Child Health and Wellbeing Building a Structure to Enable ......• Cross reference with visual and...
Transcript of Child Health and Wellbeing Building a Structure to Enable ......• Cross reference with visual and...
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Child Health and Wellbeing
Building a Structure to
Enable Integrated Change - Getting System Engagement Right
Third Regional Engagement June 25th
Your Voice Your Network
Hosted by
Brandon, Samantha, & Saul
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Social Media
@NorthNetworks #NEChildren
#YourVoiceYourNetwork
Camera Shy – let us know
Slido.com
#YourVoiceYourNetwork
Wifi code - BT Openzone
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Who has joined us?
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12 Clinical
Commissioning
Groups
12 unitary local
authorities in NE
(plus N Yorks and
Cumbria County
Councils with
districts)
Cumbria
North
Yorkshire
Integrated Care System
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Evolving Hypothesis
“In the North East and North Cumbria we
believe all children and young people should be
given the opportunity to flourish and reach their
potential, and be advantaged by organisations
working together”
-
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Our ask of you today
• Listen to other perspectives
• Think Child over organisational boundaries
• Share your perspective
• Commit to help progress things
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Dr Mike McKean
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Our Journey so far…..
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Journey so far…………..
• 3 residential meetings attended by 16 senior leaders
• 2 regional events attended by 240 professionals and young people
• 2 surveys with 1000 responses
• Published Survey findings (x2)
• Had our first Network Huddle with International expert on Population Health
• Defined our Priorities
• Developed a list of network contacts
• Developed a list of what is wanted from the network
• Some quotes from the CYP……..
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Comparison of top themes / priorities of CYP with those
highlighted by professionals working with CYP
Professional Survey (Feb 19)
CYP feedback: both focus groups and survey
Top 5 priorities for children and young people
(n = 497)
The top four most frequently mentioned themes
(n= 600 approx.)
Mental health
Mental health and wellbeing,
Poverty – children living in low income families
Being physically healthy
Children with additional needs (learning and physical
disabilities
Having enough money to make healthy
choices/reducing poverty.
Health promotion and prevention of illness
Ensuring that young people are prepared for
adulthood.
Equitable access to services including mental health
services
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Messages to the network from young people
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A Word on Wellbeing and the Arts
Eldridge Labinjo
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Question Time
Purpose of a Network
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System discussions around your table
theme
Heather Corlett
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60 mins – down to business!
First 30 mins
• Facilitator & Young person – identify a scribe
• System introductions and connection to theme
• Brainstorm opportunities
Middle 20 mins
• Shortlist (paper provided)
• Cross reference with visual and UNICEF
Last 10 mins
• A few thoughts in plenary
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Quick Cuppa
Quick Refreshments
Back for a prompt start at 11.20
Don’t forget to Tweet!!
@NorthNetworks #NEChildren
#YourVoiceYourNetwork
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Mike McKean
My Story
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Michael Wood
How can we work together?
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Doing our bit - How can we work together?
Michael Wood
Head of Health Economic Partnerships
NHS Confederation
25 June 2019
@NHSLocalGrowth
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Cost Invest-ment
How do local partners see the health sector?
Is the NHS involved in local discussions about raising money or spending money?
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Why am I here today?
• Child health and wellbeing is the main building
block of a functioning and fair society and economy
• Developing the ‘place’ is challenging yet fun
• What is our role in this? • Taking the first (or second, third) step…
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The productivity puzzle and ‘place’
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Why ‘place’ really matters?
• UK regional productivity often similar or
worse than Poland, Hungary and Slovakia
and former DDR
• Very weak levels of business investment
in R&D; and concentrated in too few (EU dependent)
sectors
• Interregional problem is worst in OECD with ‘decoupling,
dislocating and disconnecting’
• Measured comparatively, 11 of the 21 poorest local
economies in Northern Europe are in England (Eurostat)
• Most UK regions up to 4 times as dependent on EU markets
than London / South East
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What does this mean for local: • Demand for public services?
• Tax receipts?
• Business investment?
• The future workforce?
• Opportunities for young people?
• Living standards?
