Transcript Integration of Care Co-ordination model within GIRFEC in

Integration of Care Coordination model within
GIRFEC in the Scottish
Borders
Dawn Moss
Nurse Consultant
Vulnerable Children & Young People
There’s so much to tell you…
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A bit about the Borders
The development of Care Co-ordination
The need to change
GIRFEC in the Borders
Challenges
Transition of moving Care Co-ordination
into the Integrated Assessment
Framework
Scottish Borders
• Population children & young people: 25,441
(23%)
• Borders with Lothian, Dumfries & Galloway &
Northumberland
• NHS Borders Children & Young People’s Health
Network
• Scottish Borders Council – Integrated Children’s
Services (Social Work and Education)
• Integrated Assessment Framework
In the beginning…
• Referral criteria:
• Children with complex needs needing coordination
of care and services
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Team around the child
Independent chair
Focus on child’s progress
Child and parents views
Action Plan
Key worker role v key point of contact
A few years along the road…
• Achieving aim of reducing duplication by
ensuring that care is delivered in a consistent
and co-ordinated way, with effective interagency
working and sharing of information
• Increasing numbers of referrals
• Breadth of referrals
• Evidence of good practice and multi professional
working
• Extend chairing role to other professionals
Pausing for thought…
• Is Care Coordination meeting the needs of
children, young people and their and
families?
• Are actions agreed within meetings
followed through?
• Audit 2009 (parental and professional
questionnaire)
What professionals told us
• 57% response rate (53 returned from health,
education, social work & voluntary sector)
• 77% thought Care Co-ordination was useful
• 81% said they had been able to carry out agreed
actions
• Only 12 of the 53 respondents gave a definite
commitment to chairing future meetings
• Only 15% were certain the Care Co-ordination
would still be needed once IAF was fully
implemented with 62% saying they didn’t know
• 32% felt Care Co-ordination could be improved
What parents told us
• 53% response rate (21 returned)
• 76% knew who their named key worker
was
• 29% said that all of the actions agreed at
the meeting had been followed thought
whilst 38% felt that ‘most’ of them had
whilst 5% felt ‘none’ of them had
“Get rid of it or make sure it does what it is
supposed to do and co-ordinate!”
Reach for the stars
• GIRFEC
• Integrated Assessment Framework
• Introduced to one locality in 2008
• Full implementation in Feb 2010
• Support from across the organisation and
from all partner agencies
• Integrated Children’s Services
GIRFEC in the Borders
• Tools to support the IAF process launched in
February 2010 across all services (e.g.
documentation, guidance, training)
• Report to Children’s Reporter’s
• Programme of training and workshops
• Quality audit
• Locality and central procedures and processes
are being rewritten to incorporate IAF structures
- including the Child Protection Guidelines
• Learning from the Highland Pathfinder and links
to the GIRFEC Scottish Government team
Achievements
• Common integrated assessment used by all agencies
• Shift to locality structures to enable better-informed,
more localised, timely decision-making
• Information Sharing Protocol agreed between all
agencies working with children, young people and
families
• Agreed process for obtaining and renewing consent
within IAF
• IAF process includes requirement for recording views of
children, young people and families
• All professional groups are supported to take on the
Lead Professional role where indicated
What - no problems?
• Documentation
• IT- knowledge, skills, systems, etc, etc
• Role of chairing meetings – issues of skills
and confidence
• Locality v central services
• Children with complex health needs –
where are they in this new world?
Onwards…
• Transition of moving Care Co-ordination
into Integrated Assessment Framework
• No new referrals to Care Coordination
since June 2010
• Team around the Child
• Meetings Around the Child
• Child’s Plan – outcome focused
• Supporting staff
To infinity and beyond
How is IAF different to Care Co-ordination?
• Shared language
• Consent and information sharing
• Building confidence in taking decisions and
removing barriers to timely decision-making
• Focus on outcomes - SHANARRI
• Core documentation for health visiting, CCN
Team, CAMHS
Good luck!