NES NES/13/40 Item 8a (To Follow) June 2013 NHS Education for Scotland Board Paper Summary 1. Title of Paper NES Contribution to Early Years 2. Author(s) of Paper Judy Thomson Mary Boyle Stewart Irvine Brenda Renz Marita Brack Rose Marie Parr Pauline Beirne Robert Parry David Felix Hazel Mackenzie Ann Wales Colette Ferguson 3. Purpose of Paper To advise Board colleagues of NES’ contribution to Early Years in Scotland in the light of the Early Years Collaborative (EYC). 4. Key Issues The Scottish Government has made it clear that the implementation of the Early Years framework, together with the broader policies of early intervention and preventative spending, have the highest priority. The policy of health and social care integration is also critically important in the context of the cross sectoral Early Years workforce. Significant Scottish Government funding has been announced to support the delivery of these policy objectives. 5. Educational Implications NES is already making a significant contribution to the Early Years agenda through the pre and post registration and training of core NHS disciplines, and in a growing commitment to multi professional and multi agency training. Ensuring that the education and training of core health disciplines has appropriate early years content and that the multi professional and multi agency training and education develops coherently will be important for NES, while we respond to the new opportunities and challenges arising from the Early Years Collaborative. 6. Financial Implications NES has a small group of cross directorate staff working on this agenda.

7. Which NES Strategic Objective(s) does this align to? 1 – We will deliver consistent evidence-based excellence in education for improved care. 3 – We will continue to build co-ordinated joint working and engagement with our partners. 4 – We will provide education in quality improvement for enhanced patient safety and people’s experience of services. 6 – We will provide integrated education to support models of care which are closer to people in their communities. 7 – We will support education in partnership that maximises shared knowledge and understanding. 8. Impact on the Quality Ambitions The education and training that NES provides/commissions to support the delivery of the Early Years framework will have an impact on all the Quality Ambitions. 9. Key Risks and Proposals to Mitigate the Risks The early years agenda requires the involvement of multiple partners and stakeholders across Scottish Government, local government, health, social care, education, and the third sector. Achieving clarity about the role and contribution of NES to the Early Years Collaborative is challenging in this context. Malcolm Wright’s involvement in the Early Years taskforce as well as his chairmanship of the ministerial group (the Children and Young People’s Health Support Group) helps mitigate this, as does Robert Parry’s substantial involvement with SSSC. Judy Thomson’s chairmanship of the NES Children’s Programme Board is helpful as are the significant contacts NMAHP directorate and Psychology directorate staff have developed with Scottish Government and other partners. NES has two staff roles with the Practice Development Team that supports the Community Planning Partnerships and our contribution to the development of the workforce in Quality Improvement Skills and through Knowledge Services and Leadership is under discussion. 10. Equality and Diversity Impact Assessment Please select one of the boxes

Impact Assessment is not required at this stage because:

Equality and Diversity Impact Assessment has been planned (briefly summarise your arrangements for undertaking the EQIA):

Rapid Impact Assessment completed*

Full Impact Assessment completed*

* Copies of Impact Assessments can be provided upon request. The results of Impact Assessments are summarised in the main paper. Advice on Equality Impact Assessment is available on the intranet at http://intranet.nes.scot.nhs.uk/pfpi/impactassessment/ or from the Equality and Diversity Adviser (kristi.long@nes.scot.nhs.uk or 0131 313 8097).

11. Communications Plan

A Communications Plan has been produced and a copy sent to the Head of Communications for information and retention:

Yes No A Communications Plan format template is available in the ‘Meetings’ and

‘Communications’ sections of the NES Intranet. 12. Recommendation(s) for Decision

• NES to ensure that the content of the education and training for the core NHS disciplines of the Early Years workforce is appropriate, and to maximise opportunities for sharing across disciplines.

• NES to continue to develop partnership working with Early Years stakeholders to

ensure that the education and training we commission, develop and deliver is responsive to Early Years workforce requirements.

• NES to continue to identify the Early Years workstream as an important

component of work governed via NES Children’s Programme Board.

