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Improving Health Needs Assessment processes for newly looked after children

and young people.AHPs leading better care in a multi professional, partnership setting.

A Macleod, Clinical Lead Dietitian, Paediatrics§, R Barclay, Service Development Manager, Children’s Services§, Dr L Watson, Consultant in Public Health Medicine, Child Health Commissioner§ Dr L Hay, School of Medicine† § NHS Fife † University of St Andrews, Fife. Contact: alisonmacleod1@nhs.net

BackgroundLooked after children and young people have poorer life outcomes and are likely to have additional physical and emotional health needs compared with their non looked after peers1.Health Boards in Scotland are expected to provide all newly looked after children (LAC) with a Health Needs Assessment (HA) within 28 days of notification by the Council2, enabling earlier planned access to any required services, to improve wellbeing and enable them to reach their full potential3.In 2015, NHS Fife Corporate Parent Board approved a target to increase by 31 March 2016 (Stage 1), from 60% to 80% the proportion of newly looked after children who are offered an HA within 4 weeks of notification from Social Work. This poster describes parts of a project undertaken by Alison Macleod (AM) to improve the HA processes for LAC.

AimsAM was seconded to a project (0.2 WTE for 6 months) to i) review Social Work and NHS processes ii) work with key staff to streamline systems, increase NHS capacity and make more effective use of available resources to meet the HA target.Audit work4 identified a need for improvements in the following processes:1. Notification and receipt of all required referral

documentation from Social Work (SW) to NHS Fife, to enable the HA to be undertaken within the agreed timescales, and

2. Improve communication between NHS and Social Work to ensure families attend the agreed appointments.

MethodsBlended learning and resources, focused on project/change management and quality improvement tools were used to direct the performance of teams, working in partnership to promote collaborative discussions across staff groups in both organisations. This helped to facilitate focused problem solving on selected topics and communicate consistent messages about progress, using data for improvement and data for performance.

Results and OutcomesThis project has increased • from 16% to 30% cases that can proceed to

HA with all required data obtained from SW• from 26% to 50% children receiving a HA

within 8 weeks (56 days) of notification to NHS

• the number of children with a completed HA from 35 over 9 months in 2014 to 39 in the last 4 months (2015/16)

This range of activities has also reduced average time taken for all documents to be sent from Social Work to NHS from 49 to 26 days.

Achievements• Methods for reliable NHS data collection have

been validated.• Blocks in systems and less helpful variation

in the processes were identified and in some cases, eliminated.

• Updated, streamlined, transparent processes for HA, with written agreement between Fife Council and NHS Fife have been established. Desired outcomes and target times for each stage have been agreed by stakeholders.

• Increased awareness of the importance of the HA, the targets and correct processes for NHS clerical staff, leading to greater confidence in managing this workload.

• A new single point of contact (SPOC) in health and all-electronic transfer of documents in process, to speed up system and enable HA progress tracking.

ConclusionsA number of NES resources have been helpful in undertaking this project. More training and tools to facilitate AHP leadership in multiagency project management would be welcome. This would further spread the use of improvement methodology in organisational change and service redesign.

References1. Scott S, Hattie R & Tannahill C (2013) Looked After Children in Glasgow

and Scotland: A Health Needs Assessment. Glasgow: Scottish Public Health Network (ScotPHN).

2. Scottish Government (2009) Implementation of Action 15 of the Looked After Children and Young People: We Can and Must Do Better Report. CEL 16 (2009). Edinburgh: Scottish Government. www.sehd.scot.nhs.uk/mels/CEL2009_16.pdf

3. Scottish Government (2015) Getting It Right For Looked After Children and Young People; Early Engagement, early permanence and improving the quality of care. Edinburgh: Scottish Government.

4. Hay L (2015) Looked After Children’s Health Assessment Audit, NHS Fife, January 2015, REPORT (Revised 6/2/15). NHS Fife, February 2015.

“Getting one person to collating all the

documents will save lots of clerical time”.(Clerical Team)

“I think being able to email the Social Worker

will make a big difference and help speed up the

process. Looking forward to trying it out”. (Clerical Team)

“The process map is very useful and reminds me what I need to do

when” (Social Worker)

“I am new to Fife. It was helpful to be given the

timescales and the steps that I need to do and

what health does in the process”

(Social Worker)

“Good to have the reasons explained for importance of health needs assessment and reasons for timescales”

(Social Worker)