Gill Harries, General Manager Childrens Services CHFT, and Dil Ashraf GP, Great Huddersfield CCG Childrens Lead present on child health care closer to home on behalf of the C3 project team.

1. Gill Harries General Manager Childrens Services CHFT
Dil Ashraf GP, Great Huddersfield CCG Childrens Lead
On behalf of the C3 project team

2. C3 Working In Partnership

3. Result required!
• To move non-acute care into the community setting
• To ensure that patient views and experience are at the heart of
the project.
• Empower families to have the confidence to manage their own
health conditions and to maximise their independence
• Forge closer links/communication with GPs/HV/ ScN, Public health
and local authority etc.
• Develop pathways of care and offer education and expertise
within primary care

4. Testing -C3 Pilot Areas
Greater Huddersfield pilot area- GP surgery
deprived area with overcrowded housing, high ethnic
mix, high population of children.
Calderdale pilot area- Children Centre
deprived area, 2nd generation unemployed, high % of
social housing, teenage mothers, 95% population of
white British,

5. What we have found out so far!
• Reduction in DNA rates and lower new to follow up ratios
• Very positive patient feedback – offering services for a
community in their community.
• Developed pathways for primary care e.g asthma, constipation,
abdominal pain, enuresis
• Developed a website for professionals/families with health
advice, clinical pathways
• Developed key links between Primary and Secondary care
• Offer a learning environment for students, GPs
• Phlebotomy service for children in primary care setting
• Close links with Public Health working towards the Maximising
Independence agenda.
• monthly news letter for GP practices and other partners

8. C3 What have the families said!
• Good idea having a clinic outside the hospital”
• “We found it very handy as we just live down the road”
• “Good luck and hope it works as it’s good having a clinic
close by that we can get to at a more convenient time of
day”
• “It’s so much easier to park here!”
• “Got a quick appointment”
• “was only waiting about 5 minutes which is much better
than waiting time at the hospital. Very convenient, the
staff were very friendly. It was pleasant”.
• “The consultant and Nurse Practitioner were fantastic”.
• My child already goes to the nursery here so it is very good
We could come at the same time that we pick her up.

9. C3 What the professional involved said
• has increased my confidence to care for Non acute cases (APNP)
• Delivering a clinic in a non clinical environment has its draw backs
(Consultant)
• Education meeting prior to C3 clinic for gp's in that federation eg once a
month where they could discuss any current case scenario's in their practice
(GP)
• I have really enjoyed the pilot and definitely feel more confident. Also have a
greater understanding of the processes within secondary care.
• I have greatly enjoyed and benefitted from collaborative working. The
discussion of referrals at the start of clinic and debrief after is invaluable and I
would say an essential part of the collaboration and future model (GP )
• Multi agency working has been really good, working alongside Sarah, Amanda
and David has given me a different perspective and helped me think
differently about situations. It has also helped about discussing other clinical
situations not related to the clinic! (Consultant )

10. C3Learning !
• Delivering family friendly services in the community results in
multiple family members attending. We utilize this opportunity
to offer education especially in the evening service.
• Delivering services in a children centre has required creative
solutions
• Change requires tenacity and commitment from all involved
• Communication is key with everyone from families to
professionals!
• Opportunist clinical supervision offers different way of working
and has been a benefit to all
• Multi agency working is complex as we all have different view
points, drivers and pressures
• Acute Trust is good at providing services within the hospital
setting but it can raise challenges in a Primary Care setting.

11. C3 Future
• Integrate IT systems
• Further ddevelopment of roles- ANPs and CCNs, training
opportunities
• Applied for further funding from the Health Foundation
• 2nd six month evaluation is underway
• Working with Nuffield Trust to explore innovation in
community delivered services
• Looing at how further acute care can move to community
settings
• Working with public health to looking at health needs of
pilot populations
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12. Let Us Share Our Learning?
• Please contact us : gill.harries@cht.nhs.uk
• Dilshad.ashraf@greaterhuddersfieldccg.nhs.uk
• Link to our C3 website: http://c3.cht.nhs.uk