• NES to continue to support the Early Years Collaborative. Board colleagues are invited to comment on the paper. NES January 2012 JT

1

NHS Education for Scotland Board Paper NES Contribution to Early Years

June 2013 Authors of Paper Judy Thomson Mary Boyle Stewart Irvine

Brenda Renz Marita Brack Rose Marie Parr

Pauline Beirne Robert Parry David Felix

Lesley Anne Smith Hazel McKenzie Anne Wales

Colette Ferguson

Context

The Scottish Government has made it clear that the implementation of the Early

Years framework, together with the broader policies of early intervention and

preventative spending, have the highest priority. The policy of health and social

care integration is also critically important in the context of the cross sectoral

Early Years workforce.

The Early Years Framework, published in December 2008, signified an important

milestone in encouraging partnership working to deliver a shared commitment to

giving children the best start in life and to improving the life chances of children,

young people and families at risk. The Early Years Taskforce began in July 2011

and shares this commitment. The objective of the Early Years Collaborative

(EYC) launched in January 2013 is to accelerate the conversion of the high level

principles set out in Getting It Right For Every Child (GIRFEC) and the Early

Years Framework into practical action. This must:

2

• Deliver tangible improvement in outcomes and reduce inequalities for

Scotland’s vulnerable children.

• Put Scotland squarely on course to shifting the balance of public services

towards early intervention and prevention by 2016.

• Sustain this change to 2018 and beyond.

The Government believes Scotland has reached a point where there is the

commitment and the will to deliver in this area, and strong evidence about what

works to make improvements. What is lacking is a method to take pockets of

excellent practice to scale, and ensure that every baby, child, mother, father and

family in Scotland has access to the best supports available.

The EYC is premised on the fact that there is strong evidence about costs and

outcomes of current and desired practice, but much of this is not being used in

daily work. Practice does not always reliably recreate what the evidence tells us,

and there is inconsistency and patchy implementation. In other words, there is a

gap between what is known to work, and what is done.

The aim of the EYC is to will help organisations close that gap by:

• Creating a structure in which partners can easily learn from each other

and from recognised experts in areas where they want to make

improvements.

• Supporting the application of improvement methodology to bridge the gap

between what we know works and what we do.

3

Ambitions of Early Years Collaborative

To make Scotland the best place in the world to grow up in by improving

outcomes, and reducing inequalities, for all babies, children, mothers, fathers and

families across Scotland to ensure that all children have the best start in life and

are ready to succeed.

Stretch aims:

1. To ensure that women experience positive pregnancies which result in the

birth of more healthy babies as evidenced by a reduction of 15% in the

rates of stillbirths (from 4.9 per 1,000 births in 2010 to 4.3 per 1,000 births

in 2015) and infant mortality (from 3.7 per 1,000 live births in 2010 to 3.1

per 1,000 live births in 2015).

2. To ensure that 85% of all children within each Community Planning

Partnership have reached all of the expected developmental milestones at

the time of the child’s 27-30 month child health review, by end-2016.

3. To ensure that 90% of all children within each Community Planning

Partnership have reached all of the expected developmental milestones at

the time the child starts primary school, by end-2017.

The Underpinning Principles of this Work

1. A coherent approach 2. Helping children, families and communities to secure outcomes for

themselves 3. Breaking cycles of poverty, inequality and poor outcomes in and

through early years 4. A focus on engagement and empowerment of children, families and

communities 5. Using the strength of universal services to deliver prevention and

early intervention 6. Putting quality at the heart of service delivery 7. Services that meet the needs of children and families 8. Improving outcomes and children’s quality of life through play 9. Simplifying and streamlining delivery 10. More effective collaborations

4

Community Planning Partnerships (CPPs) are the main organisations tasked

with reaching the ambitions of the EYC. Staff from the 32 CPPs have attended

two Learning session of the EYC alongside national partner organisations

including NES. Much of the focus to date has been on delivering quality

improvement, knowledge and skills amongst collaborative members. The role of

national organisations is under review. NES has developed a Cross Directorate

Early Years team to coordinate our response to the developments.

