Recommissioning of Community Health Services for Children and Young People[重新调试儿童和青少社区卫生服务](PPT132).ppt

re commissioningofcommunityhealthservicesforchildrenandyoungpeoplestakeholderworkshop re commissioningofcommunityhealthservicesforchildrenandyoungpeoplestakeholderworkshop 2 introduction welcomerichardbailey deputyheadjointcommissioning nhsneneccgandnhscorbyccg 3 purposeoftheday provideabriefingonwhatisbeingre commissioningandwhyexplainthere commissioningprocesssetouttheopportunitiestoparticipateinthere commissioningprocesssharewithyouinformationanddataderivedoffertheopportunitytodelegatestosharesomeearlythoughts 4 agenda 1 9 40 whyre commission dremmaclancy9 55 re commissioningprocessjudithcattermole alisonshipley stephenmarkssummarise questions10 15 demographics needsassessmentdavidloyd hearn sianhealesummarise questions11 00 tea coffee 5 11 15 tabletoptasks pleaseensuretaskswrittenjudithcattermole12 15feedback verbal onekeymessagetoassistre commissioning12 35nextsteps howyoucangetinvolvedrichardbailey12 40panelq a12 50closingremarksdrdarinseiger 6 agenda 2 whyre commission dremmaclancychildrenandyoungpeopleclinicalleadnhsneneccg 7 nochange notanoption growthinneed staffrunningtostandstillfrustrationfromyoungpeopleandparentsvariabilityaccesslessonsfromvictoriaclimbie babyp butchangealsobringsopportunity 8 imagineajoinedupapproachwithalocalityflavourwithservicesdeliveredinaplaceconvenientforchildren youngpeopleandfamilies 9 health localauthorityservicestogetherinchildrencentres schoolsandcommunities 10 sothat familiescouldaccessgps healthvisitors communitynurses mentalhealthsupportetc inoneplacepromotionofcommunityinvolvementandactivitieshealthismorefamilyfriendly it seasierforpatientstointegrateintocommunityandsocialschemesthereisareductioninisolation fosteringgoodsupportnetworksandpromotingphysical emotionalandmentalwellbeing 11 whatcouldwedo gpscould dochildsurveillanceclinicsimmunisationsforpregnantwomenandnew bornbabiesdropinclinicsformumsneedinggpadvicehospitalandchildrencommunityhealthservicescould runchildren soutpatientclinicrunningbasecommunitychildren snurseslocallytohelpwithadmissionavoidancework 12 whatcouldwedotogether offeramulti disciplinarynetworkincluding everythingthatchildrencentresalreadyofferbreastfeedingsupport midwiveslearningdisabilitiesandspecialneeds communitypaediatrics secondarycare gp healthvisitors camhs socialservices voluntarysectorstreamlineandintegratehealth wellbeingandsomeetallneedsforfamiliesfrompreconceptiontolateteensandbeyondusethemodeltosupporttheworkwearedoingtoimprovethecarecurrentlybeinggiventolookedafterchildren lac 13 wheredowestart lookatcurrentservices infrastructureandestategetfeedbackaboutwhatworkswellandwhere andwhatcouldbedonebetter differentlyusethattodeviseacentrallycommissionedserviceusingthebestmodelsandrecreatingthemtofillgaps munitypaediatricnursesinthenorthmightbeusefulinthesouth flexingapproachestosuitlocalcircumstancestodayisthestartofthatjourney 14 ourvision childrenandyoungpeople scommunityhealthserviceswithinnorthamptonshirewillputthevoiceofchildren youngpeopleandtheirfamiliesatthecentreofeverythingwedo overthenext3yearsandbeyond wewillcontinuetoimprovecommunityhealthservicestoensuretheyareresponsive equitableandinclusive serviceswillbeavailablewhereandwhentheyareneededthemost byworkingtogetherweaimtoensurechildrenandyoungpeoplearehappy healthy safeandresilient enablingapositivetransitionintoadulthood 15 there commissioningprocessjudithcattermolechildrenandyoungpeoplecommissionernhsneneccg nhscorbyccg northamptonshirecountycouncilleadforre commissioningprogramme 16 whyarewedoingthisnow