Calls for independent evaluation of universal parenting programme

NHS Greater Glasgow and Clyde has been called to commit to an independent evaluation of a £5m universal parenting initiative due to be rolled out across Glasgow later this month.

A group of healthcare professionals has also expressed concern about an apparent lack of consultation and competitive tendering prior to the selection of the Triple P parenting support initiative.

One Glasgow GP says she is concerned about the “incomplete” evidence base for the programme and also “the energy and money that has been thrown at it at the expense of our infrastructure in primary care”.

While she says that a universal parenting programme sounds “superficially to be a great thing”, she fears it may lead to vulnerable families becoming lost in the system.

“If parents do not engage they will not be chased around their community until they attend classes, they will be ‘bounced back’ to the referrer. This does not help me as a GP in my daily working practices, but more importantly, I fear another bureaucratic structure being born, referring the unseen families around the system,” she says.

However, a spokesperson for NHS GGC says that the Triple P programme was selected as it was the “best fit” for Glasgow’s requirements and met the exemption to tender due to its “unique nature.” In response to queries about the depth of consultation that took place prior to its selection, the spokesperson says that Triple P was adopted as the main parenting programme in Glasgow following discussion and agreement at appropriate forum and groups, adding that Triple P was also proposed in the Parenting Support Framework that was issued for consultation to relevant stakeholders.

The spokesperson added that following a “detailed analysis” of the published evidence for parenting programmes by the Public Health and Health Improvement Directorate, Triple P was found to be the “only” programme that has taken a full population public health approach, incorporating an evidence-based universal component with an existing media and information campaign.

However, another professional working with vulnerable families in Glasgow, who has also asked to remain anonymous, questions whether the initiative will prove effective for those in the greatest need.

“Triple P is a very well produced series of interventions to support parents with parenting difficulties,” she says. “But in order to use Triple P, parents have to be reasonably motivated and reasonably literate. They get things for homework, which might be things like go read a chapter from the founder’s book.

Now, some of the parents I work with simply will be put off by that as they are not confident about their literacy skills.

“So I think its area of application is limited. The content is fine, it is good behavioural stuff, but I think its application has been grossly overestimated and overblown on the basis of very limited evidence.” Its evidence base is also entirely limited to children over three, she says.

“Yet we know that the time when most children are physically killed by their parents is in the first year of their life.

So if you are interested in child protection, if you are interested in the fact that children’s brains develop faster in the first two years of life than at any other stage in their lives then Triple P really has very little to say at all.”

Others have also questioned the impartiality of the evaluation of the programme after Triple P’s founder, Professor Matt Sanders, has been given a role in evaluating the programme’s success in Glasgow.

“This is like if NHS GGC were to tell all the doctors in Glasgow that they are only allowed to prescribe drugs made by one company, and then using the chief executive of that company to evaluate its prescribing policy,” another GP says.

He continued: “Triple P may well be the best thing ever done in Glasgow to support parents; but equally we need to know if it doesn’t work and without independent evaluation we will simply never know.”

However, a spokesperson for NHS GGC said that the Director of Public Health and the Public Health and Health Improvement Directorate that will lead the evaluation of the parenting support framework, which includes the Triple P programme, is “ideally placed” to evaluate its impact as, “they are impartial and have a duty to protect and improve the health of the population.”

Asked what role Professor Sanders will play in the evaluation, the spokesperson added that while Sanders has accepted a visiting professorship at Glasgow Caledonian University to establish a new Parenting and Family Support Research Programme, they stressed this research is separate to the evaluation that will be undertaken by the Director of Public Health.