Public presentation: The Way Forward. 18 November 2014

Tuesday 18th November 2014
• Setting the scene – what we are doing and why/ drivers for
• Process of engagement so far
• What you have told us: Children & Young People; Parent
carers; professionals
• The proposed model of future service delivery; Principles
• Opportunity for questions/ discussion
• How we will know we have improved outcomes for children
and young people?
• How well has this process worked and how could we
Setting the Scene
• Children’s community health services (CCHS) are
currently delivered by five separate organisations
• Currently 16 different services delivered in varying
ways and with inconsistent pathways across
• Wiltshire CCG, Wiltshire Council and NHS England
BGSW Area Team have agreed to re-commission all
Wiltshire Community Child Health Services
• Intention to commence new service in early 2016
Drivers for change
• NHS Mandate 2014-15 focus on children with
• Children and Families Act September 2014
• National Safeguarding agenda
• Early intervention focus
• Local partnership strategy : Early Help; Children &
Young People’s Plan
Service Elements
• The following service elements are included in the new
over-arching service
Health Visiting/Family Nurse Partnership
School Nursing/ School aged Immunisations
Community Paediatrics/audiology
Community Children's Nursing
Learning Disability Nursing
Speech & Language Therapy
Integrated Physiotherapy/Occupational Therapy
Looked After Children service
Safeguarding service
Child Health Information System
Portage ( SW Wilts)
The Vision
The Wiltshire Children & Young Peoples Plan sets out the
Joint vision of improving outcomes for children and
young people in Wiltshire; promoting safeguarding;
reducing, preventing and mitigating the effects of child
poverty; and enabling resilient individuals, families and
To deliver this vision within Community Child Health
Services we will make sure that children and young
people in Wiltshire have the best possible start in life by
the delivery of an over-arching model of Community
Child Health service that delivers accessible, high quality
services meeting the identified needs of children, young
people and families.
How we have involved you
Stakeholder launch event 1 July 2014
Summary of previous consultations
Stakeholder reference group - ongoing
Series of six topic based workshops
Children & Young People Focus Groups
Parent/carer focus groups
On-line surveys: Parent/carers; children & Young
People; Professionals
• Todays event
Parent Carers Told Us
Single Point of Contact
Early Help and Intervention
Remove Gatekeeping
Join Services Up
Equality of Access to Services
Transparency of Eligibility Criteria
Pooled or Aligned Budgets
Cross Border Arrangements
A Service That Is There When You Need It
Better and Creative Use of Technology
Services Available Nearer to Where I Live
Shared Responsibility
Whole Child/ Young Person and Whole Family
Make Best Use of the My Plan
Culture Change and Recruitment
A Needs Driven Service
A Coordinated Service
Celebrate What is Already Working Well!
Children and Young People Told us
• Information about what services provide was difficult to understand.
• Lack of young people friendly information. (Using a young people friendly
website is seen as the preferred way to communicate information about
community health services to young people).
• Closer engagement/working with schools and colleges would enable more
young people to access information and know where to go for help and
support (Stigma still attached to talking to your school nurse and they are not
visible enough).
• Face to face support is still seen as the preferred type of support.
• Importance of making time for them - getting to know them, listening to
them, explaining things to them and being honest with them.
• Having services that are accessible – that you can get to via public transport
and are close by.
• Services need to work together better.
• Importance of a consistent relationship with workers.
• Treatment/support/appointments should be offered at the point of asking
(when they need it most) to ensure that young people are not ‘put off’ or
waiting a long time.
• Appointments/support should be available at times that are more suited to
young people’s lives e.g. after school/college.
• Being seen at home is important (particularly to those receiving lifetime care).
• Importance of having a smooth transition to services.
• It is important to young people that it is explained to them how to complain.
