Workstream Breakout: CPP Knowledge Sharing: Where are

we now? What are we learning?

Dr Graham Foster, NHS Forth Valley

Early Years Collaborative Learning Session Two Day 1

Falkirk CPP:

• NHS Forth Valley• Falkirk Council• Scottish Police Force• 3rd Sector - Barnardo’s, Aberlour• 154,380 population (0-5yrs – 7.25%/Scottish – 6.74%)

• Central Belt - Falkirk, Grangemouth, Bo’ness• Falkirk Children’s Commission

• Work stream 1 – Early Booking – 80% by 12 weeks– Maternal Vitamins– Routine Vaccinations– Health Checks for Children Looked After at Home– Registration with dentist by 8 weeks

Our Portfolio of Early Years Projects

• Workstream 2 – Vitamins for LAC and Foster Care– Play @home book– Routine Vaccinations

• Workstream 3– Nursery Children in structured group time– Play at home in playgroups– Police VPR to nursery

Our Portfolio of Early Years Projects

• Work stream 4 – Establish Twitter and retweet– Identify Mentor/Programme Manager– Tests of change form and process– Recording tests of change

Our Portfolio of Early Years Projects

Our Learning To Date

• Choose an easy starting point/ something you have to do any way – MCQIC

• Build on what you already have • Management buy in• Set clear targets• Are you as good as you think you are?• Practice makes perfect• Measurement and Run charts

Our Experiences:Measurement Development

• Well above target when we started!• Natural Variation – small numbers or slow to respond big

numbers• Dealing with bad news• Are we measuring the right thing• 80% at 12 weeks > 95% at 12 or 80% at 11• Focus on the last 5%!!!• Run charts need to run…..

Workstream 1

4th March – Develop posters and send out to GPs 18th March – Information cards put in pharmacies 25th March – Poster put in Nurseries and Family Centres

04/0

3/13

08/0

3/13

12/0

3/13

16/0

3/13

20/0

3/13

24/0

3/13

28/0

3/13

01/0

4/13

05/0

4/13

09/0

4/13

13/0

4/13

17/0

4/13

21/0

4/13

25/0

4/13

29/0

4/13

03/0

5/13

07/0

5/13

11/0

5/13

15/0

5/13

19/0

5/13

0%

20%

40%

60%

80%

100%

Booked by 12 weeks

Did they know how to access

Did they access direct

Was the phone anwered on 1st attempt

Our Big Wins & Successes:Measurement Development

• Measurement was slow to develop• Get going early• Run charts may flat line to begin with• Set up an easy system (web or excel)• Feel the rhythm - Rapid cycles• Learn to measure what you are changing!• Tests of change run chart

Workstream 4

Our Big Wins & Successes:Iterative Testing

• Think Big – Act Small• Home Teams and Away Teams• Get confident before roll out• Practitioners are key• Talk don’t post• Light touch or Motivational touch?• The process is your permission

Our Big Wins & Successes:Iterative Testing

• Working together across agencies• Don’t write policies – make changes• Same journey different stages• “Muddle through together”• Leadership Group• Mentor• Positive Attitude• Feel good factor

• 50 Ambassadors = lots of tests• Tests all supporting each other?• Influencing Upstream• Run charts may start to show success

• Keep it small, keep it real• Measurement is vital – but difficult• We think this can work!

In the next 3 – 6 months…