For further information about funding and Driver Diagrams across 4 workstreams

see Appendices 1 and 2.

Also see NES poster highlighting contributions for EYC partners in Appendix 3.

The Contribution of NES NES is already making a significant contribution to the Early Years agenda

through the pre and post registration and training of core NHS disciplines, and in

a growing commitment to multi professional and multi agency training. Ensuring

that the education and training of core health disciplines has appropriate early

years content and that the multi professional and multi agency training and

education develops coherently will be important for NES. NES has a small group

of cross directorate staff working on this agenda.

As a consequence of the breadth of the Early Years agenda with the involvement

of multiple partners and stakeholders across Scottish Government, local

government, health, social care, education, and the third sector. It is an exciting

and challenging environment in which to deliver coherent educational responses.

Malcolm Wright’s involvement in the Early Years taskforce as well as his

chairmanship of the ministerial group (the Children and Young People’s Support

Group) and membership of the Ministerial Taskforce is important, as is Robert

5

Parry’s substantial involvement with SSSC. Judy Thomson’s chairmanship of the

NES Children’s Programme Board is helpful as are the significant contacts at

NMAHP directorate and Psychology directorate staff have developed with

Scottish Government and other partners.

The purpose of this paper is to advise board colleagues of NES’ contribution to

Early Years. As the main focus is on Early Years, other broader aspects of

NES’s support for children’s Services are not covered in this paper.

1. Education and Training of Pre and Post Registration of Core NHS Disciplines

NES is involved in the pre and post registration training of the core NHS

disciplines for Early Years services in a variety of ways. See below for updates

by Directorate.

The Pharmacy Directorate provides a wide range of educational support for

pharmacists and technicians – including CPD face to face, courses across

Scotland each year covering topics such as immunisation, minor ailments, and

child health. Distance learning courses offered include Paediatric Pharmaceutical

Care, Child Protection (including a newly updated e-learning version) and the

Pharmaceutical Care of Breastfeeding Mothers.

To develop these resources, NES Pharmacy works in partnership with specialist

pharmacy groups in NHS Scotland, such as the Scottish Neonatal and Paediatric

Pharmacists (SNAPP) Group, and cross directorate eg. With NMAHP for the

breastfeeding and medicines courses.

6

As part of the Pre-Registration Pharmacist Scheme, all 170 trainees are required

to complete child protection, specific paediatric pharmaceutical care modules and

attend practical training on child health.

The Medical Directorate of NES supports the Early Years framework by

recruiting, directing and supervising the education of 234 paediatric trainees on

an 8 year training programme and 174 obstetric trainees on a 7 year programme.

There are 4 programmes in each specialty which provide the opportunity for the

specialty trainees to gain competences as required by the General Medical

Council approved curricula. These programmes are quality managed by annual

review of each trainee’s progression, outcome evaluation, post feedback and

hospital visits as required. In addition, we support approximately 900 trainees in

general practice, some of whom will be undertaking training posts directly relating

to these specialties, but all of whom will contribute significantly to the early years

framework as trained doctors.

NES medical directorate currently funds 20 GP paediatric scholarships. These

posts, which have proved very popular, are aimed at established GPs or trainees

with a significant amount of paediatric experience and are designed to allow

these doctors to develop further skills in the care of children. The programme

evolved out of our earlier paediatric fellowships. A formal evaluation at the end of

2012 was extremely positive.

The Dental Directorate is involved in the funding of training for undergraduate

dental students as well as pre-registration training for dental care professionals.

In addition NES has responsibility for delivery of appropriate training in this

important area to the General Dental Services and Salaried Dental Service

workforce as well as managing training for the specialty of paediatric dentistry.

NES has also been responsible for playing a key role in the development and

coordination of Childsmile - a national programme designed to improve the oral

7

health of children in Scotland and reduce inequalities both in dental health and

access to dental services.

The NMAHP Directorate offers a number of training programmes which provide

educational support for staff working in the field of Early Years. Provision ranges

from Pre-registration Nursing and Midwifery to Post-registration courses in Public

Health Nursing.

