Doing with or doing to? A realist case study of factors affecting the implementation of guidance on child sexual exploitation in Wales

There is currently limited research which considers the implementation of new policies in child protection practice. In this article, we explore policy implementation in children’s social care using recent Welsh policy on Child Sexual Exploitation (CSE) as a case study. We conducted a realist evaluation of the implementation of the new CSE guidance in a two-phased study. The development of an initial programme theory was done during phase 1 of the study and is discussed in a previous article. In this article we focus on the programme theory refinement, presenting our hypotheses and findings from semi-structured interviews, observation of practice and a Wales-wide survey, which illustrate how aspects of the context and the organisation have an impact on policy implementation. Our findings highlight the importance of clear implementation plans which engage key stakeholders and are appropriately resourced. We suggest recommendations for developing implementation plans, including appropriate training materials, access to formal and informal collaborative spaces for knowledge exchange, and the importance of a supportive organisational structure. These findings illustrate how child protection policies are implemented in practice by local authorities in Wales and shed light on how policies can be more effectively implemented in practice.