specifically recruited from these three groups. The next phase kicking off in mid February will see the researchers moving on to Wales, Scotland, Northern Ireland and the South West. The final phase in Yorkshire, Birmingham and London will be completed by mid April. We expect this research to give us a deeper insight into what it might take to get more people from each group to engage with more NCT services.

More than 200 practitioners, volunteers and staff have signed up to get involved in the project, so thank you all for your enthusiasm. We will shortly be sharing details of regional visits where myself, Annie Raff and Sarah McMullen will be observing services and hearing about the successes and challenges of service delivery first hand. There will be lots of opportunities to engage over the next year whether face-to-face or online and it’s not too late to sign up.

More information and regular updates about the ourNCTservices project can be found our Babble page.

The ourNCTservices team – Annie Raff, Sarah McMullen and Caroline Star

ourNCTservices – a time for insight and review

The ourNCTservices team – Annie Raff, Sarah McMullen and Caroline Star

Autumn has been a busy time for the newly formed ourNCTservices team,  as we get underway with our review of NCT’s portfolio of services. This is a project close to my heart, as it aims to drive the very changes which brought me to NCT in the first place.  I feel so lucky to have a job which offers such opportunity to improve experiences and outcomes for new parents and their babies. Being part of such a critical project for strengthening and increasing the reach of our support is really exciting.

At NCT, we’re no stranger to a big vision and real ambition in what we aim to achieve – that all parents should be supported to have the best possible experience of pregnancy, birth and early parenthood. And what a difference this would make for the emotional and physical wellbeing of babies and families too.

But a big vision and real ambition is no more than a pipe dream, without the right people, plans and a good dose of passion behind them. We know we have the people and passion – in droves! – and we’ve been focusing hard on the plans. 

ourNCTservices aims to explore what our services for parents should look like in the future and identify how we’re going to get there. What should we continue doing, adapt or stop doing? And what new things should we consider doing?

We are focusing first on strengthening our core services, across antenatal, infant feeding and postnatal. Alongside this we need to lay the foundations to increase our reach to support more parents from less affluent communities and at greater risk of isolation, and to expand our support postnatally.

Why is it so important that we review our services?

We know that the way in which parents access information and forge new networks has changed hugely in the past ten years. And that the world in which we deliver services continues to change rapidly – in terms of parents’ expectations, the context in which they are having babies and the other support on offer.

We also know that many more people could benefit from NCT than do so at present, and that we can do more to support parents postnatally.

So we are taking an honest, complete and creative look at what we deliver, how and to whom. This is to ensure that in ten years’ time NCT’s services are readily accessible and relevant to new and expectant parents. And that these services help them have the best possible experience of pregnancy, birth and early parenthood.

Where will we start?

We will start with parents – our beneficiaries – firmly grounded in their experiences and behaviours, and their wants and needs. If we are to achieve the greatest possible impact for parents, then we need to be truly parent-centred in the way we develop and deliver our services.

We will be mining the brilliant data we already have from our extensive evaluation of our services, including the wealth of qualitative feedback. We will be looking at wider research to understand trends, challenges and opportunities. We will also be working with the brilliant Good Innovation to conduct new research with parents, using creative techniques to understand experiences, behaviours and attitudes.

At the same time, we’ll be mapping our existing service portfolio. Taking an aerial view of the range of services we deliver. This will include reviewing the service and funding models, the benefits and value to parents, and what their potential for expansion or adaptation might be. We’ll also be considering their fit with each other and with NCT’s mission, and our capability and capacity to deliver at scale.

Working with you

We can of course only get this right by working with the practitioners, tutors, volunteers and staff who support families every day.  A huge amount of knowledge, expertise and experience exists across our amazing network. We want to hear your views and test emerging findings with you.

There’ll be lots of ways to get involved as the project progresses. The project team – myself, Caroline Star and Annie Raff will be spending lots of our time on listening and learning. As a first step, we’d love to hear how you’d like to get involved and you can also contribute to our evidence gathering stage. Perhaps you have a particular way of working locally that you think we could learn from? Or have data or ideas to share with us?

This is a really exciting project looking at the future of the charity we love so much and how we achieve the greatest impact for parents. Get involved by signing up here!