In 2013 having secured significant funding from Scottish Government, we are

tendering for the development and delivery of a 3 years Masters Programme for

Advanced Practice Children and Neonatal Nursing. In addition, we have, in

collaboration with providers in Colleges Scotland and HEIs, revised and reviewed

the integrated education for cross sector working in Early Years at Support

Worker level. This revision has resulted in updating of the education in line with

current developments in Children and Young People’s policy and legislation.

We have also completed in partnership with providers the review and revision of

the Early Years Capability Framework, which underpins support worker

education. Students continue to access training on the Pre-registration Children’s

Nursing Course, the Pre-registration Midwifery course and the Public Health

Nursing Education.

On behalf of SGHD, NES manages the annual performance and review of the six

commissioned universities delivering pre-registration nursing and midwifery

education in Scotland. The performance management framework includes

annual surveys of students, mentors and charge nurse perceptions and student

attrition data.

We continue to work to develop resources to support the work force delivering

services to Children and Young People and in 2013 will launch a resource aimed

8

at supporting practitioners in the identifying the sick child in collaboration with

Remote and Rural Healthcare Educational Alliance (RRHEAL). This resource will

support services in Community settings in decision making.

We are working as partners in the Early Years Collaborative and have two Senior

Project Officers from the Project Implementation team working with NES. The

work to support the aims of the collaborative will represent significant component

of our work in 2013/2014.

The Psychology Directorate commissions and supports the delivery of training

of Clinical Psychologists including those who follow CAMHS aligned training

pathways and those who enter the children’s service workforce. We also

commission and support the delivery of a Masters level training to equip

Psychology graduates in Early Years competences. There are currently 30

doctoral and 17 Masters level possible training posts for children’s services being

supported. All psychology programmes are subject to NES Educational

Governance policies and procedures. We gather data to track our trainees into

the workforce. Attrition from clinical psychology training is very low (<5%) and

retention in the NHS Scottish workforce is very high (average of 90% since

2003). The Psychology Directorate is also responsible for the commissioning of

Child Psychotherapy training, 6 trainees are due to complete in 2013 with 5 due

to start in October 2013.

9

2. Public Health/Community Paediatrics Policy Context

The Community Child Health in the 21st Century report, which was completed

over 2 years warns of “depletion or potential eradication” of Community

Paediatric Services unless a workforce solution is found within the next 5 years.

Scottish Government are currently considering a response to the reported

workforce issues including a specific focus on medical workforce with input from

NES.

Refreshed Hall 4 puts additional work pressure on the Community Health

Workforce.

The current review of Public Health Nursing (as part of Modernising Nursing in

the Community) points clearly to the need for a review of Public

Health/Community roles.

The 27-30 month check (from Early Years agenda) will fall to the Community

Health Workforce.

There is a need for education to support skill mix and NES are in discussion with

Scottish Government to consider a way forward. Educational Solutions

discussed to date include:-

Development of Advanced Practice roles in Early Years for Nurses and AHPs.

Public Heath Assistant roles e.g. Senior Health Care Support Workers and

Assistant Practitioners to release pressure on Band 5 staff. NES is working with

Scottish Government to look at viable education solutions for development of this

role.

10

Establishment of a “Career Framework” for Health staff working within Early

Years.

Core Career and development frameworks for Public Health have been

developed by NES under the auspices of the Scottish Government’s Modernising

Nursing in the Community (MNiC) Programme of Work.

3. Refreshed Framework for Maternity Care in Scotland

Policy Context and Educational Solutions

a) The Refreshed Framework for Maternity Care in Scotland was

launched in January 2011 alongside a suite of related policy and guidance. The

aim of the refreshment process is to strengthen the contribution maternity care

makes to improving maternal and infant health, reducing inequalities and

applying the principles of Getting it Right for Every Child. Collaborative work by

NHS Education for Scotland and NHS Health Scotland to deliver the workforce

education and development solutions will support NHS boards in the

implementation of the Refreshed Framework. Specific actions are outlined in the

following three policy and guidance documents;

