CYPHSC workshop_AA

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Amanda Allard, Principal Officer Council for Disabled Children. Embedding children’s voices within the new NHS

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  • It’s not just fluffy stuff, it really does have an impact on outcomes and in fact if it’s all about outcomes, which it should be, then whose outcomes should the health service be working towards?
  • Symbiosis between compliance and experience with an important side order of autonomy
  • Crash points for children are in infancy and adolescence.
  • Reason for optimism?Children being taken seriously at a more senior level than ever before? Certainly within last 25 years. CMO report focusing on children with chapter on neurodisabled children – usually talks about MRSA – still some way to go, didn’t think could do any focus groups with neurodisabled children.Continued commitment to the Outcomes ForumForum recommended 4 new indicators government accepted recommendation – talk about under drivers
  • Understanding the health system so we can make it listen!!
  • Currently CCGs at sea with person centred commissioning
  • The Mandate – Dan Poulter wants significant read across to the pledge when the Mandate is refreshed ready for April 2015NHS Outcomes Framework, originally included very few outcomes directly related to children and young people and a number that could have related were not measured for under 16s. The Government have accepted the HOF recommendations and have included two new outcomes for 13/14Potential years of life lost for c&ypCancer survival rates for childrenAll data will be presented in 5 year age bands to enable effective transition to be monitoredPlaceholder for developing a PREM, this should be ready shortly according to DH.DH looking at best way to capture patient experience of integrated care across all age ranges.Also looking at measures of child development at 2-2.5 years and school readiness.Looking at feasibility of extending all relevant measures to cover children.Are also looking at outcomes in the following areas:Further work around PREMsIntegrated careTime to diagnosis or agreed treatment planTransitionImpact of poor health on educationPH Outcomes Framework can’t be altered until 2015Maternal mental healthMental health problems in C&YPQuality and Outcomes Framework – QOF How GPs earn extra moneyThe ‘quality premium’ is intended to reward clinical commissioning groups (CCGs) for improvements in the quality of the services that they commission and for associated improvements in health outcomes and reducing inequalities. CQUINS similarly are payment designed to reward improvements in the delivery of careSpecialised Service Specifications outline expectations around what a good service should look like and sets key service outcomes. NHS England have just finished a consultation around transforming participation in specialised services and are recommending making stronger connections between the patient/carer reps on different groupsWomen and Children is one of the five national Programmes of Care (PoC), which have been designed to organise the individual service areas into five functional groupings.The national Women and Children PoC covers services in women and children, congenital and inherited diseases; this relates to both specialised and highly specialised prescribed services, and includes both surgical and medical services.The services in the PoC are clustered into Clinical Reference Groups (CRGs) to support the national work in these areas. There are 13 CRGs in the Women and ChildrenPoC and each CRG has 4 patient and carer member places.
  • Francis has recommended that Monitor and CQC be combined.
  • Local healthwatch have been told on set up that they have to act as a champion for children and young people. NCB have produced a fantastic resource which aims to help local Healthwatchs learn from the LiNKS and Healthwatch Pathfinder experiences of engaging with children and young peopleLocal Healthwatch have a seat at their HWBB – will feed in evidence from their local community to HWBB and Commissioners – virtuous feedback loop
  • Currently running a campaign to find out what people think about their local complaints system with intention of improving process 3 – collect and collate evidence from local groups to inform HWBB and Commissioners
  • Lots of tips for local healthwatch on how to successfully engage children and young people.
  • Changing culture, NHS focusing a lot of attention on changing culture of staff and we need to do what we can to change the culture of being a patient. Supporting people to become empowered consumers of the health system and that means not only understanding what the system is and how it works, what our rights are, but also knowing how to complain if those rights and our needs are not being met.
  • ‘many of the problems we face behave like epidemics. They aren't linear phenomena in the sense that they steadily and predictably change according to the level of effort brought to bear against them. They are capable of sudden and dramatic changes in direction. Years of well-intentioned intervention may have no impact at all, yet the right intervention - at just the right time - can start a cascade of change.’
  • CYPHSC workshop_AA

