Family hubs: beyond co-location

Our learning from working on family hubs in five local authorities

Co-locating services is an important part of the family hubs model. However, in and of itself, it doesn’t guarantee better outcomes for families. It’s only the start. Purposefully designed family hubs should make it easy for families to ask for the help they need and to get it quickly. But what needs to be done to achieve this? We see three key areas of development.

Firstly, hubs need to adopt a relational approach. Building real connection with families helps to create the conditions needed for professionals to understand and meet their needs holistically. This also means allowing time for professionals to build relationships with one another, across the relevant organisations in the area.

Secondly, local connections and referral routes between the hub and wider support need to be developed, including within the hyperlocal community. These connections ensure that when families move from one service to the next, they don’t fall through the cracks.

Thirdly, the user experience in family hubs needs to be tested and improved over time. When developing support for families with complex needs it’s important to recognise the design will not be ‘right first time’. Family hubs exist in a complex dynamic system. The way they interact with and support families needs to be prototyped and adapted over time.

Conscious development of these three areas will help to ensure family hubs in every locality deliver on their promise and provide effective and timely help to families.

We’ve described these development areas in detail below, but first, as Dylan Thomas would say, let’s begin at the beginning.

What are family hubs?

Family hubs provide families with a single access point to integrated family support services for early help with social, emotional, physical and financial needs. Each family hub is bespoke to its local community while incorporating three key delivery principles: access, connection, and relationships (see National Centre for Family Hubs).

In response to successive rounds of funding local authorities across the UK are wrestling with how to implement central government’s vision for family hubs in their localities. In the last year, we’ve helped several councils to make progress on this initiative. Although most hubs we’ve worked with are still in the early stages of development we think some of our learning might be useful to others working on the challenge. We’re sharing our current thinking and will update it as we learn more.

Designing for complexity is not easy — a bad and good example

At this stage in the programme, many councils have published their Start for Life offer and have co-located some of their services in one or two pilot sites. More than likely, what a family hub looks and feels like in reality is starting to become clear.

Co-locating services is difficult in any context. Finding an appropriate location and the right building is never as easy as it sounds. A common challenge we’ve experienced is that while a particular building could look perfect on paper, it might come with a refit bill that blows the budget.

For front-line staff, being moved to a new locality and asked to work in a different team with a broader focus is also anxiety provoking. The change management required to address these anxieties is significant. And once this is overcome, it becomes clear in most contexts that setting up regular multi-disciplinary team meetings (MDTs) is not enough to enable genuine collaboration and knowledge sharing between services.

Co-location doesn’t guarantee better outcomes for families. Families who most need support are often the least able to explain what help they need. There are all kinds of reasons for this. It could be due to language barriers, cultural reasons that make asking for help for specific services difficult, it could be they are experiencing mental health challenges, or simply because they are suffering from a lack of mental bandwidth due to stress and the feeling of ‘scarcity’.

It is essential that the user experience of family hubs is designed in the knowledge that people won’t always find it easy to ask for help or explain their needs. Unless this is taken into account there’s a risk that families only receive a superficial service and quickly disengage.

To illustrate the importance of this consideration, as well as how far the user experiences can diverge, we’ll take two examples of how a family hub could support a resident with complex and multiple needs. The examples are based loosely on some of our experiences.

Paula is a single mum with two young children. She’s concerned about her eldest son’s health and she thinks he needs to do more exercise. She hears about the family hub from a friend and comes along to see if she can get some help.

There are lots of different ways in which Paula’s trip to the family hub could go, but we’ll look at the two extremes.

Paula’s Story #1

• When Paula arrives at the family hub the door is closed. She wonders if she’s in the right location and considers leaving but before she spots a buzzer and rings it.
• When she walks into the hub she sees Rowan on reception. She explains that her son Kieran is always tired and doesn’t get enough exercise.
• Rowan says the hub isn’t really for that kind of support but he wants to help so he looks up the details of a running club on the council’s website.
• He gives Paula the details and says she can contact them directly. Before she leaves he asks if there’s anything else he can help with.
• Paula says no and leaves. She doesn’t think Kieran will be interested in running but she looks up the details on the website anyway. She gives the club a call but the phone number no longer works.
• Paula is really disappointed. She still doesn’t know how she can help her son and feels silly for going to the hub in the first place.