- A Refreshed Framework for Maternity Care in Scotland calls for a

workforce skilled in continuous, holistic assessment and the use of

strengths/assets based approaches to health improvement. A Workforce

Education and Development Steering Group has been convened by NES to take

forward and complete its work by the end of March 2014. The group has

representation from NHS national and territorial boards, Scottish Government,

Royal Colleges, Higher education, Scottish Social Services Council. A learning

needs analysis has been commissioned to inform the work of the steering group

by identifying key educational priorities, approaches and solutions currently in

11

use across NHS Scotland and identify gaps. The final report from the LNA will

be delivered by 31st March 2012

- Reducing Antenatal Health Inequalities- Outcome Focused Evidence into

action Guidance – NHS Education for Scotland will produce a workforce

development plan and knowledge and skills framework in order to support NHS

boards to address antenatal inequalities.

- Improving Maternal and Infant Nutrition a Framework for Action – NHS

Health Scotland and NHS Education for Scotland will produce a national training

resource on maternal and infant nutrition to include behaviour change models

which can be adapted according to scope of practice and used for local CPD.

Training opportunities will be available to engage more effectively with

disadvantaged groups.

The existing NES health inequalities resource “Bridging the Gap” will make an

important contribution to this work.

Each policy and guidance document has a unique focus. However the

educational themes are intersecting, emphasising the development of a maternity

care workforce with enhanced knowledge, skills and capabilities.

b) Public Health Role of the Midwife

A Public Health and Midwifery Education Scoping Project has been undertaken

by Queens University Belfast on behalf of NES. The report highlighted that the

current level of understanding around midwifery and public health needed to be

strengthened in order to maximise the public health impact of midwifery practice.

NES have commissioned the development of educational resources to support

this work through the collection and interpretation of practitioner stories. These

stories will be used to identify key experiences, interactions, responses and

attitudes of midwifery staff that reflect:

12

the positive interventions carried out by midwives in their day to day work that

promote health but which they may not recognise as ‘promoting public health’.

the opportunities to promote health that might easily be missed.

the value of midwives’ contribution to public health to both women and their

families.

midwifery practice in both community and hospital settings.

The stories were developed into an interactive drama and a series of events last

year. These have now been further developed into an online educational

resource.

4. Education for an Integrated Early Years Workforce Policy Context There is a policy imperative to develop a “mobile Early Years workforce”. The

Early Years Framework, documents the need for up-skilling of the Early Years

Workforce and in particular an increase in the ability to work across

organisational boundaries and adopt joint roles. Related to this is the Ministerial

imperative to have a Common Core of skills, knowledge and values for all staff

working with Children and Young People in Scotland. The pace of legislative and

policy change in Scotland in relation to CYP requires a shift in the culture of

practice across agencies with a real emphasis on the Rights of Children and

Young People and the delivery of compassionate joined up care with the child at

the centre.

Educational Solutions

There are a number of current NES initiatives which have been developed to

support a more robust Early Year’s workforce by building workforce capacity and

capability both within Health and across other sectors. The close relationship

13

between NES and SSSC has enabled a major step to be taken over the past two

years towards an integrated educational agenda in the field of Early Years.

Outputs of collaborative ventures to date are:

- Review and revision of the Shared Early Years Capability Framework

between Health and Social Care in line with current policy and legislation

- Review and revision of the “Joint” SCQF Level 7 and 8 education to

include Maternity Care Assistant Practitioner Education, based on the

external evaluation

- A prototype for a cross sector Early Years resource between Health Social

Care Education and Criminal Justice.

Further focused joint working between NES and SSSC could fast track the

mobile workforce agenda by:-

- Development of a new National Occupational Standard (NOS) on Early

Years

- Sufficient alignment of components of BSc in Childhood Practice (Social

Care) with Health related BSc qualifications

- Development of education for Support Workers and Assistant Practitioners

new to maternity services and in public health/community nursing.

