Transcript Document

People Group
FROM FRAGMENTATION TO INTEGRATION
Children’s Health and Wellbeing in the West
Midlands
Wendy Fabbro
Strategic Director - People Services
Warwickshire
4 December 2012
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Common themes for Munro and Marmot..
• Putting children, young people and their
families at the heart of what happens
• Acting early and intervening at the right time
• Integration and partnership-Multi agency
systems approach
• Safe and sustainable services
• Priority focus on early years
• High quality workforce and training
• Investment in programmes that work- evidence
base
• incentives
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On a national level we know that..
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45% of looked after children (and 72% in residential
care) have a mental health disorder;
Two thirds of looked after children have at least one
physical health complaint;
Almost half of young women leaving care become
pregnant within 18 to 24 months;
32% of young people leaving care report problems with
drugs or alcohol a year later; and
Looked after children and care leavers are between four
and five times more likely to attempt suicide in adulthood
Attainment of FSM students at GCSE
5A-C =28%
•The UK remains very low on
international rankings of social
mobility. Parental income
continues to exert a very
powerful influence on the
academic progress of children
•The influence of parental
income on the income of British
children is the strongest in the
Attainment of non FSM students=59%
OECD and over 50% stronger
than in Canada, Germany or the
Netherlands
(Sutton Trust)
“ the best thing you can do for
your childs health is to read to
them” (Marmot)
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Does your Health and Well-being Board..
• Link effectively with the CTB, SCB, CCG
• Have an agreed process to ensure children's issues receive
sufficient focus
• Contribute to early help offer
• Make use of mechanisms to listen to children, YP and families
• Analyse health needs for CYP
• Factor in staff views
• Have a method to engage with schools
• Have a plan to use public assets to improve health outcomes for
children
• Embed the CAF in the local partnership
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Dartington work programme
• Aligning services better to the specific needs of children
at the ‘edge of care’
• Developing community based alternatives to becoming
looked after
• Improving the ways in which we manage the looked after
service
• Supporting our staff in developing their practice in
assessing needs and planning and delivering effective
help to these vulnerable families.
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Public Health, NHS & CYP
Outcomes Frameworks
• Improvements in measured outcomes for CYP is at a
slower rate in the UK
• CYP Health outcomes strategy being developed,
• Specific interventions in relation to pregnancy, early years
• LAC routinely experience poor health outcomes AND
• Their outcomes remain less positive than others
(impact of poverty, poor parenting, chaotic lifestyles and
abuse or neglect
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CYP Health Outcomes Strategy identifies
the need for
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CCGs with their local authority partners to ensure
sufficient clinical expertise and leadership for looked
after children, including a designated doctor and nurse;
Directors of Children’s Services to be responsible for
overseeing the overall quality and delivery of health and
wellbeing for looked after children, leading to a
measured reduction in their health inequalities;
All health organisations (including health watch) must
demonstrate how they have listened to the voice of
children and young people
Social workers to be responsible for ensuring LAC (and
particualrly 18-25)are registered with GP
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• The NHS CB only accepting GPs on the local performers list
who can demonstrate competences set out in, Looked after
children: knowledge, skills and competencies of healthcare
staff (2012);
• The NHS CB ensuring work to develop a tariff for the
statutory health assessments for looked after children is
implemented
• Regulators to promote and prioritise the issue of integrated
provision.
• NHS number to be used!
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Public Health Outcomes Framework measures that
can only be delivered through effective partnerships
with children’s services
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School readiness
Pupil absence
Infant mortality rates
16-18 year olds not in education, employment or training
People with mental illness of disability in settled accommodation
Emotional wellbeing of looked after children
Smoking prevalence amongst 15 year olds
Under 18 conception rates
Chlamydia diagnosis (15 – 24 year olds)
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The integration word
Life course approach and
Pathways
Networks to bring together the fragmentation
Public health-Lead for training
Child health records accessible for patients and professionals
Needs of the CYP population in the JSNA, especially those with
disabilities or ltc
• Leadership- set out responsibilities, budget, national leadership
required
• Thematic reviews
• Regulators working together
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