nationalandlocaldriverslegislativechanges pupilswithspecialeducationalneeds sen neweducationhealthandcareplan ehc witheffectfromseptember2014driveforpersonalisationandpersonalhealthbudgets phb ncc reviewofdesignatedspecialprovision dsp s ncc devolutionoffundstoschoolssafeguardingrequirementstodevelopearlyhelpstrategiesandservices recentofstedinspectionofnccandpartnersregardingadoptionandfostering safeguardingandlookedafterchildren lac services 17 localhealthprovision children scommunityhealthservicestwomainproviders northamptongeneralhospital ngh andnorthamptonhealthcarefoundationtrust nhft inequityandinconsistencyandgaps intermsofpathwaysandeaseofaccesstospecialistservicesrisingdemandforspecialistserviceshighdemanda eservices childrenunderfive self harmrates riseinthenumberoflongtermventilatedbabiesriseinthenumberofinpatientmentalhealthadmissionspressureonhomecaresupport packages childrenremaininginhospitaloncemedicallyfitfordischargeimpactuponthequalityoflifeforourmostcomplexchildrenandtheirfamilies 18 financialchallenges costofa eandinpatientadmissionsaretariffbasedandhighfinancialchallengesimpactinguponallorganisations needtodevelopmoreeffectiveandefficientlocalservicesacrossagencieswhichavoidduplicationensurestreamlinedpathwaysimproveoutcomesvalueformoneycamhservicesweresubjecttoatenderexerciseandneedtobere tenderednolaterthan1stoctober2014 19 jointcommissioningopportunities ncccurrentlycarryingout2majorareasofre provisioningsen disability designatedspecialprovision dsp review ehcplansre commissioningearlyhelpandpreventionservices children scentresandsupportservicestoover5 sopportunitiestofullyaligncommissioningactivitynow 20 ehcplansandsenprovisionreviewsenchangesanddesignatedspecialistprovisiondspreviewalisonshipleynorthamptonshirecountycouncil ehcprocesssupportschild family schoolswithlocalofferifassessmentorplansnotagreedgreaterpersonalisationshorterprocess 20weeks externallyfacilitatedco ordinationofeducation healthandcareneeds provisionasrequiredreviewedannuallypossibilityofnotionalorrealpersonalbudgetscanbeinplace0 25ifrequired ehcprocess plans rolloutfornewrequestsforstatutoryassessmentehcprocesscurrentlybeingofferedtonewapplicantsinkettering corby wellingborough eastnorthants ehcprocesswillbeofferedtootherareason 1stnovember2013 daventry south 1stjanuary2013 countywiderowangatespecialschooltriallingtransferofstatementstoehcplansfromnovember2013 ehcrollout thereviewwascommissionedtoevaluate thediversityofprovisioninthecounty sresourcedprovisions rps andsenunitprovisions ups theimpactofthespecial specialistprovisionondevelopinginclusivepracticeandimprovingoutcomesforallchildrenaswellasthosesupportedinspecial specialistprovisionthecostofcurrentspecial specialistprovisionanditssustainabilityinthelightofchangesinfundingmechanismsandcurrentfinancialrestraints senprovisionreview scope childrenandyoungpeopleshouldaccessawiderrangeofopportunitieslocally andamorepersonalisededucationoffer throughthepartnershipworkingofschoolswithotherschools alternativeprovidersandspecial specialistservicesreviewthespeechandlanguageresourcedprovisionsinpartnershipwiththeneneandcorbyclinicalcommissioninggroupsffacilitatetheprovisionofanallthroughspecialschoolinthesouthofthecountyforasd sldandpmld senprovisionreview implicationsforall commissionbridgingplacesforsecondaryagedyoungpeopleforthelatouseforday6provision assessmentforpermanentlyexcludedpupilsandforschoolstocommission placesfortheassessmentofpupilsatriskofpermanentexclusionorinneedofspecialistsupportforre integrationdevelopacontinuumofprovisionacrossthecountyforbesdandautismpromotingpartnershipworkingbetweenspecialschools