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Children and Young People3P review and redesign
multi-agency event
Development of an overall model of service delivery for children 0 -4 years of age which is adaptable to local multi-agency working and resources
Targets
Develop TEWV’s core offer for children 0 – 4 years Model of service delivery must be cost neutral. Identify gaps in service delivery for children and young people 0 – 4 years. Core offer should be applicable to all localities although event focus is Stockton Local Authority area
Deliverables:
• Model outline and summary • High level process map• Briefing sheet and communication plan • Action plan/newspaper
Case for Change
Present situation
• Commissioned for a 0-18 service• Predominantly provide for 5-18 year olds• Primary schools are reporting significant
issues in early years• Local authorities are focusing on early
help and early intervention• Fragmented pathways
Key Drivers
• Future in Mind-promoting, protecting and improving our children and young people’s mental health and wellbeing
• Autumn Statement 0-2 year early intervention pilots to avoid problems in later life
• Health Child Programme – (update due) child health programmes for 0-5 years to promote infant/parental attachment
Key Drivers continued
• Health Education England Mandate – Every birthing unit should have access to specialist perinatal mental health clinician
• Institute of Health Visitors & RC of Midwifery – training on MH
• Commissioning – Transfer of commissioning 0-5yrs public health services to local government
Conclusion
• Focus on recognising & promoting good mental health & wellbeing in all people, not just focusing on those with a mental illness or diagnosis.
• Evidence that supporting families & carers, building resilience reduces the burden of MH & PH over the whole life course
• Integrated & partnership approach is crucial to defining & meeting needs
Key Features of the Model • Whole system integration • Collaborative and transparent • Relationship led infrastructure • Clear process pathways • Universal offer• Creatively accessible • Positive outcomes • Comprehensive and high
quality • Needs led• Easy and simple • Ultra early intervention
• Helpful • Culturally intelligent• Celebrating success• Educational • Information sharing • Wellbeing • Engagement • Inclusive
Team Compact • Final Coat of Arms Two Team Designs
7 Designs
63 designs were produced by the group for consideration in the design build stage of the process
Model 1 THE PENGUINS
• Integrating mental health services into existing systems at the appropriate time
• Capacity building in workforce and community
• Managing complexity through supervision joint working and training
• Right intervention, right families, right time , right place with right outcomes
• Clear pathway driven by the CAF system
Model 2 THE TREE
• Collaboratively working to ensure families needs are met
• Responsive to the needs of families and provide timely response
• Open to all no matter what culture or belief
• Ensure that families know and understand the role of all services
• Celebrate with families and show case achievement.
Final Model
Mission
Working together we will promote, protect and improve the mental health and wellbeing of children under 5 and their families. This will support and enable the best start in life.
Model Features
• We will work together across all agencies to promote positive wellbeing for under 5’s, their families and communities
• We will use a single assessment tool to prevent families having to continuously re tell their story and improve information sharing
• We will ensure that a mental health perspective is available for every family that need it
Model Features cont.• We will provide ultra-early mental health support/advice/
interventions which will improve outcomes for children and their families
• We will strengthen the knowledge and expertise in early years mental health across services, families and communities
• We will ensure children and their families are able to access the right intervention at the right time in the right place to support the right outcome
• We will ensure that there are no barriers to access services with clear pathways that are simple to use
Accountability and Governance
TEWV Governance and Management Structure
Early Help Implementation Group
Children and Young People’s Partnership
Health and Well Being Board
Governance & Accountability
Governance & Accountability
Operational Delivery
Governance, Accountability
and Operational Delivery
Tees, Esk and Wear Valleys NHS Foundation Trust Under 5 Years Core Offer
UNIVERSAL
E.g. Health VisitorsMidwiferyGP’sChildren’s Centre’s VCSEducation Settings
TEWV CORE OFFER:Under 5 LeadWorkforce Development Support and ConsultationLiaison and Partnership Working.
EARLY HELP
Early Help HubTargeted Delivery from Universal ServicesTargeted ServicesE.g. Troubled Families, CAB, Housing, Social Care
TEWV CORE OFFER:
Under 5 LeadBespoke TrainingTargeted InterventionSupport and Consultation
MACH
Children and Families displaying higher level of need.
TEWV CORE OFFER:
Clinical SpecialistUnder 5 LeadJoint AssessmentConsultation and Supervision
TEWV & Specialist ServicesTargeted & Specialist CAMHSCrisisUnder 5 LeadPaediatricsSpeech and LanguageEducational PsychologyLooked After Children
Perinatal Mental HealthAdult Mental HealthOccupational TherapyFamily Nurse PartnershipSubstance MisuseHarbourSpecialist 3rd Sector Provision
What would this look like for families and children under 5 ?
Single assessment
Accessible
Ultra-early intervention
Evidence based
Whole Family approach
Timely
SeamlessTeam
working
DIAGRAMMING- FISHBONE DIAGRAM
People/skills/training
Policy
Method
Partners/clients Communication
Systems
Place/surroundingsEnvironment/technology
Management/money
Key Challenges
• Philosophical shift from having C&YP services at the end of the process
• Having a shared vision• Agreeing the detail and getting the buy in• Increase of referrals • Implementing the new model
Key Lessons Learnt • Breadth and depth of challenge and good
practice already in place• Increased understanding of multi-agency role
and contribution• Change can improve both work and you• Its gets better - stay with it• Innovative 3P approach which can be taken
back to own practice
We would like to thank ……..
• Sponsors Chris Davis and David Brown• Brian and Donna for their advice and
support• To everyone- it’s been great• Parents who shared their experience and
thoughts• Karen, Paul and Pauline
Special thanks
To all the partner agencies for their time, commitment and
invaluable contribution.