Children and Young People3P review and redesign

multi-agency event

Development of an overall model of service delivery for children 0 -4 years of age which is adaptable to local multi-agency working and resources

Targets

Develop TEWV’s core offer for children 0 – 4 years Model of service delivery must be cost neutral. Identify gaps in service delivery for children and young people 0 – 4 years. Core offer should be applicable to all localities although event focus is Stockton Local Authority area

Deliverables:

• Model outline and summary • High level process map• Briefing sheet and communication plan • Action plan/newspaper

Case for Change

Present situation

• Commissioned for a 0-18 service• Predominantly provide for 5-18 year olds• Primary schools are reporting significant

issues in early years• Local authorities are focusing on early

help and early intervention• Fragmented pathways

Key Drivers

• Future in Mind-promoting, protecting and improving our children and young people’s mental health and wellbeing

• Autumn Statement 0-2 year early intervention pilots to avoid problems in later life

• Health Child Programme – (update due) child health programmes for 0-5 years to promote infant/parental attachment

Key Drivers continued

• Health Education England Mandate – Every birthing unit should have access to specialist perinatal mental health clinician

• Institute of Health Visitors & RC of Midwifery – training on MH

• Commissioning – Transfer of commissioning 0-5yrs public health services to local government

Conclusion

• Focus on recognising & promoting good mental health & wellbeing in all people, not just focusing on those with a mental illness or diagnosis.

• Evidence that supporting families & carers, building resilience reduces the burden of MH & PH over the whole life course

• Integrated & partnership approach is crucial to defining & meeting needs

Key Features of the Model • Whole system integration • Collaborative and transparent • Relationship led infrastructure • Clear process pathways • Universal offer• Creatively accessible • Positive outcomes • Comprehensive and high

quality • Needs led• Easy and simple • Ultra early intervention

• Helpful • Culturally intelligent• Celebrating success• Educational • Information sharing • Wellbeing • Engagement • Inclusive

Team Compact • Final Coat of Arms Two Team Designs

7 Designs

63 designs were produced by the group for consideration in the design build stage of the process

Model 1 THE PENGUINS

• Integrating mental health services into existing systems at the appropriate time

• Capacity building in workforce and community

• Managing complexity through supervision joint working and training

• Right intervention, right families, right time , right place with right outcomes

• Clear pathway driven by the CAF system

Model 2 THE TREE

• Collaboratively working to ensure families needs are met

• Responsive to the needs of families and provide timely response

• Open to all no matter what culture or belief

• Ensure that families know and understand the role of all services

• Celebrate with families and show case achievement.

Final Model

Mission

Working together we will promote, protect and improve the mental health and wellbeing of children under 5 and their families. This will support and enable the best start in life.

Model Features

• We will work together across all agencies to promote positive wellbeing for under 5’s, their families and communities

• We will use a single assessment tool to prevent families having to continuously re tell their story and improve information sharing

• We will ensure that a mental health perspective is available for every family that need it

Model Features cont.• We will provide ultra-early mental health support/advice/

interventions which will improve outcomes for children and their families

• We will strengthen the knowledge and expertise in early years mental health across services, families and communities

• We will ensure children and their families are able to access the right intervention at the right time in the right place to support the right outcome

• We will ensure that there are no barriers to access services with clear pathways that are simple to use

Accountability and Governance

TEWV Governance and Management Structure

Early Help Implementation Group

Children and Young People’s Partnership

Health and Well Being Board

Governance & Accountability

Governance & Accountability

Operational Delivery

Governance, Accountability

and Operational Delivery

Tees, Esk and Wear Valleys NHS Foundation Trust Under 5 Years Core Offer

UNIVERSAL

E.g. Health VisitorsMidwiferyGP’sChildren’s Centre’s VCSEducation Settings

TEWV CORE OFFER:Under 5 LeadWorkforce Development Support and ConsultationLiaison and Partnership Working.

EARLY HELP

Early Help HubTargeted Delivery from Universal ServicesTargeted ServicesE.g. Troubled Families, CAB, Housing, Social Care

TEWV CORE OFFER:

Under 5 LeadBespoke TrainingTargeted InterventionSupport and Consultation

MACH

Children and Families displaying higher level of need.

TEWV CORE OFFER:

Clinical SpecialistUnder 5 LeadJoint AssessmentConsultation and Supervision

TEWV & Specialist ServicesTargeted & Specialist CAMHSCrisisUnder 5 LeadPaediatricsSpeech and LanguageEducational PsychologyLooked After Children

Perinatal Mental HealthAdult Mental HealthOccupational TherapyFamily Nurse PartnershipSubstance MisuseHarbourSpecialist 3rd Sector Provision

What would this look like for families and children under 5 ?

Single assessment

Accessible

Ultra-early intervention

Evidence based

Whole Family approach

Timely

SeamlessTeam

working

DIAGRAMMING- FISHBONE DIAGRAM

People/skills/training

Policy

Method

Partners/clients Communication

Systems

Place/surroundingsEnvironment/technology

Management/money

Key Challenges

• Philosophical shift from having C&YP services at the end of the process

• Having a shared vision• Agreeing the detail and getting the buy in• Increase of referrals • Implementing the new model

Key Lessons Learnt • Breadth and depth of challenge and good

practice already in place• Increased understanding of multi-agency role

and contribution• Change can improve both work and you• Its gets better - stay with it• Innovative 3P approach which can be taken

back to own practice

We would like to thank ……..

• Sponsors Chris Davis and David Brown• Brian and Donna for their advice and

support• To everyone- it’s been great• Parents who shared their experience and

thoughts• Karen, Paul and Pauline

Special thanks

To all the partner agencies for their time, commitment and

invaluable contribution.

Every mighty oak was once a tiny acorn!