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London Clinical Senate Forum Susan Malkin 26th January 2017
London Clinical Senate Forum Susan Malkin
26th January 2017
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Introduction
Who we are? The Children and Young People Health Partnership (CYPHP) is a local partnership of Commissioners and Providers, Parents, Carers, Young people, and Researchers committed to changing the way healthcare is delivered to children and young people in Southwark and Lambeth. What is CYPHP? An evidence based, system wide Transformation Programme which will be implemented over 4 years 2017-2020. Implementation will focus on:
• Creating children's health teams working together delivering everyday care closer to home and school • Promoting good health, delivering proactive care, and empowering children and families
How we’ll do it? Through a clinically led programme that consists of a core team made up of clinical staff (a paediatrician, gp, specialist nurses, pharmacist, and psychiatrist) and programme managers. The intention is that the programme team will work in a fully integrated way with Partners throughout the programme ensuring lessons are learned and embedding its work into core business of Partner organisations. Evaluation – planned throughout the programme to enable continuous learning and improvement of the model.
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• Why the initiative was set up • The CYPHP service model • Approach to implementation • Desired outcomes/impact
Children & Young People’s Health Partnership
Outcome are poor
Avoidable deaths - Child mortality rates locally are higher than national average
Services fail to maximise children and young peoples potential
Increasing demand – escalating costs - reducing budgets
Unacceptable variation
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Why the initiative was set up
Small scale change in itself will be insufficient to address problems in delivery and quality of care – Transformational change is required across the system
Healthcare and the health system have failed to adapt to contemporary needs of children
Our overall aim/vision for the programme is that all children, young people, and their families, in Lambeth and Southwark will have access to everyday healthcare that is
safe, clinically effective, and delivered efficiently as close to home as possible
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The CYP Service Model
1. Clinically led programme – the CYP core team made up of clinical staff (paediatrician, gp, specialist nurses, pharmacist, psychiatrist)
2. Early intervention and treatment in the community
3. The Programme comprises two service delivery projects to:
• Improve everyday healthcare (in reach)
• Service for CYP with long term conditions (asthma and epilepsy)
4. As well as cross cutting themes:
• Improving access to care for vulnerable and looked after children
• Strong emphasis on sustainable training and workforce development for all professionals – schools, social work, primary, community and secondary care
5. Promoting good health, delivering proactive care, and empowering children and families
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• Develop pathways of care around the child and family, rather than existing organisational and professional silos.
• We are looking to improve young people’s knowledge of the health and wellbeing services available to them, and how to access them.
• Invest in Paediatric Consultant and Children’s Nurse time to do ‘in-reach’ clinics
• Invest in Specialist nurses for asthma and epilepsy that will work with CYP who have these long term conditions (LTC).
• Provide training to non-health professionals
• Make health services more friendly and accessible for YP:
• Improve access to services for looked-after children (LAC )
Approach to implementation
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A Learning Health System for CYP Evaluation embedded within the programme – a cycle of continuous improvement
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What Success will Look Like
Improved child health
Self-reported health outcomes
Fewer disease exacerbations
Better attendance and participation at school
Improved healthcare quality
Improved service delivery -improved guideline compliance
Better prescribing
Better self-care of minor and chronic illness
Greater confidence and satisfaction with care
Strengthened CYP health system
Reduced acute activity - Fewer emergency attendances and admissions for everyday conditions
Fewer ambulatory-care sensitive hospital contacts
Fewer outpatient referrals
Learning Health System in place
CYPHP on a page
Suboptimal
child health
Variable and
sometimes
poor quality
healthcare
CYP health
system not fit
for purpose
Challenges Rationale
A population health approach to care focuses
on the everyday problems of the
majority…
and delivers maximal health
gain.
Improved
child health
Improved
healthcare
quality
Strengthened
CYP health
system
Long-Term
Condition Care
Everyday Healthcare
CYP Health Teams
Access to Care
Health Promotion
Mind and Body
CLINICAL SERVICES
ENABLERS OF CARE
ATTRIBUTES OF CARE
Model of care Approach
4 dimensions
of integration
A Learning
Healthcare
System
Outcomes
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A research driven approach to design, delivery, and evaluation
Ten principles for CYPHP’s work
Strong clinical leadership
Health promotion and disease prevention as core to services
Bio-psycho-social approach and child centred care
Transformative health professional education
A sustainable Learning Healthcare System
Hearts and minds: co-production with partners and families
UN Convention on the Rights of the Child
Generalisable model of care
Education, training, resilience for families
Why
How
Clinical
Education
Research
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Contacts
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Dr Ingrid Wolfe: CYPHP Programme Director. Consultant Paediatrician Public Health, Evelina London Children's Healthcare. Clinical Senior Lecturer, King's College London. [email protected] Dr Claire Lemer: CYPHP Deputy Director and Lead for Clinical Service Transformation. Consultant Paediatrician, Evelina London Children's Healthcare. [email protected] Susan Malkin: CYPHP Transformation Lead [email protected]