- Development of a new scenario based interactive resource aligned with

the Early Years Collaborative aims

In addition, the development of the Essential Shared Capabilities for the work

force in Children and Young People’s Services, aims to support practitioners

across agencies to consider their values in relation to their management of

children, underpinned by Getting it Right for Every Child, the Children and Young

People’s Rights Bill (2012) and the aims of the Early Years Collaborative.

14

This scenario based resource aims to support practitioners across agencies and

disciplines in the delivery of effective and efficient care across settings.

In collaboration with NHS Health Improvement Scotland, NES is working to

develop a repository of national education resources designed to support the

implementation of Getting it Right for Every Child. The intention is to create an

interagency cross profession repository which will be accessible across

organisations to support the principles of Girfec in practice.

5. Family Nurse Partnership

Policy Context

The Family Nurse Partnership (FNP) is an early intervention, preventative home

visiting programme for young first time mothers. It offers intensive and structured

home visiting, delivered by specially trained nurses, from early pregnancy until

age two. It aims to improve pregnancy outcomes, including maternal health,

improve child health development and improve the economic self-sufficiency of

the family. Expansion of the FNP programme across Scotland is now Scottish

Government policy, with the First Minster announcing plans for expansion across

the whole of Scotland. FNP is delivered in 7 NHS Board areas – NHS Lothian,

NHS Fife, NHS Tayside, NHS Ayrshire and Arran, NHS Greater Glasgow and

Clyde, Highland (Integrated), and the most recent area - NHS Lanarkshire, who

begin to recruit families 8th July 2013. There are a total of 1555 place available to

families in 2013, and 1090 of those places were filled by the end of March 2013.

So far this year, 430 families have been recruited. The total percentage of

Scottish population covered by the programme is around 33%. The aspiration of

Scottish Government and NES is to offer the programme to all those meeting the

criterior in the next 3 years.

15

There are 11 Family Nurse Supervisors in Scotland and 67 Family Nurses. Each

site has a designated FNP Lead, usually a senior Community Nurse Manager

and the Project Sponsor accountable to Scottish Government (SG) for the

programme is Nurse Director in all sites except NHS GGC where it is a General

Manager with CHCP /CHP responsibility.

There are a further 4 NHS Boards where FNP is a viable model; NHS Forth

Valley, NHS Grampian, NHS Borders and NHS Dumfries and Galloway. Work by

National Unit (NU) will begin towards the end of 2013 to look at developing and

supporting ‘site readiness’ and revisiting the previous process for expressing

interest in the programme. It is also anticipated that at this time a simultaneous

review will be undertaken by NU for expansion of FNP in some of the established

areas. Current work is underway by both SG and NES in ensuring that these

scaling up requirements are reflected in the impending spending review.

NES contribution to FNP

NES has been working in partnership with the Children & Families Directorate,

Scottish Government in supporting the establishment of the dedicated ‘ Family

Nurse Partnership National Unit’ ( FNP NU) within NES. The agreed functions

of an NU as defined by Professor David Olds and international NU colleagues

(license holder University Colorado, Denver) are;

• Professional and Clinical Leadership

• Learning programme and clinical support for Family Nurses and

Supervisors

• Monitoring of fidelity and license requirements

• Business Management

• Sustainability planning

• Information and Data Management

16

The NU has developed further posts to support the expansion of FNP in

Scotland. The most recent being; FNP Education Projects Manager, FNP Data

Analyst and FNP Clinical Director. Two further posts are being recruited to; FNP

Development Lead and FNP Lead Nurse post. An FNP Project Officer and FNP

Administrator have been recently appointed and are working with NU in

supporting the process of ‘scaling up with quality’

The license for the FNP programme remains with Scottish Government and the

NU will retain its close working relationship in monitoring and maintaining license

and fidelity requirements by establishing a ‘shared’ role within NU and SG. This

role is currently being developed and is likely to be through a secondment

/Service Level agreement with Scottish Government.

The final evaluation of FNP in Scotland is due to be published later this year and

whilst it highlights the success of transferring FNP into the Scottish setting there

are areas of learning for all services and practitioners involved in the process of

co-production as well as the work of supporting young families, often considered

hard to engage. Overall the evaluation is very positive and highlights both

challenges and successes of implementing an evidence based, licensed

programme in Scotland at such a large scale.

