Annual Review
Foundations for successful system design in neurodiversity pathways
— Case study

Foundations for successful system design in neurodiversity pathways

The South West AHSN has been supporting the First Steps collaboration in Torbay and South Devon NHS Foundation Trust as part of its focus on identifying and spreading innovation and connecting to system-wide change in Children and Young People's services. Our work focused on building capability, as well as supporting design and evaluation foundations.

The First Steps Collaboration is a pilot based in Torbay and South Devon NHS Foundation Trust which aims to create a common neurodiversity pathway for Children and Young People (CYP). The pathway helps move towards a child-centred and needs-led approach, which facilitates joint-working and links agencies together.

The support provided by the South West AHSN Evaluation and Learning team was delivered through a Theory of Change (ToC) approach. This involves identifying and testing underlying assumptions about how a programme’s activities lead to desired outcomes, and ensuring there is a framework for evaluating the implementation and effectiveness of a programme. The ToC approach is useful as it helps to include system thinking in design and learning; it enables thinking about complex systems and the interrelationships and interdependencies between various components of the system.  

Individual meetings, document review, and ToC workshops were facilitated with the teams within Torbay and South Devon NHS Trust, Children and Family Health Devon, and alignment meetings with Devon Integrated Care System. 

Through the workshops, the core components of the pilot were mapped along with initial insights on barriers and enablers, a complete ToC was created, and an evaluation measure framework started.  

The workshops and outputs were turned into a workbook to enable the team to further the development of an evaluation, support communication with stakeholders, and enable alignment with wider system change strategy and partners. 

Little boy sitting cross legged, enjoying a book in a children's library
  • A robust Theory of Change co-produced with eight key stakeholders detailing how the programme will achieve change, and a measurement framework to provide guidance on how the project can measure and understand impact. 
  • Embedded system thinking in the model, and mapped current contextual insights about the system, mechanisms, enablers, and barriers to change. 
  • Enabled opportunities for system alignment, cross organisational communication, and partnership working.  
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