Having the courage to do things differently

Investing in the early years isn’t just about saving money in the long term, it’s about responding to what families really need and want. It’s about moving the old system towards something more networked, agile and relevant. This is what we set out to do with the Knee High Design Challenge.

In 2010 Professor Sir Michael Marmot published the report Fair Society Healthy Lives. It concluded that reducing health inequalities for people in the UK required a much greater investment in the first five years of our lives. It is during this time that we develop our emotional, social and cognitive skills. It is during this time that inequality of opportunity can create a pattern of long-term disadvantage.

In partnership with Guy’s and St Thomas’ Charity and the Southwark and Lambeth Council, we decided to try a totally different approach to reducing health inequalities in Southwark and Lambeth. Inspired by Marmot’s report, we focussed on the early years and created a three-year open-innovation programme that brought together talented and ambitious people with the courage and the imagination to build new solutions.

We called this the Knee High Design Challenge.

The health and wellbeing of today’s children and those children when they become adults depend on us having the courage and imagination to do things differently

Sir Michael Marmot

Below are five aspects of the Knee High Design Challenge approach.

One size does not fit all.  

The Government has been criticised for launching large public health improvement programmes that assume all problems are the same for all people, and all people respond in exactly the same way. But of course human behaviour and our experiences are much more nuanced and complex.

We created the Knee High Design Challenge to improve the health and wellbeing of children under five years old living in Southwark and Lambeth. We then brought together a diverse range of thinkers, makers and doers to create ventures that would achieve this goal in different ways.

We ended up supporting 25 teams of people to develop their ideas. Ideas ranged from redesigning the maternity experience for dads, a musical about post-natal depression, and making underused outdoor spaces more playable for under-fives.

If you’re always seeing the same problems, you will always find the same answers.

We wanted to reframe the question from the very beginning and help people ask new questions. To achieve this we spent time with families and early years practitioners to better understand what mattered to them and what really needed to change. We experienced the realities of people’s everyday lives, listened to the people who often go unheard, and built a clearer picture of where the opportunities lay to make a difference.

For example, we turned the question:
How can we get more families using our services more often?

Into:
What would enable more families to leave their houses and connect meaningfully with the people and places around them?

We then worked with those families and practitioners to then create three design briefs. These were intended as provocations, to stimulate new ideas for services and products that would make the necessary difference.

What would connect more families to people and places beyond the boundaries of their home?

What would make it possible for more young children to learn and develop in their everyday lives?

What would alleviate the stress, anxiety and depression experienced by parents during the ups and downs of everyday life?

You can read more about this in our original Call for Ideas brief.

The best ideas emerge from between the cracks.

We sought to make the Knee High Design Challenge as open and as accessible as possible. We believe that people collaborating from different places, with a range of different experiences have the capabilities to build something extraordinary.

We wanted anyone to apply to be part of the Knee High Design Challenge. From people working within large national charities, to community groups who have a fire in their belly, to parents who have the empathy and direct understanding of what would make their world better.

Making something good happen takes time and it takes nerve.

The Knee High Design Challenge was looking for bold new ideas, and new ideas are fragile. We needed to practically understand what would work and what wouldn’t, before investing too much time and money into building something new.

Current commissioning can often place investments in programmes that are deemed able to reach a large scale quickly. It is sometimes difficult for these of programmes to respond if they find out certain bits are not working. It is also hard to understand what would work better.

At the start of the Knee High Design Challenge, we gave small sums of money to as many projects as possible to help them make the transition from ideas to actions that were rapid, experimental, open and thoughtful. The time, support and funding grew as the ideas (and the people behind them) demonstrated their ability to make something real and effective.

We wanted to invest wisely to maximise the chance of a successful outcome.

Throughout the Design Challenge we used a design methodology to support the teams getting their ideas off the ground. This involved prototyping ideas quickly and early with families, and testing which bits of the idea did and didn’t work. We also supported teams to develop their networks, strengthen the capabilities of their team, build their business models, and run experiments to measure their impact.

The need for evidence should not outweigh the need for new ideas.

While we understand that there is a need for doing things differently, commissioners are still expected to commission evidence-based programmes. Programmes that have been tried and tested over many years and are seen as low risk investments. But if we keep commissioning the same thing, and it’s not achieving enough, surely we need to think again.