• Better use of social media e.g. skype and text messages
Professionals told us
Working together is important
Core values
Child at the centre of everything we do
Single point of access ; clear criteria
Clear pathways within and between services
Training and development to deliver best practice
Parents are key partners in all service delivery
Streamline processes
Good IT systems are vital
Proposed Model
• A single Children's Community Health Service for
• Single point of access and information
• Over arching service principles and outcomes
• Over arching performance and quality framework
that is focused on delivery of outcomes
• One workforce that identify themselves as delivering
a Community Child Health Service for Wiltshire's
children & Young People
Principle 1
• Engaging with the voice of children, young
people and families – putting them at the
heart of everything we do and making sure
that we work together with them in
designing, delivering and monitoring services
• Seeking out needs
• Having a ‘Can do’ culture
• Finding out if children ,young people &
Families are satisfied with services
• Designing services around needs of the child,
young person & family
• Providing easily accessible information to
children, young people and their families
• Advocating for children and young people
Principle 2
• Early identification and intervention - making
sure that needs are identified early and help
is offered to support the child and family as
early as possible.
Focusing on identifying needs and intervening early on
Training staff to screen and identify needs
Making sure staff work flexibly
Supporting other settings to deliver packages of early
Providing services in family friendly settings
Safeguarding pathways embedded in all service areas
Providing good quality information about services and
keeping waiting times to a minimum
Principle 3
• A family based approach - empowering
families to work in partnership with
professionals in delivering the care their child
or young persons needs and working with
them to tackle issues affecting the whole
• Taking the needs of the family into account, whilst ensuring
that the needs of the child remain paramount.
• co-ordinated services (including appointments, assessments)
whenever possible
• one professional able to co-ordinate care and support.
• Implementing clear, well publicised pathways between
individual service elements and between other key service
• adopting a person centred approach and understanding the
needs of the whole family .
• Making sure families can access services easily and are able to
exercise choice where appropriate
• Services signpost to the voluntary and community sector
when appropriate.
Principle 4
• Strengthen partnership working within and
across organisations to deliver services that
are coordinated and responsive to children
and young people’s needs
• A single point of access to services ; Giving information,
advice, signposting and ability to refer to other services or tp
re-access services
• Developing integrated care pathways
• Making arrangements with border commissioners to ensure
reciprocal arrangements for care and support are in place
• Transferring health records when children move out of area
• working well with partners to achieve equitable life outcomes
for vulnerable children and young people
• publicising referral criteria and response times for every
element of the service.
• Established good links with local GP practices
Principle 5
• Equity of access to safe, high quality,
evidence based services – continually
making sure that we are delivering the best
practice to meet identified need
• Access to appropriate services, regardless of
geographical location
• Making sure care is of the best quality
• All services meet national standards and guidance
• Staff are appropriately trained and registered and
kept up to date with service and practice
• Ensuring consistent clinical, management and
safeguarding supervision arrangements are in place.
Principle 6
• An excellent workforce - ensuring that the
people who work with children , young
people and families in Wiltshire are
appropriately trained, well supported to
develop their skills and committed to
delivering the best care possible.
• A competent, caring , dynamic workforce practicing
in an evidence based way and standards
• Training staff in person centred approaches
• A committed workforce that goes the extra mile
• Ensuring staff are supportive and put the child or
young person at the centre of all they do.
• A workforce that is empowered to make decisions as
close to the ‘front-line’ as is possible.
• Excellent leadership
Principle 7
• Moving into adulthood – working with young
people and their families to help them access
adult services where needed
• Ensuring young people are able to move easily into adult
services if required
• Making sure the needs of young people are met across the
transition age boundaries
• Preparing Young people and families for eventual move to
adult service provision, at an appropriately early enough
• Services working well with colleagues in Adult services to
ensure that appropriate information is shared
Principle 8
• Efficiency and value for money - making sure
that resources are used wisely and applied in
the most effective ways with full use of
existing and emerging technologies
• Services that can be accessed at the point of need and are
placed in geographically suitable locations.
• Delivery of outcome based interventions
• Use of multi-media solutions as an innovative way of
delivering services at times and places that best suit service
• Development of efficient admin processes
• Effective data collection mechanisms
• Systems of good communication between agencies
• Good use of technology to communicate with children, young
people and their families
Group Exercise 1
• Working on the two priorities on your table:
How will we know we have delivered these
principles and that outcomes have improved for
children and young people ?
Please give concrete examples of how a service
could demonstrate improved outcomes
Group Exercise 2
• How well have we worked with you to hear
your views?
– What did we do well?
– What could we improve?