1. CLINICAL COMMISSIONING GROUP 2013 AND BEYOND! Children and Young People Commissioning

2. The East Lancashire picture The 2011 census highlighted that there were 94,969 0-19 year olds East Lancashire has been shown to perform worse than the national average against national benchmarking for: Teenage pregnancy Low birth weight Breastfeeding rates Admissions to hospital for children and young people Infant mortality In East Lancashire we have a higher than average: Number of children on a child protection plans Number of children living with a disability Number of children diagnosed with a Mental health problem

3. Strategic Guidance NHS Outcomes Framework (2013/14) Infant Mortality Rate of Unplanned hospital admissions asthma/epilepsy diabetes Rate of emergency admissions for children with LRTI Public Health Outcomes Framework (2013-16) Breastfeeding Smoking at time of Delivery Domestic Violence Teenage Pregnancy

4. Clinical Commissioning Group Responsibility Hospital Services Maternity Paediatrics – A&E, COAU, Admissions Community Services Safeguarding Services Children Looked After Support Special School Nursing Therapies eg. Speech and Language

5. Commissioning Organisations Clinical Commissioning Group (East Lancashire PCT footprint) Clinical Support Unit – Lancashire Wide (Commissioning /contracts/‘back office functions’) Public Health Commissioning Board – Local Area Team (Lancashire Wide)

6. Aim Reduce avoidable attendances and admissions to secondary care services. Ensure young people are seen in the right place at the right time by the right person. Pennine Lancashire Paediatric Pathways Group (PLPPG)

7. Rate of Emergency Admissions per 1000 population to M07 2012-13 : PAEDIATRICS [Provisional]

8. NEL + NELSD + NELST : Paediatrics Paediatrics activity still running above plan profile. Significant financial activity and cost impacts NHS EL: +£1,129k overspend ( £39k more than @ M10) NHS BwD: +£504k overspend ( £31k more than @ M10) Activity remains above plan though does now appear to have reverted back to a typical annual profile pattern following the disjoin in the first 6 months of 2012-13

9. Emergency Admissions for Paediatric Medicine (PA) HRG CodeHRG Description PA02Epilepsy Syndrome PA11Acute Upper Respiratory Tract Infection PA12Asthma or Wheezing PA14Lower Respiratory Tract Disorders without Acute Bronchiolitis PA15Acute Bronchiolitis PA19Viral Infections PA21Infectious and Non-Infectious Gastroenteritis Approximately 50% of all Paediatric ‘Non Elective’ (NEL) admissions are associated and coded to 7 descriptor HRG codes

10. PA - Paediatric Medicine HRG Analysis : Analysis by Age Band of Patient NHS EL – Delivery Year 2011/2012 – Admission Type ‘Non-Elective’

11. Service Redesign Expansion of children’s community nursing service Development of paediatric hot clinics Consultant Hot line for Primary Care Implementation of Paediatric Early Warning Score Tool

12. PLPPG Delivery Plan 2013 onwards Review and redesign of pathways for asthma, epilepsy and diabetes Primary Care development  Regular paediatric training programmes for primary care and community  Shadowing of Paediatric Consultants  Peer reviews Development of Communications Plan  Resources – seasonal, locality focussed, self care etc Expansion of Advanced Paediatric Nurse Practitioner Service