Title: Family Group Conferencing for children and families: Evaluation of implementation, context and effectiveness (Family VOICE)
Funder: Health and Care Research Wales (Welsh Government)

Abstract: A Family Group Conference (FGC) is a meeting where the wider family discuss children who need support and protection and decide on a plan for looking after them._x000D_ _x000D_ AIM OF THE RESEARCH_x000D_ _x000D_ The aim is to increase understanding of quality and effectiveness in family group conferencing._x000D_ _x000D_ These are the research questions:_x000D_ 1. How widely are FGCs on offer in England and Wales and what are they used for?_x000D_ 2. What do families and practitioners think affects how successful FGCs are?_x000D_ 3. How do the quality of FGCs and variation in how they are used affect families’ experience and what happens to the family over the next year?_x000D_ 4. What happens over the next two years to families who have had an FGC? Is there a difference in their use of services, compared with families who have not taken part in FGCs, and what does this cost?_x000D_ _x000D_ BACKGROUND TO THE RESEARCH_x000D_ _x000D_ Existing research on family group conferences shows a mixed picture. Small studies with only FGC participants tend to show positive experiences, but when we look at studies with a comparison group of similar families who have not had a FGC, things are less clear. The most commonly measured ‘outcome’ is keeping children out of care and the success of FGCs in achieving this is not clear. Only a few comparative studies have measured family satisfaction and empowerment and these also show a mixed picture. _x000D_ _x000D_ This mixed picture may be because of problems with how the research has been done. It may also be to do with variation in the quality of FGCs – for example how well people are supported to give their views at the meeting. There is also variation in when FGCs are offered - they take place at very different stages of concern, from when family problems first emerge right through to when a child is at risk of coming into care. It is important to understand all the different factors that affect how successful FGCs are, including the extent of family problems and the culture of the local authority children’s services. _x000D_ _x000D_ DESIGN AND METHODS USED_x000D_ _x000D_ Work package (WP) 1 involves working with a group of families with experience of FGCs to work out the best approach for measuring FGC quality and what factors influence how well things work out._x000D_ _x000D_ WP2 involves working with a group of FGC projects across England and Wales to get families to fill in the questionnaires we designed in WP1. We will contact those family members again 1 year later. _x000D_ _x000D_ WP3 involves following up what happens to children and their main carers, in the 2 years after following the FGC, using routinely collected data from social care and health records (with no individuals identifiable when we do the analysis). This information will be compared with other families with similar difficulties who have not taken part in an FGC, because this was not offered in their local authority._x000D_ _x000D_ PUBLIC INVOLVEMENT_x000D_ _x000D_ We will work closely with families who have been through FGCs, using two family members as peer researchers. This will be more intensive in WP1 but one family member will be a core member of the research team and we will have a families’ group advising throughout the project._x000D_ _x000D_ DISSEMINATION_x000D_ _x000D_ The results will be presented in events for families and practitioners and also published online, including videos. Papers will be written for academic journals. We hope our questionnaire will become routinely used by FGC projects in future.

Lay abstract: BACKGROUND_x000D_ _x000D_ Family group conferences (FGCs) in child welfare bring immediate and wider family members together to decide on the best way to meet a child’s needs. Unlike in professionally-led traditional case conferences, decision-making is shared with family members. _x000D_ _x000D_ Qualitative and mixed-method research with FGC participants tend to show positive experiences: most participants feel their voices are heard; FGCs facilitate family-driven solutions and closer relationships - within families and with social workers. Although there is an existing literature on FGCs, there is a paucity of robust comparative UK evaluations. Comparative studies internationally have focused on a fairly narrow range of outcomes, not recognised the importance of context on FGC effects, and paid little attention to quality of delivery. Some qualitative studies have considered process and context but there is scant measurement of these. _x000D_ _x000D_ AIMS AND OBJECTIVES_x000D_ _x000D_ The aim is to establish how FGCs improve outcomes for families and what factors vary their quality. Given the importance of process and context, an evaluation informed by realist and complex systems approaches is needed. _x000D_ _x000D_ RESEARCH QUESTIONS_x000D_ _x000D_ - RQ1: What is the extent and nature of FGC provision for child welfare in the UK?_x000D_ - RQ2: How do families and practitioners see FGCs as impacting on families and what do they think might support or hinder their effectiveness?_x000D_ - RQ3: How does variation in the quality and implementation of FGCs impact on outcomes and acceptability?_x000D_ - RQ4: What are the longer terms outcomes of FGCs in terms of service use, e.g. child protection involvement and health care? How do these compare with similar families who have not taken part in FGCs and what are the economic consequences of FGCs?_x000D_ _x000D_ METHODS_x000D_ _x000D_ It is a multi-method evaluation, including the following elements:_x000D_ _x000D_ Work package (WP)1: Identification and modelling of FGCs in the UK; modelling programme theory and development of evaluation design._x000D_ - A survey of FGC projects in all UK local authorities (n=212) to map service provision._x000D_ - Co-production of programme theory and evaluation measures with family members who have experienced an FGC (n=16-24) and practitioners (n=16-24) in each of two sites._x000D_ _x000D_ WP2: Prospective single-arm study of FGC variability and outcomes after 12 months._x000D_ - A survey of family members (n˜200 families) just before an FCG, one month and 12 months after, to assess process, context and self-reported outcomes; plus a survey of FGC co-ordinators to further assess context. _x000D_ _x000D_ WP3: Comparison of service use in FGC participants and a comparison group after 2 years using a natural experiment._x000D_ - A study of longer-term service-use outcomes and their cost, using anonymised and linked routine administrative data on social care and health services. Families who have attended an FGC (n=300) will be compared with similar families from local authorities with no FGC service (n=1000)._x000D_ _x000D_ TIMELINES FOR DELIVERY_x000D_ _x000D_ The project starts in Sept 21 and lasts 4 years._x000D_ _x000D_ ANTICIPATED IMPACT AND DISSEMINATION_x000D_ _x000D_ An evaluation questionnaire which has been co-produced with families and practitioners will be available for use in routine FGC practice beyond the life of the project. Findings about FGC process, context and outcomes should be relevant to improving practice. There will be dissemination in accessible formats for practitioners and families, including video, as well as via academic conferences and journals.

Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: GENERIC HEALTH RELEVANCE