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Running Horse Group - Event Outcomes (25th May 2018)


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Summary notes from the RHG meeting held at the Health Foundation. For information on the RHG go to

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Running Horse Group - Event Outcomes (25th May 2018)

  1. 1. Running Horse Group meeting The Health Foundation Friday 25th May 2018
  2. 2. Meeting Overview • Mapping the problems faced in Children Health • Sharing current members’ projects & their learning • Thinking about the future and potential to become a special interest group within the Health Foundation’s Q network
  3. 3. Social determinants Patient involvement Data Ethics Sharing information Use of technology Finance & funding Political voice of childrenStaffing & morale Models of care Prevention Quality Improvement Innovation What did attendees think were the core problems?
  4. 4. Healthier Together project (Sanjay) • Broader approaches to school measures (eg. School attendance) • Other issues in lives of families that are more pressing eg deportation, money issues and employment Child Health Festival (Guddi/ Camilla) • Getting trainees to attend • Other organizations are not willing to share/disseminate knowledge • Whole Family wellness • Prevention work – obesity and allergy Core Issues Suggested Projects
  5. 5. Hospital services review (Nicola Jay) • Peer networks like this to generate ideas, learn from innovators and elsewhere in the UK MEDS IQ • Seeing what has worked well as sharing the knowledge Other • Lack of evaluation of QI projects affects sustainability of long- term funding • Satisfaction with mediocrity • How to change culture • Understanding and measuring of QI • Not modernising as fast as the rest of society eg social, medical and new ways of communicating • Need for innovation – we’re doing things because we have always done them that way Innovation Core Issues Suggested Projects
  6. 6. RCPCH and US • Passion of the And Us team at RCPCH and the CYP engagement committee as great example YYA programme • Persuading people to be brave enough to embrace a new way of working Community Organising (Imperial Citizens UK ) Bob K Meaningfully involve children & young people in service design & strategic priority setting • No focal point for child health • Enabling patients and public to have control and do more • Voice of the baby – group need to embrace the 0 of the 0-12yrs too • Lack of asking what people want/need for their health “co-production” is superficial or absent • Lack of clarity about what the “ask” is from CYP when involving them • PPI (patient and public involvement) groups through college or hospital • Perception of others that informal/age-appropriate format means content generated less serious or important Core Issues Suggested Projects
  7. 7. Child health Promise • Data regulation – building barriers to those outside health to contribute Other • Parental rights versus children rights • Long term ventilation • Consistent messages and values of the profession Ethics Core Issues Suggested Projects
  8. 8. PIER network – Kate Pryde/ Southampto n Child Health Promise (Camilla/ Guddi/ RSM) Working together programme South Yorkshire (Nicola Jay) Healthier Together programme (Sanjay) • Tension between people and systems • Sharing GP/other hospital data/social care data/community/CAMHS data • Repetition of evidence/writing/information/access areas/multiple Drs and lack of awareness of what else out there or been done before/not aware of who is going or has done what • Understanding data pathways, systems and networks Sharing information • Consistency/sharing information – education programme/Spanning HVs/ED/midwives/A&E/ GPs • Creating/joining effective network - need face to face and online interaction • Creating strong relationship - dancing together! • Breaking down silos and building buy-in without resources Core Issues Suggested Projects
  9. 9. Perinatal and paediatric future technologies hub for London (David Cox) Role of telemedicine in NHS 111 project – Hampshire STP and Healthier Together project Drug Calculator Apps (Meds IQ) • Capital expenditure limits blocking investment in tech • Working in new ways across boundaries population health integration and digital health • Outdated hardware and software hampering staff • Transforming care through technology • Difficulty for vulnerable groups to access and use technology • Governance issues blocking tech innovation Core Issues Suggested Projects
  10. 10. Broaden the Frame of sustainability Health Economics training for doctors Engaging with managers • Cost and narrative – making the argument for an economic impact Core Issues Suggested Projects
  11. 11. • Developing political strategy to make short-term wins and long term wins • Translating evidence into policy – both locally and nationally • Lack of national priority for children Political voice of children • National policy and drivers • Rewards, need per charge and reward intent from think tanks • <5% of medical research is for CYP Core Issues
  12. 12. Everyone Can Groove (Guddi) Create educational work schedules for all paediatric trainees Randomised Coffee Trials at Addie’s – 70+ people turned up Working together programme/ Vanguarding (Nicola Jay) Joy in work “sprinkling glitter” Hospital services review (Nicola Jay) Staff resilience programme (Chloe & Evelina) Staffing & morale • Staff wellbeing and burnout • Recruitment and retention • “Own worst enemy” • Workforce skill mix • Morale of staff  all about the discretionary effort • Health Foundation Spark tool • Personalised work schedule in enshrining protected time for trainees to solve some of these issues • Common enabler along projects – enthusiastic and committed staff • Funding and local sustainability • Develop skills in QI/L&M/ Policy etc • Short -termism – fill rota slot for SpR shift tonight versus moral/feeling valued/promoting motivation • Workforce strategy is still Dr centric, and still based on Consultant numbers • Lack of common training pathways in paediatric and public health Core Issues Suggested Projects
  13. 13. @mumba be2gether Sending young people appointment reminder as well as their parents – in trial Improved ambulatory service PICH (Chloe M) Reducing variation in acute asthma care CC4C Bob K +Mando Hospital services review (Nicola Jay) Healthier Together (Sanjay) • System fragmentation • Models of care – need to respond to new demands • Risks associated with service fragmentation • Enthusiasm of people who want to make things better • Resistance to change • Joined up data (WSIC – NW London) • Change takes time • “difficult people” • Connecting care children’s hubs in pilot- Hampshire – Healthier Together/Hampshire Children’s STP • Networks and children’s engagement Models of care Toolkit to share with other regions/spread Core Issues Suggested Projects
  14. 14. Trauma prevention work What does the implementation of prevention look like? • Strategic intention to focus on prevention boy National Services 5YFV • No network to tap into Working together programs/ vanguard (Nicola Jay) • Committed motivated people who are on board with integrating prevention Prevention • Political interest in prevention • Long term outcomes not appealing to short political cycles Core Issues Suggested Projects
  15. 15. Huddles (RCPCH SAFE) QI Education QI IQ HUB (RCPCH) QIPS forum (RCPCH)) Diabetes QI collaborative) SAFE (RCPCH) Quality Improvement • Lack of QI network • Variable standards of QI implementation Core Issues Suggested Projects
  16. 16. Current RHG network
  17. 17. Potential activities of RHG network
  18. 18. The Big Picture: National Policy Political Influence Media Pressures Socio-Economic impact The Local Context: Staffing Relationships (Intra/Inter Department) Responsivity to change Regulatory Pressure (CQC etc.) We are all pulled in two directions (which are related but not always easy to deal with simultaneously)
  19. 19. Next steps… Opportunity to become a Special interest group within Q network Applications to become a Q member will reopen on 14th June 2018 Before deciding to become a SIG, working group meeting to establish: (i) Purpose of the RHG network within current paediatric landscape (ii) Identify a strategy to develop the network (iii) Consider relationships with other paediatric networks Date of working group meeting TBC – (July/Aug 2018)