How can we make ourselves better and better off?
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A glimpse of the scale of the NHS
• Deals with over one million patients every 36 hours • Employs 1.3m staff • Annual health budget of £125bn (c7-9% of GPD) • Second largest public land owner (behind MoD) • Responsible for 5% of all road traffic journeys • Largest payer of Apprenticeship Levy • Been promised £20bn uplift over 5 years (3.4%)
But is it doing enough for what your ‘place’ needs?
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• Employment 2014/15 (based on review of
local CCG and NHS Trust accounts)
• Permanent employment: 29,000 jobs (24,200 full-time (FTE) equivalent jobs)
• Plus Bank (4,400) and Agency staff (2,100) FTE
• Total direct jobs funded by the NHS: 30,800 FTE
o 6.3% of the Black Country workforce
• Total impact (after multipliers): 40,800 FTE
o 8.3% of the Black Country workforce
• Informal care: 3.9m hours per week (c100,000 FTE)
• Expenditure 2014/15 (based on a review of local CCG and NHS Trust accounts)
• Annual spend of £2 billion on
o Wages / other benefits: £1.1bn
o Purchases: £0.9bn
• Gross Value Added 2014/15 (based on wages and
reported surpluses)
• Direct economic impact: £1.1bn
o 5.5% of Black Country GVA
• Total impact (after multipliers): £1.5bn
o 7.9% of Black Country GVA
NHS spending and jobs in the Black Country
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Skills and inclusive growth • NHS the largest employer in every area yet
currently has c100,000 vacancies (at every level) nationally
• Challenging local labour markets with increased competition – how are we engaging schoolchildren in 350+ careers? Our role in Careers Advice? Inspiring? T-Levels?
• UK in-work poverty increased by 40% in last 20 years – can we target recruitment across local areas to fill vacancies and (more importantly) increase population health?
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Innovation
• UK govt committed to increasing spend on R&I to 2.4% by 2027
• ‘Healthy Ageing’ a grand challenge of the Industrial Strategy and noted NE priority – how can child healthy agenda be recognised as complementary? Is this narrative recognised?
• New research funding targeted at economic priority areas and needing local collaborations – where is your voice in new research funding world?
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Infrastructure
• £10bn backlog on NHS capital infrastructure – 18% of hospital estate pre-dates NHS
• DHSC has housing target of releasing land to build 26,000 homes by 2020 – will these houses be ‘healthy’? Key-worker? Is there a need to develop principles for developers on child wellbeing?
• North of England desperately missing out on national financing of transport infrastructure – are we championing HS2/ECML?
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Anchor institutions
• NHS organisations one of key assets in every local economy; in terms of employment, procurement, estates, investments etc
• Increased awareness of economic and social externalities of NHS board level decision-making – what ‘measures’ could boards in NE sign up to that fit with child health and wellbeing network? How do we address the sustainability agenda?
• ‘Value’ of NHS organisations often found outside NHS – what does it mean for local economy? – Can we support the NHS roll-out of social value and/or establish anchor networks?
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Where is the child health and well-being voice when we are planning for:
Addressing our future workforce
Increasing wellbeing
Managing demand for
services
Adopting and scaling
innovations into practice
Developing an estate fit for the
21st Century
Pooling investment
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Final thoughts from me • Do you know how important you are? – The economy of the
North East depends on these discussions
• What are your main ‘asks’ and ‘offer’? – for both a local and a national audience
• Opportunities to pool resource, particularly around 3.4% uplift in NHS funding – hardest part is often translation
Michael Wood @NHSLocalGrowth [email protected]
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Innovation hub to share great practice ! Summary of Hubs on your table Commences at 12.30 sharp after lunch. Minimum of 4 iterations of c12 minutes each. 6 minutes of discussion and 6 minutes of Q&A/discussions Music will sound the close of each session and then the next session commences when the music stops. Enjoy!
