Children’s Strategic Clinical Network - Overview

1. London Strategic Clinical Networks Children’s Strategic Clinical Network - Overview Tracy Parr SCN Lead Children and Maternity Children England December 10th 2013

2. What is a Strategic Clinical Network (SCN)? • Area requiring large scale change • Resistant to previous attempts to improve • Strategic approach • Contrast with Operational Delivery Networks

3. Clinical areas covered by SCNs

4. London’s Children • Population of London 7.8 million (ONS 2011) • 2,049,576 children aged 0 – 19 in London • Approx 1.7 million children in Kent Surrey Sussex, and East of England many of whom accessspecialisedservices in London • 134,186 live births in London 2012 (ONS)

5. Why a Children’s SCN? UK has a higher all-cause childhood mortality rate compared with Sweden, France, Italy, Germany and Netherlands

6. London has higher than expected mortality for 1 – 19 year olds Data courtesy of London Health Programmes

7. Hospital mortality for children in London is rising compared to other areas of UK

8. Nearly half of children are not reviewed by a consultant surgeon within 12 hrs of admission

9. At weekends this worsens to less than 30% consultant review within 12 hours

10. Over 50% of hospitals do not have a paediatric anaesthetist available

11. Attendance at A & E by children is very high in London 26 London boroughs have A and E attendance higher than the national average for children Data courtesy of ChiMat

12. Some boroughs have high rates of admission to hospital for asthma

13. Solutions to the care of children “Children’s services should be seen as a whole system, designed within a framework of pathways and networks which enable the right things to be done, at the right time and place, using teams that work together within a managed network.” RCPCH 2013

14. Issues across healthcare systems “It is clear that in relation to service failure, problems often occur at the borders between one organisation or team and another” Learning from Investigations Healthcare Commission February 2008

15. Initial work • Implement networks of care across all children's providers • Identify standards of care within the networks building on existing standards: • Service specifications for specialised services • All existing standards for children in-hospital care (eg RCPCH, London Health Programmes, RCA, RCS) • General practice outcome standards

16. SCN Oversight Group London Strategic Clinical Networks December 2013 Clinical Senate Governance Assurance Children’s Strategic Clinical Network Children’s Commissioning Group Strategic Clinical Leadership Group Patients and public PATHWAYS PATHWAYS ENABLERS ENABLERS Children’s Network STANDARDS Children’s Network Community care Children’s Network Children’s Network • Collaborating with: • Academic Health Science Networks • Clinical Commissioning Groups (CCGs) • Health and Wellbeing Board • Local Education and Training Boards • Royal Colleges • Voluntary sector • Public Health England • Regulatory bodies Primary care STANDARDS Secondary care Tertiary care

17. Linking with other organisations • Networks • Establishment of a Regional CYP&F voluntary and community sector network • Regional networks and resources on engaging with health & schools • Supporting local networks and effectiverepresentation • Briefings on effective engagement and representation

18. Patient and Public Involvement in SCN • Critical part of our work • Challenges • Options • Discussion