Future Health Policy related to Children and Young People

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Future Health Policy related to Children and
Young People The Contribution of Childrens
Nursing

• Liz Morgan Professional Advisor
• Children, Young People Families
• Department of Health
• 13th November 2008

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Improving health and well-being
We value people We care about people and put
their health and well-being at the heart of
everything we do
Setting direction and priorities Supporting
delivery Leading health and well-being for
Government Accounting to Parliament and the
public Supporting DH staff to succeed
We value purpose We focus our actions and
decisions on achieving shared goals
WHAT WE DO
Better health well-being Bettercare Better
value
WHAT WE VALUE
WHY WE ARE HERE
We value working together We work together as one
department and with our partners and stakeholders
FORALL
We value accountability We take responsibility
and are open to challenge
Working with the NHS, social care and partners
Working with Ministers
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Purpose, Role and Values
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Purpose, Role and Values
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Children, Families Maternity Mapping to DH
Strategic Objectives
BETTER HEALTH WELLBEING FOR ALL
BETTER CARE FOR ALL
BETTER VALUE FOR ALL
Providing top quality public parliamentary
accountability for CFM Health Policy
Improving access to appropriate care for CFM
Improving CFMs experience of care
Improving safety quality of care for CFM
Providing continuity of Care across integrated
care pathways
Supporting the NHS and partners in the
development of World Class Commissioning for CFM
services through provision of modelling and other
tools improved data and evidence
Reducing inequalities in health outcomes for CFM
Delivering Top Quality partnerships engagement
with stakeholders
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• So
• The Challenges of Policy Making for Children
  Young People

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The NHS Next Stage review High Quality for All
(DARZI)

• Working with NHS staff to ensure that clinical
  decision-making is at the heart of the future of
  the NHS and the pattern of service delivery
• Improving patient care, including high-quality,
  joined-up services for those suffering long-term
  or life-threatening conditions, and ensuring
  patients are treated with dignity in safe, clean
  environments
• Delivering more accessible and more convenient
  care integrated across primary and secondary
  providers, reflecting best value for money and
  offering services in the most appropriate
  settings for patients

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Defining Quality (NSR)

• Three elements
• Patient Safety
• Effectiveness of Care
• Patient Experience

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Principles of Change

• Co-production working together
• Subsidiarity decisions made as close to
  patients the community as possible
• Clinical Leadership
• System alignment same goals

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Key Policy Messages translated to Children
Families

• Listening to the child family
• Developing services around the family
• Care closer to home/at home
• Integration of the workforce
• Partnership working across health, education
  social care

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The Childrens Plan Building brighter futures

• Childrens Plan sets out the vision for children
  young people, and trailed development of a
  Child Health Strategy.
• Governments 2020 ambition for all children and
  young people is to
• Secure the wellbeing and health of children and
  young people
• Safeguard the young and vulnerable
• Achieve world class standards in education and
• Close the gap in educational achievement for
  children from disadvantaged families
• Ensure young people are participating and
  achieving their potential to 18 and beyond
• Keep children an young people of the path to
  success.

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Joint DH/DCSF Child health Strategy - development

• Purpose of the Strategy
• Reinforce and capitalise on the existing vision
• and policy for child health
• Profile and maximise impact of current
  commitments and activity over the current CSR
  period
• Identify additional work required to underpin
  delivery of the long term vision set out in the
• Childrens Plan, NSF and Every Child Matters
• Engage parents and families in the long term
  challenges and aspirations while focussing on
  mechanisms for delivery

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The Child Health Strategy must respond to the
specific challenges faced by vulnerable groups
and ill children, as well as promoting healthy
behaviour by all children and young people

• We need to ensure services are sufficiently
• Integrated
• Personalised
• Preventative
• Targeted

• We are struggling to meet many of todays biggest
  public health challenges and there are worrying
  trends.
• Health promotion is critical.

• Children with long term conditions or
  disabilities do not get the support needed to
  fulfill their potential.
• Key issues around access to specialists and
  age-appropriateness of settings where treatment
  is received.

• We do not consistently undertake risk assessments
  and target support.
• Groups suffer disproportionately poor health
  outcomes
• Miss opportunities to intervene early

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Child Health Strategy development contd.

• Key Challenges to address
• Unwanted variability in outcomes and
• effectiveness of services
• Poor co-ordination of services a barrier to
  personalisation and a shift to prevention
• Nature of public health challenges

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Child Health Strategy development contd.