Paula’s Story #2

• Paula arrives at the family hub and when she walks through the door Rashidat, from the Early Help service, goes over to say hello. She’s really friendly and welcoming.
• Paula explains that her son Kieran is always tired and doesn’t get enough exercise.
• Rashidat asks her if she’d like to chat further about the situation in some comfy seats in a quiet spot. Paula says that would be great.
• Rashidat explains that she is really interested in sport and physical activity for younger children. She asks Paula what kind of sport her son likes and Paula explains that Kieran has recently started collecting football stickers. They decide that checking out a local football club might be a good place to start. Kieran will get lots of exercise while making new friends in the process.
• Rashidat suggests they jump on a quick video call with Steve, who runs a football club near where Paula lives. Rashidat met Steve recently at an event put on by the family hub for local voluntary and community organisations to get to know one another. They have a chat and Steve says Kieran is very welcome to join the next session. He offers to have a chat with Keiran and tell him about the club beforehand.
• Once that’s sorted Rashidat asks Paula when she noticed changes in her son’s physical health.
• Paula is starting to like and trust Rashidat so she tells her that her husband left a few months back. The change in Kieran’s mood and physical health happened around the same time.
• Rashidat tells Paula that she can imagine she must be going through a tough time at the moment. She explains that the family hub provides lots of other support like help with mental health and finances. She gets the sense that Paula needs to be getting going but asks her if she’d like to book a time to come back next week to chat further. Paula says that would be great and they book a slot.
• The next time Paula comes back she’s pleased to see Rashidat. Kieran has started at the football club. He was reluctant at first but he loves Steve (he thinks he’s very funny) and seems the happiest he’s been for months
• Paula and Rashidat talk about Paula and through the conversation it becomes clear that Paula is having some trouble keeping on top of her bills. Rashidat introduces her to Jane, who is also based in the hub and is part of the financial inclusion team. She introduced them to one another and explains that Jane can help her with some financial advice…

The difference between these two ends of the spectrum is stark. We know we’re at risk of simplifying things here. But we think there is enough truth in these stories to illustrate the potential family hubs could have for families with multiple needs.

We think there are three things local authorities can do to help ensure their family hubs deliver great outcomes for families with a range of different circumstances.

1. Adopt a relational approach

We think the key to achieving the vision for family hubs and enabling Paula’s second story is taking a “relational” approach.

Relational practice is a movement that’s been around for a long time. We first became interested in the idea because we noticed in our projects that the agile value, “individuals and interactions OVER processes and tools” was applicable not just to the approach we were using to run projects — but also to the design of services themselves. To get started with this approach, there are three conditions or pillars that need to be in place. Family hub staff need:

1. Space and time to build relationships with service users
2. Support and training to become multi-skilled practitioners
3. The opportunities and encouragement to build relationships and connections with other organisations in the local community

You can read more about this in Dennis’s article here.

Relational practice is at the heart of many effective family hubs. Often, the easiest place to begin developing a relational approach is by running a form of Core Conversations training. The training enables practitioners to share best practice in having meaningful conversations with residents that go beyond the surface level in a safe environment. They can take this practice with them, back into their hubs.

2. Build connections between family hub staff and organisations in the community

The support, opportunities and interventions in a given community are always changing. Directories go out of date very quickly and people move on. Family hub staff need more than phone numbers or referral forms for other services to be effective. As much as possible they need to know and have connections with other professional and with the community itself.

We’ve found that it’s useful to bring people together from different parts of the system through concrete activities, such as training or workshops (e.g. bite-sized learning on the most relevant support available in the community). As part of the session, people start to build relationships with one another and learn about the wider system of support. These connections between people and organisations mean that practitioners on the front line can easily navigate the changing landscape of support available in the community.

3. Prototype the user experience

We are great believers in the truth of Kurt Lewin’s quote: “You never understand a system until you try to change it”. Getting the user experience right in a family hub is essential. It needs to be easy to ask for help, and the process of bringing in different professionals to provide it needs to be seamless.

There’s no perfect design for the family hubs' user experience. It will depend on the needs of the community, the design of the building and the services within it. Even from the earliest stages of co-location, prototyping different aspects of the user experience is really important. By testing out different approaches with real families, each family hub will be able to work out what works best in its own unique context. Some of the things authorities could consider prototyping include:

• where and how details of the service offer are shared, including the language, branding and marketing materials;
• the layout and signage of the building;
• the initial conversation with a new family;
• how workers connect with one another in the physical space and virtually;
• how information about residents is managed and shared, as well as how workers collaborate, to avoid families having to repeat their stories; and
• how the process of handovers works in practice to ensure families don’t fall through the cracks.

Family hubs have the potential to help families with a range of different circumstances to thrive

Establishing the first family hub in any locality is a messy problem. While the first steps are complicated (publishing offers, finding a space and moving people in), the work very quickly becomes complex. There is no easy template to work from that is guaranteed to lead to better outcomes for families.

However, we genuinely believe that family hubs at their best could support families with a broad range of circumstances, to thrive. To make this a reality, they need to go beyond co-location. Consciously designing and developing the three areas we’ve described in this post and iterating on the approach in response to learning is essential.

In essence, the work is simple. But simple is not easy. Building real connection with families and between professionals requires sustained effort. Being willing to accept that the initial design of a hub might need to change over time requires stubborn perseverance. But with these approaches at the heart of the design, we think Paula’s second journey could be commonplace across the country.

This article was written by Max Goodall, Joe Badman and Dennis Vergne.