The Governance requirements within NES will be through the Child Health

Programme Board. The work of the ‘FNP Task and Finish Group’ is almost

complete which was originally established to oversee, through partnership

working, the NES contribution to the establishment of National FNP Unit. A new

work stream is underway within NES; Communication about the ‘re-launch of

FNP NU’ with all stakeholders. The FNP Annual Conference is planned for

November /December 2013, in NHS Fife and will be an opportunity for all FNP

teams to reflect on the previous years progress. It is anticipated that NES Nurse

Director will Chair the event.

17

6. Psychology of Parenting Project The Early Years Framework emphasises the importance of parenting support

and in 2012, the Early Years Taskforce approved a national roll-out of the

Psychology of Parenting Project implementation model (PoPP). Commitments

relating to PoPP are included in the new Mental Health and National Parenting

Strategies. In addition, the Pop plan chimes with the GIRFEC framework as it

places children at the centre of services, and values the assets of the families

and communities in which they live.

The Psychology of Parenting project, established within NHS Education for

Scotland aims

• To improve outcomes for 3 and 4 year-old children with significant levels

of early-onset disruptive behaviour problems

• To increase workforce capacity and promote evidence-based practice in

relation to two specific parenting programmes ( Incredible Years Pre-

school programme and Level 4 Group Triple P) for which there is already

strong scientific and practice-based evidence of effectiveness and

efficacy.

• To assist services to shift towards preventive early years spending

• To promote effective early years partnership working

The Scotland-wide Pop dissemination plan addresses:

• The training and educational infrastructure required to make the full

benefits of the two already extensively evidence-based programmes

available to the target group of children and their families

• The organisational supports required to complement this initiative

18

• Funding to enable Community Planning Partnerships to install the

programmes within their routine service delivery mechanisms. This

includes all training, a variety of supervisory and fidelity monitoring

supports and first year delivery costs but excludes the staff time.

In December 2012 NES wrote to all NHS Territorial Health Boards across

Scotland to inform them of the opportunity for CPPs to participate in the national

roll out of the PoPP. Fifteen of the 32 CPP areas across Scotland noted an initial

expression of interest. Eight of these CPP areas subsequently undertook an

assessment of readiness process and 2 sites progressed to become Wave 1

implementation sites. The first set of parents’ groups will start to be delivered in

these areas in September 2013.

The PoPP team have been in contact with the other interested 6 CPP areas and

2 early adopters and are now actively engaged in helping 7 of them to progress

their readiness to adopt PoPP in the future. The Wave 2 roll out of PoPP is

planned to start in September 2013, with the first set of parents’ groups starting

to be delivered in those areas selected in January 2014. It is anticipated that

subsequent wave sites will commence PoPP adoption every 6 months for the

life-span of the project (3-4 years)

Using data to support and guide decision-making and improvement efforts is a

core aspect of the PoPP. At a national level, the PoPP team is currently

developing a data system designed to integrate information from all participating

service areas. In addition to tracking all key aspects of the implementation

framework, the data system will carefully monitor outcomes in terms of changes

in disruptive behaviour levels in children and stress levels in parents.

19

7. Leadership Development

The NLU will work with partners through the newly established Public Service

Collaborative Learning (PSCL) to scope out the broad and generic development

needs of CPP’s. This work is at an early stage and the following points should be

noted.

1. There will be a strong emphasis on PSCL engaging with CPP's, with a

clear recognition of the importance of meaningful engagement prior to any

design work.

2. 2 CPP requirements will vary and therefore any work needs to take

account of this.

3. Work with CPP's may take a geographic or thematic approach. A design

and delivery team has now been established to agree the next steps.

8. Early Years Collaborative - Improvement Support

The Early Years Collaborative is based on the Breakthrough Series Collaborative

Model developed by the Institute for Healthcare Improvement (IHI). A

Breakthrough Series Collaborative is a short-term learning system that brings

together a large number of teams to seek improvement in a focused topic area.

