Health Visiting in the FACT; from Collaboration to Integration

Health Visiting in the FACT; from Collaboration to Integration

Health Visiting Strategy and Planning Day • Welcome and expected outcomes • Defining ‘Integration and key messages from Integrated Services consultation • FACT plans and Integrated services • Children’s Centres – national guidance and local implementation – Guy Kirk Children’s Centre Programme Manager • Health visiting service specification – Janet Leigh, Trainee General Manager • Short break • Identification of risks and controls for integration – working groups • Lunch and networking • Locality planning for integration - working groups • Closing discussion

Objectives for the Day • Clarify national and local policy drivers influencing FACT/integration agenda • Facilitate effective communication channels between health visiting service and FACT/NCT • Enable HV’s and colleagues to contribute to operationalising integrated services • Harness HV knowledge to identify risks and solutions to barriers/challenges

Background and Context • Why Integrated Services? • ECM, Choosing Health, CNO Review, Children’s NSF – Duty of Partnership placed by Government on Statutory organisations • The FACT - a 'Care Trust for Children‘. NCT Board adopted FACT 'High Level Partnership Agreement' December 2003, a commitment to integrate resources (human and financial) with NCC Children's Services Directorate • ‘Delivering a Strategic Direction for Northumberland Care Trust’ (improving health, FACT as delivery mechanism, LAA’s, partnership approaches, Director of County-Wide services member of FACT Leadership Team)

Integration • “Integration refers to a single system of service planning and/or provision put in place and managed together by partners (parent bodies) who nevertheless remain legally independent”(Integrated Care Network) • An integrated system means a united mission, culture, management, budgets, accommodation, administration and records • From fragmentation to integration – complex care, safeguarding work

WHO Framework

Some Conclusions • Overarching aim “to raise the achievement of all children in Northumberland” accepted, if understood it means ensuring children are as healthy as they can be, have the emotional security and social development necessary to ‘achieve’. • The principle of integrated service delivery through integrated teams fully supported. • Arrangements for teams and membership of teams to be detailed in the local planning for services. Includes the issue of school partnership area or locality; how can children be prevented from falling through service provision gaps if they live in one area but attend an ‘out of area’ school partnership? • Matrix management arrangements need detailed planning for integrated teams – a cause of anxiety. • Develop clarity of understanding around the role and responsibilities of integrated teams, to determine which professionals belong in which team - most staff will belong to a number of teams. To include the safeguarding of staff identity, skills and support but will also need to ensure that the child is central to service planning and delivery.

Some Conclusions • Staff training for all integrated team staff before the team becomes operational. Staff support must be available and communication open, honest, timely and in a variety of formats. • The inter-relationship between extended schools, children’s centres, integrated teams, youth service, Connexions need to be clearly identified and communicated. • Asset management needs to clearly identify its resources and opportunities for co-location, including the option of multiple bases for teams in rural areas and multiple bases for staff. • Business processes need to be agreed and implemented with issues such as recording policy and process, confidentiality, and data collection and storage. • The role of administration will need to be determined, including roles in co-ordinating information gathering and support.

The Way Forward • Small team to take forward implementation of Integrated Teams, matching them to local context – roll out April 06 - September 07 • HR working group produce policies and procedures, complaints processes, personnel issues, training and preparation for integrated team development • Asset Management planning group to analyse and recommend options for integrated co-location • Business systems group looking at referral processes, data collection/storage, information sharing and confidentiality • Management group including representation from the voluntary sector to co-ordinate and oversee the groups and project development

Children’s Centres – national guidance and local implementation Guy Kirk Children’s Centre Programme Manager 1/2/2006

What I will cover today: • ‘Setting the scene’ - national context, legislative framework, key policy initiatives • Children’s Centres – what are they and where do they fit in? • Local plans and progress • Where does primary care fit in?

We are at the beginning of a long term commitment

Some Key National Policy and Strategy Documents Inter-departmental Childcare Review (2002) Every Child Matters: Change for Children National Service Framework for Children, Young people and Maternity Services Ten year strategy for Child Care Working with voluntary and community organisations to deliver change for children Youth Matters Green Paper Children Act 2004 Children’s Trusts (and the CYPPlan)

Be healthy Stay safe Enjoy and achieve Make a positive contribution Achieve economic wellbeing (ECM:Change for Children,2004) Every Child Matters Change for Children Programme “Children and young people have told us that five outcomes are key to well being in childhood and later life”

National Service Framework for Children, Young People and Maternity Services “Improving the health and welfare of mothers and their children is the surest way to a healthier nation – the best way to achieve a fairer society is to improve health and tackle inequalities in childhood” (Professor Al Aynsley-Green : foreword to the NSF 2004)

Legislative underpinning • The Children Act 2004 provides the legal underpinning for Every Child Matters: Change for Children. (ECM:Change for Children 2004)

Children Act 2004 • Establish a Children’s Commissioner for England • LA’s to make arrangements to promote cooperation between agencies to improve children’s well-being • Safeguarding and promoting welfare of children – key agencies must work together • Joined up databases • Local Safeguarding Children Boards • Children and Young People’s Plan • Director of Children’s Services – responsible for (at least) education and children’s social services functions • Integrated Inspection Framework

ECM : radical change with whole system transformation • Improvement and integration of universal services • More specialised help • Reconfiguring services around the child and family • Sharing responsibility across agencies • Leadership – at all levels of the system • Listening to children, young people and families

ECM: a national framework with a local focus • Step change in quality, accessibility and coherence of services • Transformational agenda • Involving everyone • Partnership • Dialogue • Local change programmes • Build on what works and tailor services to need

Part of the ‘Sure Start’ initiative Key mechanism for delivering both the ECM outcomes and the NSF agenda Part of the continuum of extended services to babies, children and their families in the journey to adulthood and beyond….. Children’s Centres; what are they and where do they fit in?

The Children’s Centre Vision • Improving outcomes for all young children • Reducing inequalities in outcomes between the most disadvantaged children and the rest • Children’s Centre services in all the most disadvantaged areas – moving to reach every child and every community by 2010 • Services tailored to need

Children’s Centres – key to delivering:- • The best start in life for every child • Better opportunities for parents • Affordable good quality childcare • Stronger and safer communities

Role of Children’s Centres • Coordinating the delivery of effective integrated early years and childcare services across the county • Bringing all partners together to identify need and deliver services in a way that meets local need • A way of ‘thinking and doing’ • Better outcomes for families and children

The ‘Core Offer’ • Good quality early learning - integrated with full day care provision • Good quality teacher input to lead the development of learning within each centre • Parental outreach • Family support services

The ‘Core Offer’ (cont.) • Support for parents and children with special needs and disabled children including early identification of need and provision of services • Child and family health services – including antenatal services • Local advice and information for parents

Children’s Centre’s will also……. • act as a ‘service hub’ within the community for parents and providers of childcare services for children of all ages • offer a base for childminder networks with a link to local Neighbourhood Nurseries, out of school clubs and extended schools” ……and “have links with local training and education providers, Jobcentre Plus and Children’s Information Services” ……plus • Provide management and workforce training

All partners working together…..to achieve….. • Services for all • Flexible at point of delivery • Starting early • Respectful and transparent • Community driven and professionally led • Outcome focussed • Integrated and joined up

Local plans and progress • 2004 – 2006 NCC to: • Create 239 additional childcare places in 20% most disadvantaged wards • Reach 3,573 under 5’s

Blyth Town ABC Cramlington ABC Blyth Ashington Berwick Wooler Bedlington Choppington - SSD - Barnardos - Barnardos - NCH - SSD - SSD - SSD - SSD Delivered by Phase 1 Centres