1. Chi
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Improving Health Needs Assessment
processes for newly looked after children
and young people.
AHPs leading better care in a multi professional, partnership setting.
A Macleod, Clinical Lead Dietitian, Paediatrics§
, R Barclay, Service Development Manager, Children’s Services§
, Dr L Watson, Consultant in Public Health Medicine, Child Health Commissioner§
Dr L Hay, School of Medicine†
§
NHS Fife †
University of St Andrews, Fife. Contact: alisonmacleod1@nhs.net
Background
Looked after children and young people have
poorer life outcomes and are likely to have
additional physical and emotional health needs
compared with their non looked after peers1
.
Health Boards in Scotland are expected to
provide all newly looked after children (LAC)
with a Health Needs Assessment (HA) within 28
days of notification by the Council2
, enabling
earlier planned access to any required services, to
improve wellbeing and enable them to reach their
full potential3
.
In 2015, NHS Fife Corporate Parent Board
approved a target to increase by 31 March 2016
(Stage 1), from 60% to 80% the proportion of
newly looked after children who are offered an HA
within 4 weeks of notification from Social Work.
This poster describes parts of a project undertaken
by Alison Macleod (AM) to improve the HA
processes for LAC.
Aims
AM was seconded to a project (0.2 WTE for
6 months) to i) review Social Work and NHS
processes ii) work with key staff to streamline
systems, increase NHS capacity and make
more effective use of available resources to
meet the HA target.
Audit work4
identified a need for
improvements in the following processes:
1. Notification and receipt of all required referral
documentation from Social Work (SW) to NHS
Fife, to enable the HA to be undertaken within
the agreed timescales, and
2. Improve communication between NHS and
Social Work to ensure families attend the
agreed appointments.
Methods
Blended learning and resources, focused
on project/change management and
quality improvement tools were used
to direct the performance of teams,
working in partnership to promote
collaborative discussions across staff
groups in both organisations. This helped
to facilitate focused problem solving
on selected topics and communicate
consistent messages about progress,
using data for improvement and data for
performance.
Results and Outcomes
This project has increased
• from 16% to 30% cases that can proceed to
HA with all required data obtained from SW
• from 26% to 50% children receiving a HA
within 8 weeks (56 days) of notification to
NHS
• the number of children with a completed HA
from 35 over 9 months in 2014 to 39 in
the last 4 months (2015/16)
This range of activities has also reduced
average time taken for all documents to be
sent from Social Work to NHS from 49 to
26 days.
Achievements
• Methods for reliable NHS data collection have
been validated.
• Blocks in systems and less helpful variation
in the processes were identified and in some
cases, eliminated.
• Updated, streamlined, transparent processes
for HA, with written agreement between Fife
Council and NHS Fife have been established.
Desired outcomes and target times for each
stage have been agreed by stakeholders.
• Increased awareness of the importance of the
HA, the targets and correct processes for NHS
clerical staff, leading to greater confidence in
managing this workload.
• A new single point of contact (SPOC) in health
and all-electronic transfer of documents in
process, to speed up system and enable HA
progress tracking.
Conclusions
A number of NES resources have
been helpful in undertaking this
project. More training and tools
to facilitate AHP leadership in
multiagency project management
would be welcome. This would
further spread the use of
improvement methodology in
organisational change and service
redesign.
References
1. Scott S, Hattie R Tannahill C (2013) Looked After Children in Glasgow
and Scotland: A Health Needs Assessment. Glasgow: Scottish Public Health
Network (ScotPHN).
2. Scottish Government (2009) Implementation of Action 15 of the Looked
After Children and Young People: We Can and Must Do Better Report. CEL
16 (2009). Edinburgh: Scottish Government. www.sehd.scot.nhs.uk/
mels/CEL2009_16.pdf
3. Scottish Government (2015) Getting It Right For Looked After Children
and Young People; Early Engagement, early permanence and improving the
quality of care. Edinburgh: Scottish Government.
4. Hay L (2015) Looked After Children’s Health Assessment Audit, NHS Fife,
January 2015, REPORT (Revised 6/2/15). NHS Fife, February 2015.
“Getting one person
to collating all the
documents will save lots
of clerical time”.
(Clerical Team)
“I think being able to
email the Social Worker
will make a big difference
and help speed up the
process. Looking forward
to trying it out”.
(Clerical Team)
“The process map is
very useful and reminds
me what I need to do
when”
(Social Worker)
“I am new to Fife. It was
helpful to be given the
timescales and the steps
that I need to do and
what health does in the
process”
(Social Worker)
“Good to have the
reasons explained for
importance of health
needs assessment and
reasons for timescales”
(Social Worker)