Each team typically sends a number of its members to attend Learning Sessions

with additional members working on improvements in the local organisation.

Traditional Learning Sessions are face-to-face meetings bringing together

multidisciplinary teams from each organisation and the subject matter and expert

(subject matter and improvement) faculty to exchange ideas. During Action

Periods between the Learning Sessions, teams test and implement changes in

their local settings and are supported by conference calls, peer site visits, and

Web-based discussions that enable them to share information and learn from

national experts and other organisations.

20

The Leading Improvement Team at the Scottish Government is leading the

Early Years Collaborative supported by expert improvement faculty from IHI. The

Improvement Service has overall responsibility for building improvement

capacity and capability in Community Planning Partnerships supported by the

Joint Improvement Team and the NHS Scotland Quality Improvement (QI) Hub. The QI Hub is a strategic partnership between Healthcare Improvement

Scotland, NHS Education for Scotland, Health Scotland, Information Services

Division, National Services Scotland and Quality and Efficiency Support Team.

The purpose of the QI Hub is to support the implementation of the Quality

Strategy through the provision of support, education, training and technical

expertise in improvement science.

All of the above Scottish Improvement Bodies met two weeks ago to explore the

vision and ambition to build a quality improvement infrastructure in Scotland;

share respective initiative and priorities, explore synergies and opportunity for

greater collaboration; and agree priority areas for action to build momentum in

improving quality of health and social care. NES was represented at this meeting

by Professor Brian Durward and Dr Lesley Anne Smith.

9. Knowledge Services

In addition to the general support for learners across agencies that is provided

via the Knowledge Network and the QI hub and the Children and Young People's

Managed Knowledge Network, some specific support from Knowledge Services

is being made available to the Early Years Collaborative. Details will be gathered

from the national organisations that participated in LS2 about what

services/support/expertise etc they have to offer the Collaborative. The next

step will be to make this information available via the Extranet or on a webpage

that can be linked to from the Extranet. The aim is to raise awareness at the

next Learning Session of the support available from national organisations, and

21

perhaps to generate some tests of change of using this support.

10. Recommendations

• NES to ensure that the content of the education and training for the core

NHS disciplines of the Early Years workforce is appropriate, and to

maximise opportunities for sharing across disciplines.

• NES to continue to develop partnership working with Early Years

stakeholders to ensure that the education and training we commission,

develop and deliver is responsive to Early Years workforce requirements.

• NES to continue to identify the Early Years workstream as an important

component of work governed via NES Children’s Programme Board.

• NES to continue to support the Early Years Collaborative.

Board colleagues are invited to comment on the paper.

22

Appendix 1 - Funding Scottish Government contribution to the Early Years Change Fund

2012 -13 2013 – 14 2014 -15 2015 – 16 Total £10.5m £14.5m £16.5m £8.5m £50m

This will be supplemented by a small amount from Positive Futures (Early Years) core funding over the current Spending Review period (2012-13/2013-14/2014-15) to ensure maximum flexibility and synergy. This gives the following totals:

£11.31m £15.25m £17.25m £8.5m £52.25m The following funding is committed:

Roots of Empathy £0.249m £0.474m £0.491m - -

Home Safety Programme £0.24m - - - -

PlayTalkRead £1m £1m £1m - £3m

Bookbug £1.5m £1.5m £1.5m - £4.5m

Parenting Strategy £0.05m £0.05m £0.05m - £0.15m

Play £1m £1m £1m - £3m

Families and Communities

Fund £1.5m £1.5m £1.5m - £4.5m

Early Learning and

childcare £1.5m £1.5m £1.5m - £4.5m

Family Support (LA) £3m £3m £3m - £9m

Family Support

(unallocated) - £3m £6m - £9m

Psychology of Parenting £0.672m £0.672m

Local support £0.6m £0.8m £0.85m - £2.25m

Total £11.311m £13.823m £16.891m £0 £40.572m

This leaves uncommitted funding of:

£0m £1.427m £0.359m £8.5m £52.25m

23

Appendix 2

24

Appendix 2 cont’d

25

Appendix 3 – Early Years Poster