• By Cheryl Hopkins
  • Posted on Friday 09th April, 2010

Its Birmingham, UK - not Birmingham Alabama or Michigan

One needs only to compare the number of US-originated programmes substantiated by a robust evidence-base compared to the number of home-grown (or even European) counterparts. The scientists are sold on the idea. Programme developers, researchers, practitioners and policy makers are highly cognizant of the need for fidelity. The legislation supporting and funding the development of evidence-based programmes is steaming ahead under the Obama administration. Yet whilst the UK may lag behind in the science and development of evidence-based programmes our children’s services system is perhaps better placed to embrace and embed these programmes within systems - a critical distinction highlighted by the ‘pioneers of prevention’ opening the conference yesterday morning. We are not there yet - but we are on the way.So what makes the UK context different? I think it comes down to three things. First, unlike the US the UK has a national children’s strategy grounded in legislation. Birmingham, as a local authority, is required to demonstrate to central Government improvements in children’s health and development outcomes. We are accountable. As the ‘pioneers’ pointed out this morning, this is something currently lacking in the US. Second, our systems are organised differently. We have a truly universal healthcare system (something the US is getting closer to but is still a long way off). A substantive difference again comes down to accountability - and not just for service indicators of efficiency - but for demonstrable improvements in children’s health and development outcomes. Each local authority has a Director of Children’s Services responsible for all agencies responsible for children’s health and development. We also have something called ‘Children’s Trusts’ which further increase the likelihood (in fact require) that agencies talk together and work with common and mutually beneficial strategies in mind that are specific to the local context. Third, and critically, funding streams operate differently. My main disconnect with what I’ve heard at the conference so far is that the majority of funding for evidence-based programmes is too often short-term and external to mainstream funding streams. Those more permanent funding streams appear to be a constant tug-of-war between Federal and State dollars. In contrast, within Birmingham we have secured an investment of £42million (about $65million) over a 15 year period. These investments are predicated on returns of at least twice this investment - savings which are guaranteed to be re-invested into further prevention and early intervention efforts. So we are in it for the long-term and the funding streams - if used boldly and creatively - have the potential to make evidence-based programmes business as usual rather than the ideal exception. So the US wins on the development of evidence-based programmes (but is struggling to find a secure place to bed them down). The UK wins on providing a context whereby evidence-based programmes have the potential to be implemented and sustained in the long-term (but are still not sold on the value of evidence-based programmes). Place your bets (or at least comments on this blog) on the what the future holds…

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