• Emerging themes
• Health promotion and prevention (eg informing
  families and supporting healthy lifestyles)
• Early intervention
• Personalised and integrated services (accessible
  and designed around the needs of users)
• Effective, targeted access to specialist services

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What are the Current Priorities of Policy
Colleagues

• Delivering Maternity Matters and CHPP in
  appropriate
• settings
• Supporting the Neonatal Taskforce
• Supporting School Health Services
• Delivering Care for sick children and young
  people (Acute
• care, care closer to home, long term conditions)
• Need for more health staff (including nurses)
  working with
• other members of the wider childrens workforce
  in the
• community and in school settings
• Need for common core training for those working
  with
• children and young people early in their
  training
• Need to keep a focus on the sick child and
  workforce
• issues for acute services (including doctors)
  and complex
• care
• Need for Skills for Health to expand to include
  more on
• children and young people

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Current Childrens Workforce Issues

• Darzi Next Stage review including review
  maternity,
• the new born and childrens services as well as
  the
• review of workforce planning - High Quality
  for All
• Primary Care Strategy
• Inequalities Agenda
• DSCF long term Workforce strategy to support 10
  year Childrens Plan
• PCT LA Joint Needs Assessments joint
• commissioning and workforce planning
• SHA role
• National Neonatal Taskforce (including workforce
  sub-group)
• Maternity current and future services, access
  to help and advice within 12 weeks of pregnancy
• Adolescent health

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Nursing Workforce Priorities

• Health visiting
• School nursing
• Neonatal nursing and paediatric medicine
• Community Childrens Nursing
• Speech and Language Therapy

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• Making it Happen

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Child Health and Wellbeing is a priority for the
Government this is reflected in the NHS
Operating Framework and related Vital Signs and
NIS indicators

• NHS Operating Framework
• Children and maternity services are identified as
  part of the national priority areas for 2008-09
• Supporting this 5 of the 12 PSA indicators focus
  on child health, 4 are reflected in the Vital
  Signs indicators for PCTs
• 3 of these PSA indicators breast-feeding at
  6-8 weeks, obesity among primary aged children,
  and CAMHS are national priorities for local
  delivery i.e. all PCTs required to include in
  local plans
• There is also a PSA priority on services for
  disabled people therefore includes CYP PCTs
  working with communities and local partners
  prioritise for themselves

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2008/09 Operating Framework

• five key Areas where PCTs are expected
• (working with local partners) to pay particular
  attention
• Improving cleanliness and reducing HCAIs
• Improving access through the 18 week referral
  pledge access to GP services
• Keeping adults children well, improving health
  and reducing health inequalities
• Improving patient experience, staff satisfaction
  and engagement
• Preparing to respond in a state of emergency,
  such as an outbreak of pandemic flu

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Commissioning is the Key

• World Class Commissioning
• Transforming Community Services
• Outcomes focussed
• Data evidence

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Red Relationships

• Absolute dependency, requiring co-location
• Oncology (including haematological oncology) Red
  relationships
• Clinical haematology
• Specialised surgery
• Paediatric critical care
• Paediatric anaesthesia
• relates to the core services, required by 16
  of the 23 services in the grid.
• Changes agreed at the last Steering Group
  differentiate neuro oncology which has a red
  relationship with neurosurgery, from neurology
  which has an amber 3 relationship with neuro
  surgery.

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Amber relationships

• Amber 1 Planned intervention
• Timescale as required
• Amber 2 Visit by a consultant specialist, or
  transfer of
• care
• Timescale next working day
• Amber 3 An integrated clinical service
• Visit by consultant paediatric
  specialist / transfer of care
  Timescale available within 4 hours
  Co-location desirable but may not be practical
• in all configurations

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More Amber

• Amber 3
• co-location is essential to provide a full
• specialised service, but a decision not to
• co-locate may be made to ensure optimum
• access to service centres. If an Amber 3
  relationship is not co-located the medical
  specialty would not be able to provide a
• full specialised service and a very close
  clinical network with the relevant surgical
  specialty would be essential.

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• Contribution of Nursing

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Nursing Related Policy

• Modernising Nursing Careers
• Review of pre-registration education
• Post-registration Careers Framework
• Nurses in Society
• Assistant Practitioner
• Nursing Metrics

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• Thank you
• Questions?
• liz.morgan_at_dh.gov.gsi.uk