1. WILTSHIRE COMMUNITY CHILD HEALTH SERVICES THE WAY FORWARD Tuesday 18 th November 2014

2. WELCOME Setting the scene – what we are doing and why/ drivers for change 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 improve?

3. 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 Wiltshire CCG, Wiltshire Council and NHS England BGSW Area Team have agreed to re-commission all Wiltshire Community Child Health Services together Intention to commence new service in early 2016

4. Drivers for change NHS Mandate 2014-15 focus on children with disabilities Children and Families Act September 2014 National Safeguarding agenda Early intervention focus Local partnership strategy : Early Help; Children & Young People’s Plan

5. 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)

6. 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 communities 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.

7. 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

8. Parent Carers Told Us Single Point of Contact Early Help and Intervention Remove Gatekeeping Join Services Up Trust Equality of Access to Services Transparency of Eligibility Criteria Honesty Pooled or Aligned Budgets Accountability Cross Border Arrangements Information A Service That Is There When You Need It

9. cont’d… Appointments! Better and Creative Use of Technology Services Available Nearer to Where I Live Consistency 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!

10. 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.

11. 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 cont’d…

12. 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

13. Proposed Model A single Children's Community Health Service for Wiltshire 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

14. 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

15. By………… 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

16. 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.

17. By……… 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 intervention Providing services in family friendly settings Safeguarding pathways embedded in all service areas Providing good quality information about services and interventions keeping waiting times to a minimum

18. 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 family.

19. By……….. 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 areas 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.

20. Principle 4 Strengthen partnership working within and across organisations to deliver services that are coordinated and responsive to children and young people’s needs

21. By…… 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

22. 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

23. By……. 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 developments Ensuring consistent clinical, management and safeguarding supervision arrangements are in place.

24. 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.

25. By…….. 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

26. Principle 7 Moving into adulthood – working with young people and their families to help them access adult services where needed

27. By…… 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 stage. Services working well with colleagues in Adult services to ensure that appropriate information is shared

28. 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

29. By…… 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 users. 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

30. 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

31. Group Exercise 2 How well have we worked with you to hear your views? – What did we do well? – What could we improve?