senunitsandmainstreamschools senprovisionreview implicationsforall establishsatelliteunitswhowillworkwithanagreednumberofprimaryschoolchildrenatanyonetimetoimplement underthesupervisionandguidanceofthespecialschools arangeofprovisionandprogrammesforprimarypupilsatriskofpermanentexclusionorpermanentlyexcluded senprovisionreview implicationsforall nccinpartnershipwithotherstakeholderstoreviewandre configurethecapacityofcentrallymanagededucationservicesregaincentralresponsibilityforreceivingdirectnotificationfromschoolsofpermanentexclusionsandarrangingday6provisionforthemcommission fromarangeofproviders packagesofeducationtailoredtomeettheneedsofeachpermanentlyexcludedsecondarypupil asclosetotheirhomeaspossiblere commission de commissionspecial specialistprovisionwherenecessary senprovisionreviewcentralservicesre design reviewthefundingarrangementsforspecial specialistprovisionensureallprovisionisofhighqualityandvalueformoneyre commissionspeechandlanguageprovisionforchildrentoestablishanequitablecountywideservice withneneandcorbyclinicalcommissioninggroups centralservicesre design informalconsultationheld7thjune2014formalconsultationwithstakeholdersoctober december2013cabinet january2014implementation may2014onwards senprovisionreview timescales earlyhelp preventionforchildrenandfamiliesinnorthamptonshirestephenmarksnorthamptonshirecountycouncil toenablechildrenandfamiliestoaccessappropriatesupportasearlyaspossible tohelpthemmaintaintheirqualityoflife preventanyproblemsgettingworseandreducethedemandforhighcost specialistsupportservices purpose allfamiliesareabletomaintainhealthyandstablelivingconditions allfamiliesarestrongenoughtomanagestressovermoney poverty unemployment allfamiliescangiveandreceivesupportfromfriends neighboursandthewidercommunity allchildrenandyoungpeopledowellineducationandthisgivesthemtheskillstheyneedtofindwork allfamiliesmaintaingoodhealthandwellbeingforhappier healthierlives allparentssupporttheirchildren shealthyphysical emotional learningandsocialdevelopment allfamiliesmaintainstableandgoodqualityfamilyrelationships outcomesforchildren families tier universal specialist specialist universal costssavingsgeneratedbyreductioninvolume stockandflow prevention earlierintervention stagenotage helpingyoutohelpyourself helpingyouwhenyoucan thelpyourself preventionanddemandmanagement current future earlyhelp earlyhelp targetedprevention targetedprevention earlyhelpforumareas statutoryandpriorityservicesfornccearlyhelpandpreventioncommissioning children scentreservices under5s supportingservicesinterpersonalviolenceservicesyouthprovisionservicesforyoungpeoplewithchallengingbehavioursparenting keytargetdates supportingservicestender launchofinvitationtotender midoctober2013tenderwillclose latenovember2013tenderevaluationandmoderation december2013tojanuary2014awardoftender late jan2014tomid feb2014mobilisation transitionandimplementation midfebtomay2014servicescommencementdate june2014 keytargetdates children scentreservicestender prequalificationquestionnaireopens lateoct2013pqqcloses earlydec2013launchofinvitationtotender middec2013tenderwillclose earlyfeb2014tenderevaluationandmoderation midfeb earlymarch2014award latemarch earlyapril2014mobilisation transitionandimplementation apriltolatejuly2014servicescommencementdatelatejuly earlyaugust2014 otherjointcommissioningopportunities regionalspecialisedcommissioning neonatalpathways highdependency acquiredbraininjury abi specialistrehabilitationandtier4inpatientcamhsetc publichealth renewedfocusonemotionalwellbeingasunderpinningpoorhealthoutcomesfurtheropportunitiestoalignapproacheswithalcoholandsubstancemisuse