Great Hall
Door Stage
Hub 1
Hub 2
Hub 3
Hub 4 Hub 8
Hub 7
Hub 6
Hub 5
lunch lunch
Hubs 9-14
WORKING LUNCH - #NoRestHere
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back at 1.20
Please
complete the
evaluation
sheets and
Over Lunch
please visit at
least 4
innovation
stands from your
list – Music starts
and closes the
short sessions
from 12.30
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Innovation Hub – Feedback from Young
People and Core Leaders
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System discussions around your table
theme – Take 2
Heather Corlett
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70 mins – take your network forward!
First 25 mins
• Reconnect – summary sheet
• 3 Small Groups
• Opportunity on a page template
Middle 25 mins
• Back as one group
• Test and improve 3 Opportunity on a page template
• Hand in all paperwork in folder!
Last 20 mins
• A few thoughts in plenary
• Commitment cards and comfort break
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Neil Davidson and Helen Leonard
Coproduction
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Sir Al Aynsley-Green
Where to now?
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New ways to improve the lives of children and young people – it really doesn’t have to be like it is now! Sir Al Aynsley-Green Kt.
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Al’s steer here in March 2019: You’re doing the right thing!
Challenges, yes.
BUT
Opportunities galore. Need to:
•Look out of the box
•See what’s going on elsewhere
•Define what we want to achieve for our children
CARPE Diem! – Seize the day
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Now: • Brilliant progress – well done!
• Unreserved support for what you are doing
• An example to the rest of the country
Because of:
• Vision based on evidence
• Refreshing willingness to ‘look out of the box!’
• Outstanding leadership across organizations and sectors
• Brilliant support staff
• Genuine participation of stakeholders especially C&YP
• Linking in openness, friendship and collaboration with others in England and overseas
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Al’s stock-take – Challenges to confront:
• Clarity on strategy and tactics
• Politics and need for independence
• Change and diffusion cascade theory
• Funding
• Media and PR
• Long term sustainability
• HDYKYDAG!
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Strategy and tactics • ‘Sweet-shoppe’ metaphor
• Massive, daunting horizon
• Focus on what’s do-able
• Absolute clarity on purpose
• Begin with the end in mind
• Values and principles
• Time invested in strategy is time well invested
• Deliver a few ‘quick wins’ to confirm credibility
Let’s look at a case history:
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The Children’s Foundation, Newcastle upon Tyne • 1984 - ambitious plans to improve the lives of children eg
head injury
• 1987 - example of the GOSH campaign
• Need for local resources through fund raising – How to do it?
• NECCRF and Brisbane and Cincinnati Children’s Hospitals
• Approach to Procter and Gamble in Gosforth
• P&G New Products Marketing Department • Maurice Harvey
• Brand identity
• Marketing
• The Children’s Foundation & The Yellow Brick Road
• Exposed to the P&G corporate culture –’Total Quality Management’ and Stephen R Covey. I was TQM’d!
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William Edwards Deming (1900-1993) Is considered to be the most influential non-Japanese person in the field of the Japanese manufacturing industry. There he defined the management principles of Total Quality Management (TQM) Key Philosophy: Understanding the customer-supplier relationship
The P&G Corporate Culture – Edwards Deming
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The P&G Corporate Culture – Stephen R Covey
Private victory: 1. Be proactive 2. Begin with the end in mind 3. Put first things first Public victory: 4.Think win-win 5.Seek first to understand then to be understood 6. Synergize
Overall: 7. Sharpen the saw!
Used by Al in all responsibilities
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The Children’s Foundation: Brand and marketing
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The initial image The ‘hub and spoke’ paradigm
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Big obstacles!
• Meeting at Dryburn Hospital 1989
• Thumbs down!
• P&G Conflicts Officer
• Understanding antipathy
• Change in presentation and function
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The ‘paradigm shift’ – a partnership network delivering mutual support through synergy
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Understanding change cascade theory
The human constituents in generating change encompass:
Innovators 2%
Early adapters 10%
Followers 48%
Agnostics 30%
Recalcitrant 5%
Saboteurs and wreckers 5%
Understanding who’s who is key! And how to handle them!