    1. 1. Amanda Allard Principal Officer Council for Disabled Children Children’s Voice and the NHS Oxymoron or opportunity?
    2. 2. Visit CDC’s website for all the latest news from our networks and members www.councilfordisabledchildren.org.uk
    3. 3. Why does voice matter? Young people Clinicians Parents/ carers
    4. 4. Why does voice matter?
    5. 5. Who’s the expert?
    6. 6. Sorry what did you say?
    7. 7. What happens if you don’t listen?
    8. 8. What happens if you don’t listen?
    9. 9. What happens if you don’t listen? hundreds of patients died at the hospital because of an obsession with meeting targets and a 'box-ticking culture'.
    10. 10. Strategic Focus on Children In response to Report of Children and Young People’s Outcomes Forum: • Defining and agreeing national leadership and accountability for children’s health in Children and Young People's Health Outcomes Board led by the Chief Medical Officer • New Children’s Partnership • New Children and Young People's Health Outcomes Forum co-chaired by Christine Lenehan, CDC • Pledge to provide better care for children and young people with long term condition and disability and increase life expectancy of those with life limiting conditions • New Outcome indicators for children and young people
    11. 11. DH Ministers Children and Young People’s Health Outcomes Forum Children and Young People’s Health Outcomes Board Children’s Health and Wellbeing Partnership LGA HEE Chair, Chief Executive NHS England Chair, Chief Executive SOLACE PHE Chair, Chief Executive Organisations accountable for policy, commissioning and delivery Independent bodies providing expertise, challenge, advice, recommendations Partnership for policy, commissioning and delivery ADCS Themed Groups Sub Groups / Task & Finish Groups Mediation & advice – with personal leadership of CMO Constructive challenge, advice, recommendations Response / decision Request for advice Two way communication Update to Recommendation from Children’s Partnership to organisation leadership. Decision by each member organisation’s governance CYP Outcome Board CYP Outcome Forum Children’s Health and Wellbeing Partnership Health Transition Task Group Aligned Themed and Sub / Task & Finish Groups to avoid duplication National organisations which are members of Children’s Partnership NHS Contribution to Public Health Governance System steward & secretariat role secretariat HWE Chair, Chief Executive DfE Ministers Health Transition Task Group NHS Contribution to Public Heath Senior Oversight Group secretariat secretariat ADPH NHS Clinical Commissioners Chair, Chief Executive
    12. 12. The new health system
    13. 13. National Health Leadership Bodies • Department of Health: Stewardship and guardianship. Secretary of State retains ultimate responsibility for NHS • NHS England: National commissioning body and system manager • Public Health England: provide information and intelligence to support local public health services and lead on national public health campaigns • Clinical Networks: bring together experts on particular conditions and service areas
    14. 14. Local Health Bodies • Clinical Commissioning Groups: Led by GP Practices with secondary specialists. Will commissioning local NHS services and will set out their strategy for local health services in annual commissioning plans • Local Authority Directors of Public Health: lead on local authorities’ new public health commissioning functions. • Health and Wellbeing Boards: bring local partners together in each local authority will to plan health, social care and public health services • Clinical Senates: Hosted by NHS England, give expert advice to the NHS Commissioning Board and CCGs in each area of the country
    15. 15. Drivers for delivery Specialised Service Specifications NHS England Senate Clinical Reference Groups to NHS England Commissioners Specifies outcomes for specific service Quality Premium and CQUINS NHS CB to CCGs and providers Additional quality specifications for additional payment Quality and Outcomes Framework NHS Commissioning Board to CCGs and providers Standard framework for rewarding contractors in the NHS for the provision of quality care Commissioning Outcome Indicator Set NHS Commissioning Board to Clinical Commissioning Groups Measures quality and outcomes to be achieved by Clinical Commissioning Groups NHS and Public Health Outcomes Frameworks Department of Health to NHS Commissioning Board General outcomes to measure impact of NHS The Mandate Department of Health to NHS Commissioning Board Broad Objectives and Priorities
    16. 16. Regulation and Oversight • Monitor: becomes economic regulator for all NHS services. Will promote economy, efficiency and effectiveness in the provision of services • CQC: responsible for overseeing compliance with quality requirements and powers to intervene to protect patient safety • Ofsted: responsible for regulation of children’s social care • Parliamentary and Health Services Ombudsman: Investigates individual complaints about poor NHS service
    17. 17. • Health Watch England: subcommittee of Care Quality Commission. Will support Local Health Watch and advise national health bodies. Can request CQC investigate poorly performing services. • Local Health Watch: Commissioned by LA, will replace LINKs and some elements of Patient Advice and Liaison Services. Will promote patient involvement in local health system, and provide info and advice about local services and choice • NHS independent complaints advocacy: commissioned by local authorities, accessible through Health Watch Voice and Involvement
    18. 18. Local Healthwatch Provide information and advice to the public about accessing health and social care services and choice in relation to aspects of those services; • make the views and experiences of people known to Healthwatch England helping it to carry out its role as national champion; • make recommendations to Healthwatch England to advise the Care Quality Commission to carry out special reviews or investigations into areas of concern (or, if the circumstances justify it, go direct to the CQC with their recommendations, for example if urgent action were required by the CQC); • promote and support the involvement of people in the monitoring, commissioning and provision of local care services; • obtain the views of people about their needs for and experience of local care services and make those views known to those involved in the commissioning, provision and scrutiny of care services; and • make reports and make recommendations about how those services could or should be improved.
    19. 19. NCB Healthwatch Resource
    20. 20. Making complaints in the new system Stage 4 Judicial Review If the complaints process is unsuccessful then you could undertake Judical Review to challenge the legality of the NHS actions. This is a big undertaking and you need legal advice. Stage 3 Complain to the PSHO They will review the way your complaint was handled using the information you provide, and can instruct the NHS to apologise or change its policies. Stage 2 Complain to the commissioner of the service This will be a CCG or NHS England. They will have their complaints information on their website Stage 1 Complain to the provider: they will have complaints manager or complaints policy They must acknowledge keep you informed of the process of your complaint
    21. 21. What is CDC doing? • Providing clinician’s with tools to better help them provide a service – Spotting the Sick Child – Managing My Way Clinic Poster – Emergency Healthcare Plans – RCPCH Neurodisability Portal • Empowerment: – Expert Parent Programme – Constitution Project – Developing methodology for involving severely communication impaired young people in research
    22. 22. So? • Grounds for considerable optimism • But starting from a low base • Lots of work to do • But a significant number of levers to pull on in getting that work prioritised • So we maybe at a tipping point
    23. 23. View our resource bank, events calendar and table of resources to support the implementation of the SEND Reforms www.councilfordisabledchildren.org.uk

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