There is often a false sense of security in evidence-based programmes. We don’t unpick and understand the details of what’s working, and what’s not. Many children’s centre managers have told me that they run parenting groups because they are evidence-based, and they can demonstrate that parent’s confidence increases over time. And this is a very good thing, but I don’t believe that this model works for all parents. There are many other ways that families can build strong, resilient and trusted relationships in order to share advice, experience and compassion.

The services and products that we funded through the Knee High Design Challenge needed to understand current evidence, and then boldly experiment with ways to make a more lasting and substantive difference. We gave the teams permission, time and the support to innovate, whilst ensuring that the ideas were always being tested practically with the people they were for.

You can read more about how we worked with the team to help test their ideas in this article by Ingrid Melvær.

Our plan for year two of the Knee High Design Challenge is to run a 12-18 month evaluation of the products and services that continue to thrive. This will help us understand what works, and what doesn’t, and why. It will also give us more information about how each service can keep improving its effectiveness and its impact.

The results

We have funded and supported 25 teams since September 2013. Now we are working closely with six teams, who are getting ready to pitch for funding that will enable them to run a 18 month pilot.

All of the teams are improving the health and wellbeing of children and families in different ways. But what they all have in common is one bold and ambitious goal:

We want to ensure more children get the best possible start in life.

The six teams

Crafty Explorers

Imagine a world where all families are venturing and playing confidently in the green spaces in their city.

One in seven children living in London have not been to a park or green space in the last year [1]. Evidence shows that outdoor play and contact with nature improves children’s health and wellbeing, learning and their personal and social skills [2].

Crafty Explorers is a new experience on a high-street, inspiring children and families to explore and learn in local parks, talk to one another and get some exercise.

EasyPeasy

Imagine a world where all children are resilient to set-backs and excited to learn.

At the start of life; love, support, and emotional investment are what help children develop self-esteem, motivation and the resilience to recover from setbacks. Parents and carers are the primary character-builders. However, they can experience many stresses and distractions every day, making it difficult to find the space for quality time and play that is so crucial to children’s early development.

EasyPeasy is an app that sends educational games to parents and carers of young children, to help develop the character traits that will prepare children for school, and life beyond. The app provides simple, fun games to play with children, aged two to five, helping them build their character.

Creative Homes 

Imagine a world where all families could enjoy quality time together at home everyday. 

The home is one of the primary influences on a child’s development in their early years and, for many families, the home environment can be overcrowded and stressful. Prolonged stress not only affects day-to-day wellbeing but can have a lasting impact on children’s emotional and physical development.

Creative Homes is a home visiting service where trained artists work with families to identify the main causes of stress within the home. The artists work closely with each family to develop appropriate, playful solutions.

Pop up Parks

Imagine a world where all families can play safely together outdoors. 

Living and raising a family in a large, built-up city can be isolating. Home life can be difficult, especially if living spaces are small. Limited space can make the challenges of raising children and giving them the space to create, imagine, play and be healthy particularly tough.

Pop up Parks quickly transforms under-used urban spaces into a playful outdoor environment for children. These are typically where families live and where they spend time: near to or within housing estates and on community streets.

KidsConnect

Imagine a world where all families have access to the best free services in their hyper-local area.

Many activities and services for children in their early years are underused by the families who would most benefit from them. Information about free activities and services for under-fives is often sparse, inaccurate, difficult to access or not written from a parent or carer’s perspective.

KidsConnect is a way to receive the most up to date and relevant information about local activities and services for children under five. It is a web application, designed for smart phones, supporting parents and carers to find fun and creative things to do.

The Good Enough Mums Club

Imagine a world where all mothers felt good enough.

It is estimated that 20% of all mothers experience some kind of postnatal mental illness [3]. Research by the National Childbirth Trust has found only 50 out of 193 NHS Trusts in England provide a specialist mental health service to women after they give birth. As a result, women who need support are often overlooked and are not receiving the help that they need. However, this support does not always need to be provided by formal public services.

The Good Enough Mums Club delivers theatrical performances, workshops and online resources that aim to challenge the stigma around maternal mental health and help increase the wellbeing of mothers.

We know that no one of these ventures will change everything for everyone. Instead, we want to create a collective groundswell of energy that gives families choices and influences a new era of early years services in Southwark and Lambeth, and beyond.