Table 2 Thematic framework, showing overarching themes, subthemes and example illustrative extracts

Communication (9)

The dissemination of GM i-THRIVE (7)

“I'm responsible for coordinating our THRIVE partnership […] forum through which we engage, keep informed, work with collaboratively in terms of our strategy and planning work, sharing information. And we have very good attendance and engagement. I think that illustrates that people are bought into the agenda and know where to go.” (Participant 1, medium control)

“That’s one of the biggest things, really, about that shared language. And I don't think we are there with that. I don't think that the wider workforce knows enough about it.” (Participant 6, low control)

The relationship between Greater Manchester and locality teams (6)

“I think that the GM team around THRIVE are really responsive. They celebrate the work that you do in a locality […] And they are a team that is quite approachable to problem-solve, so I think that's definitely a real help.” (Participant 2, medium control)

Accountability (7)

“I think some of them (locality leads) definitely have that personal accountability and responsibility, and you can see in some areas where it's really flourished […] And other areas, it's just starting to take off so there's definitely something about having the right people in place.” (Participant 4, high control)

“A challenge will be moving forward, to support the practitioners and understanding what it means to them. Where do they fit within it? What do they already offer?” (Participant 9, low control)

Networking and joint working (7)

“I think that the whole THRIVE process has strengthened our services, links with CAMHS, we've got much stronger relationships. We're more connected and understanding of each other’s ways of working. And I think that sort of helps. I think just being clear on the different quadrants and what they mean for people.” (Participant 6, low control)

Support (9)

The responsibility of locality leads (6)

“Being an advocate for the THRIVE principles, being that conduit in a system that tries to facilitate conversations between different organizations […] getting people to reflect on their own practices in accordance with the THRIVE principles, is one of the main responsibilities I'd say for a THRIVE lead.” (Participant 8, medium control)

The role of the Greater Manchester team (8)

“One of the key things is building relationships, that's it, and being open and helpful to people and trust, so bringing that familiar, having that relationship.” (Participant 4, high control)

Other senior support (4)

“What you couldn't pretend was that just having the fancy new diagram with THRIVE was going to solve that if you didn't sort out putting in the new and the extra services and the support to people. So I was somewhat cynical.” (Participant 5, high control)

Training and capacity-building (8)

“I don't think we had the right representation at the start […] It's the same people that always put their hand up, or always get nominated.” (Participant 3, medium control)

“One of the things we probably struggle with is knowing how that training’s been progressed […] to say actually ‘have you used that training for your own practice?’ or ‘have you managed to train other people in your team?’ and understand kind of how far that’s gone.” (Participant 2, medium control)

Barriers to implementation (9)

Workload (5)

“I feel like I've probably not got as much capacity to be able to truly focus on that all the time, which I think it could, it could be a role that someone could do full time, and still probably not be able to solve everything.” (Participant 2, medium control)

Conflicting priorities (6)

“The THRIVE leads are really passionate and keen, but maybe more limited with their capacity, because of their other work that they've got to do. And I think that's quite common across quite a lot of roles. But I think if you can then have that shared—ownership is probably the right word?—of continuing to implement it, bit by bit, I think that's more of a sustainable model as well.” (Participant 9, low control)

“THRIVE has tried to change practices so that it's working smarter, not harder. In the short term, it might look as if there's a little bit more of an effort, and there's a bit of time that you need to take out to reflect on your service and build it in a THRIVE-like way.” (Participant 8, medium control)

The effect of “firefighting” on progress (4)

“When I look where we were at, say, 18 months ago, and what our aspirations were to do next, we’ve not been able to move on some of those things because it's about staff well-being, staff shortages, people being off sick, system changes, it's all been about firefighting and business continuity, sadly.” (Participant 1, medium control)

Past, present and future: the implementation journey (9)

GM i-THRIVE was, and is, needed (7)

“What we were drawing on wasn't… It was things that were unsatisfactory really, actually a desire to move away from things that didn't work, and weren't as universally engaging or adaptable as what THRIVE actually is.” (Participant 1, medium control)

“It’s a really good way to challenge decisions. It didn't mean that there was a different outcome. But it's always good to have the theory behind what we should be doing.” (Participant 7, low control)

“We had what was previously the tiered model. Now, I don't think that framework is bad or wrong. And I think there's been a bit of a confusion with people saying ‘oh, THRIVE's so much better and THRIVE's much easier’. And it misses the point that the failure around the tiered model was about investment.” (Participant 5, high control)

A strong foundation (7)

“There's always been that commitment that THRIVE is the approach that we're going to take.” (Participant 2, medium control)

“We've put that effort in, and now it's just about sustaining it, keeping it, keeping the momentum going.” (Participant 3, medium control)

Evidence of change (9)

“I think the biggest difference is just more conversations and less referrals.” (Participant 8, medium control)

“I think, if it wasn't good, people wouldn't stretch it out anywhere, it wouldn't go as far as it's going now, if the effort was too much.” (Participant 4, high control)

Becoming routine (4)

“I think it has potential. But I think there needs to be a culture/thought shift amongst the whole system. And I think the challenge with that is how it aligns with other systems.” (Participant 6, low control)

Learning from reflection (7)

“Some observations I have made over time is that it's got to be more than a word. And I think that's key. It's got to be meaningful.” (Participant 9, low control)

Looking to the future (8)

“To make it sustainable, they need to sell this. It's that synergy of the bits coming together really, rather than just lots of training and people using pretty diagrams, which THRIVE does give us. But it's got to be more than that.” (Participant 5, high control)

“It feels as if now we're at that pivotal, turning point where everyone's starting to get it.” (Participant 8, medium control)

“Rethinking how we use the resources we've got now, for the best effect […] training and capacity-building is one of those, you can't just do that for a couple of years, and then hope that you’ve long-term sustained benefits, you’ve got to keep doing it.” (Participant 1, medium control)

The nuances of GM i-THRIVE (8)

Unexpected consequences (4)

“A couple of people not understanding it, or thinking it was more than what it was.” (Participant 9, low control)

“We never set out to look at that in the broadest context that we have. In a positive way, we certainly didn't set out with an ambition to apply the THRIVE concepts across much broader children’s services systems, and that's been a positive consequence.” (Participant 1, medium control)

Widespread change (8)

“Part of my portfolio encroached on the homelessness agenda. And I thought, you know what, we could use THRIVE here.” (Participant 3, medium control)

“If I was to quote THRIVE every time I made a referral, I imagine that would help in terms of the outcome of that, and that might be something I can implement myself.” (Participant 7, low control)

Flexible application (5)

“It allows people to use it in different ways as well, but brings a commonality to it, so that shared language that everyone understands.” (Participant 4, high control)

“I find that a positive and a negative, because you feel like you've got free run to do what's right for your area. But equally, you've not got anything to compare to whether you're on track.” (Participant 2, medium control)

How does the nature of THRIVE as a model influence implementation? (5)

“Because it's such a universal approach, and that it can apply to a lot of things, there's never like a definitive end where you say ‘we've officially embedded THRIVE’. It feels like it could always go on and on.” (Participant 2, medium control)

“I think people thought THRIVE was a thing, rather than a set of principles and a framework. And that was the most difficult thing to overcome […] I think a framework takes longer. But I think there's many benefits to it, because it's more flexible for the system.” (Participant 3, medium control)