sexualhealthetc policeandcommunitysafetyinitiatives focussingonprevention opportunitiesforclosercollaborationsafeguardingimprovementplans opportunitiestoconsideramorejoinedupapproach 40 serviceredesignareas keyinterfacesncc earlyhelpncc socialcarencc educationalpsychologyclinicalcommissioninggroup s adultmentalhealthcommissioningyouthoffendingservice yos keyinterfacesncc senanddisability ehc provisionreviewccg s adultldcommissioningccg s communityservices longtermconditions keyinterfacesa eandacutehospitalsncc socialcareacutepaediatricservicesccg scommunityservices whatserviceswillthisinvolve 42 linked nccfunded tamhsadhdsupportserviceyouthcounsellingserviceshomestart whatserviceswillthisinvolve 43 whatserviceswillthisinvolve 44 whatserviceswillthisinvolve 45 recommissioningareasdonotincludehealthvisitingandmainstreamschoolnursing whatisthetimeline 46 changeprocess servicescurrentlydeliveredarevaluedandwillcontinuetoberequired buildupontheareasofgoodpracticeandanopportunityfornewmodelsofdeliverystaffwillfeelanxiousandunsure wedonotwanttolosestaff ensureeffectivecommunicationthroughouttheprocesstupetransferconditionswillapply providerorganisationswillhavearesponsibilitytoensurestaffarefullybriefedaboutwhatthismeansforthemparentswillfeelanxious thisisanopportunityensureequitableandconsistentservicedelivery newservicemodelsshouldberesponsivetoparentandchild sneeds 47 programmegovernance 48 childrenandyoungpeople sre commissioning projectsteeringgroup parent carerco productionconfirm challenge childrenandyoungpeopleco productionconfirm challenge stakeholdergroups corbyccg neneccg jointcommissioningboard lscbn cypbb health wellbeingboard summary 49 questions 50 demographics needsassessmentdavidloyd hearn commissioningleadchildren youngpeopleemotionalwellbeing mentalhealthsianheale commissioningleadchildren youngpeoplesen disability acute complexandcontinuingcare 51 demographicsofchildrenandyoungpeopleinnorthamptonshire 52 needsanalysis demographics thefollowingfiguresaretakenfromvarioussourcesacrossthenhs countyanddistrictcouncils providerpartners andcentralgovernmentagencies whereprevalencefiguresorindicatorsofneedaresourced thesearetakenfromnationalandinternationalresearchpapersandappliedtothepopulationasatthe2011census thesefigureschangeonaregularbasisdependentondemandforservicesandarethereforeintendedtogiveaperspectiveonthekeytrendsaffectingchildrenandyoungpeopleservicesacrossnorthamptonshire 53 needsanalysis populationdemographics northamptonshirehasapopulationof691 952ofwhich171 736 24 8 arechildrenandyoungpeopleaged0to19yearswecanexpect1000morechildrenlivinginnorthamptonshireeachyearupto2020therewere9 229birthsin2011ofwhich21 ofbirthsweretomothersbornoutsidetheukaround24 000childreninthecountyliveinpoverty whichisapproximately1in6children rangingfrom21 innorthamptonto6 insouthnorthants75 ofthechildreninpovertylivewithaloneparent50 offamiliesinpovertyhaveachildaged0 4 54 needsanalysis populationdemographics education ofpupilsachieving5a tocgcsegrades northamptonshire55 0 corby47 0 tosouthnorthamptonshire71 2 employment adultsinemployment uk 70 1 andnorthamptonshire 76 8 physicalactivity adultparticipationin30minutes moderateintensitysport england36 0 northamptonshire34 0 wellingborough23 1 tonorthampton37 1 55 startingwell promoteswellbeingofbothparentsandinfants programmestosupportsecureattachmentwithparentsandcarersbreastfeedingsupportsupportinggoodparentingskills1930parentsaccessedparentingprogrammesincluding379parentsofchildrenwithspecialeducationneedsand1243parentswithparticularneeds 1000ofwhoaccessedservicesix 46 