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Integrated Care for children with complex needs PiP workshop 16 th June 2010. Angela Moore – consultant paediatrician Jill Wellings – Head of Early Years Wolverhampton. N SF Standard 8 Good Practice. Child centred multi-agency co-ordinated services – referral – assessment – delivery
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Integrated Care for children with complex needsPiP workshop 16th June 2010 Angela Moore – consultant paediatrician Jill Wellings – Head of Early Years Wolverhampton
NSF Standard 8 Good Practice • Child centred multi-agency co-ordinated services – referral – assessment – delivery • Early identification and intervention • High quality evidence-based care • Flexible and responsive family support services including key workers • Information for parents and children • Involved in decision making about their care and development of services
Consistent themes • Early Intervention and support • Integrate services to co-ordinate care - agencies working together • Joint fund multi-agency processes wherever possible • Address issues associated with sharing information across agencies • Consult and include a family perspective in planning and implementing service change
The Gem Centre Wolverhampton
Services • Child Development Service/SNEYS • assessment nursery • Community paediatricians • Community children’s nursing service • Physiotherapy • Occupational therapy • Speech therapy • Paediatric audiology • School health • CAMHS • Social services - disability team • Safeguarding service • Child Health records • Parent Partnership • Education and training • Café Gem
The Gem Centre • One stop Shop • Child centred multi-agency co-ordinated services – referral – assessment – delivery • Early identification and intervention (Early Support programme) • Flexible and responsive family support services • Information for parents and children
Early Support and the CDT in Wolverhampton • Neonatal unit • Joint neonatal follow up clinics • Early support strategic management group • Multi-agency referral meetings • CDT groups
Team Around the Child (TAC) • Child is discussed at multi-agency referral panel • Birth to five years and has developmental problem, disability or complex needs • Has or projected to require 3 or more agencies involved on a weekly/fortnightly basis • Based on child and family need • Consultant Paediatrician discusses with family TAC and key worker programme • TAC into schools
Child TAC Family Regular professionals Other professionals Team Around Child
Sophie's Story • Sophie is 2 years old and has complex needs affecting her physical and learning development. She attends the CDC for 2 days a week and private nursery 1 day.
Nursery Dietician Speech Therapy* Audiology* Physiotherapy* CHILD Family Community Paediatrics* Occupational Therapy* Children’s Nursing Service* Special Needs Early Years*
Sophie’s Story • Parents explained to staff Sophie’s needs e.g. sharing information around her special condition, her routine (feeding patterns, sleep, physio and medication) as well as her likes and dislikes. • As so many services involved the Team Around the Child (TAC) programme was arranged. Meetings take place every 6-8 weeks (in the parents home). • Parental involvement is important they chose the keyworker – regular contact and feedback from everyone helped to form a positive relationship between home, CDC, nursery and Support Agencies from The Gem Centre.
“A great team to help me!”Parents view • Parents felt listened to and valued • Parents views taken seriously • Collaboration with professionals • Involvement in planning • Reports with clear objectives and goals for child • Rationalised appointments • Available and reassuring
Professional Views • Working closely with other professionals • Integration and sharing of skills • Providing a consistent approach • Involvement of family • Efficient use of time
Integrated Care for children with complex needs at The GEM Centre • Integrated diagnosis, assessment and care • Early Support Key Worker scheme • Information sharing • Joint records - avoid duplicity in information collecting • joint database (Record of children with a disability) • Synchronised clinic appointments • No long waits for eg ASD children • Facilities for giving personal care in privacy • Access to information and support