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Building a resource for the future - an academic centre to support research and teaching for children and families
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Involving and giving benefit to schools
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Lessons from the saga: Overall messages:
• Professionalism in strategy and delivery coupled with effective PR, media and marketing
• Harnessing skills and resources outside NHS and University sectors
• The extraordinary generosity of the people of the North when given a concept they can relate to
• Longevity – the children’s Foundation will be 30 years old next year
Hard lessons:
• Human nature – maintaining the status quo, threats to territory, influence and funding; envy, resentment, spite
• Easy to start something new, difficult to sustain
What do these mean for the new network? Is the YBR relevant?
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A reality check – politics! Overview: Utterly dire! Brexit has sucked the life out of policy thinking Unknown consequences of leaving the EU Austerity still rules
Failure of recent policies: National Service Framework for Children and Young People Every Child Matters Northern Powerhouse - >200,000 children more in poverty Universal credit fiasco Crisis in education NHS targets not met or abandoned Social care dominated by the elderly Devaluation of politics and the political class
This is the political climate we’re working in
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Shifting the political deck chairs
Al worked under 3 Secretaries of State, and 3 ministers in 5 years
What will happen in the next five years?
Who will be the ministers?
Will the 10-year NHS Plan be delivered?
Who will be speaking for children and families?
What does this mean for planning a long-term strategy for the Network?
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A vulnerable and entirely dependent newly born citizen
Remember who we are working and speaking for!
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An aspect to consider? Children’s oral health
A key indicator on how well we’re doing for children. A canary in the mine?
Some stark facts* Improvements now reversing – 42% 2-11 yr-olds have caries in primary teeth, 23% untreated; 21% have caries in permanent teeth; linked to inequality. Its entirely preventable!
• 35,000 children admitted to hospital each year for extractions
• Cost to NHS £836/child for anaesthetic = £30.5m to NHS annually
• 27% parents are unconcerned about tooth decay
• 63% teachers concerned about the state of children’s teeth; 81% feel parents do not know enough about dental care
What about the pain, fear and impact on children eg ability to learn?
What does this mean for the Network’s children? *from the Dental Wellness Trust
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Real hope we can change things Working with and learning from other inspirational people - In England - the 3-centre collaboration:
• NEast and NCumbria Network
• Cornwall: the Duchy Health Charity’s Integrated Health in Schools initiative
• Nottingham: The Nottingham Centre for Children Young People and Families
Internationally:
• Canada: UBC Human Early Learning Partnership, Vancouver
• Finland: Early Years collaboration
• Scotland: Getting it Right for Every Child (GIRFEC); Prince Charles and the Dumfries House Foundation, East Ayrshire schools; addressing youth suicide
Do we need a travelling fund to get out to see and meet others?
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Finally, spreading the word: Local and national events/conferences.
• Each centre is already holding events bringing the Great and the Good together
• Possibility of one or more national events soon under the strap-line of the title of this presentation
• Agreement to hold event at Nottingham Trent University in 2020
• College of Medicine agrees to explore opportunities
• Royal Society for the Arts, the Prince’s Trust are alert to the possibility
• Huddles to explore the methodology/metrics to understand children’s lives: University of British Columbia, Canada
Understanding the science of effective political advocacy through research? Evidence, publications, research projects & fellows
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Wrap up:
• Despite the dismal political circumstance, there is real momentum building for change to improve the lives of children, young people and families.
• The NEast and NCumbria Network has a mouth-watering opportunity to be at the forefront of developments
• We must celebrate new ways of making a difference – it really doesn’t have to be like it is now!
Well done and Carpe Diem!
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Child Health and Wellbeing
Network – Your Network Your
Voice
Third Regional Engagement June 25th
Mike McKean
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Last few things…..
Thank you to all YOUNG PEOPLE speakers, panel members, facilitators, support staff and every participant!!
And Finally …….
• Don’t Forget your Commitment Cards
• Our website -https://nhsjoinourjourney.org.uk/what-we-are-doing/priorities/optimising-health-services/
• Grow membership to the network via [email protected]
• Watch this space!
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Ready to join our Journey?
69
It won’t be easy…..
….but it will be worth it!
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In the words of Henry Ford
“Coming together is a beginning.
Keeping together is progress.
Staying together is Success.”