012childrenaged0 4 pre schoolandschoolprogrammes 44 8 of3and4yearoldchildrenbenefitfromearlyeducationplacesinnorthamptonshire england47 97 ofunder5 sattendingpre schoolprogrammes fornorthamptonshire england86 c108 000childrenattendschoolc4000childrenandyoungpeoplehavestatements3 4 comparedtoenglandaverageof2 8 variablelocalprovisionofschoolbasedsocialemotionallearningprogrammeswhichresultinnetsavingsof 84foreach spent dh 2011 105pupils0 1 werepermanentlyexcluded 2011 12 childrenandadolescents vulnerablegroups lookedafterchildren bythestate 5foldincreasedriskofmentaldisorder meltzeretal 2003 768innorthamptonshire childrenwithlearningdisability 6 5foldincreasedriskofmentalillness emersonandhatton 2007 specialeducationalneed or3 7 parry langdonetal 2008 youngoffenders 18foldincreasedriskofsuicideformenincustodyage15 17 fazeletal 2005 childrenandadolescents vulnerablegroupschildrenwithdisability withinnorthamptonshirethereareapproximately3500 4500childrenwithadisabilityapprox 2000couldbeestimatedtohaveamoderatelearningdisabilityofthe2000withotherdisabilities thereare approx 72withprofoundandmultiplelearningdisability pmld approx 400withseverelearningdisability sld approx 700withautisticspectrumdisorder asd althoughlocalestimatesputthisnearer1000approx 400withphysicaldisability pd approx 225withsensoryimpairment si approx 30withacquiredbraininjury abi 59 needsanalysis vulnerablegroups 60 prevalenceestimatesbasedonnationalfigures riskfactors childprotectionplansinnorthamptonshire thereare667childrenwithachildprotectionplan15 020of11 17yearoldsestimatedtoexperienceseveremaltreatmentduringchildhoodsexualabusesinglelargestriskfactorformentaldisorder3081under18yearoldsexperiencesexualintercourse conductdisordernorthamptonshire conductdisorderaffectsest 5299aged5 16yearolds 795million lifetimecostofeachoneyearcohortof5 16yearoldswithconductdisorderinnorthamptonshireparentinginterventions nice 2013 firstlinepreventsantisocialpersonalitydisorderinadulthood nice 2009 2 1 154 parentsaccessedparentinggroupsinrelationtomanagingbehaviournote 632millionannualcostofcrimebyadultsinnorthamptonshirewhohadconductdisorderandsub thresholdconductdisorderduringchildhoodandadolescencenoteanestimatedsavingsof 71mifparentinginterventionssupportedallthechildrenwithconductdisorders emotionalwellbeingandmentalhealth 63 whyisemotionalwellbeingandmentalhealthsoimportantforchildrenandyoungpeople 64 impactsofemotionalandconductdisorderinchildrenandyoungpeopleinuk greenetal 2005 schoolbasedpreventioninterventions variableevidencethatfollowingcosteffectiveapproachesareprovidedinnorthamptonshire preventionofconductdisorderthroughschoolbasedsocialemotionalprogrammes 84 schoolbasedbullyingprevention 14 schoolbasedviolencepreventionprogrammesnotenorthamptonshire shighernumberoffixedperiodexclusions7 8 england6 5 andpermanentexclusions0 12 england0 08 emotionalwellbeingandmentalhealthneedsassessmentandservicereview 67 keyneedsidentified 68 reviewofselfharm nationaloutlier nationalratesofself reportedself harmare7 for11 16yearoldsbutseveraltimeshigherinthosewith emotionaldisorder 28 conductdisorder 21 adhd 18 287childrenandyoungpeoplehavepresentedata eforselfharm highestprevalencewas17 19 howeverthe11 16yearoldscontinuetorisechildandadolescentadmissionsforselfharmper100 000 2010 11 northamptonshire169 9comparedtoengland124 8 althoughweadheretotheniceguidelines applyingnationalratestonorthamptonshirewouldmeanthat359011 16yearoldswouldreportself harm ouractualfigureislower thoughinsecondaryschoolsanecdotalevidencesuggeststheratescouldbeasmanyas50 reviewofselfharm nationaloutlier northamptonshireperformswith