Partners in Paediatrics Annual Conference 12.10 · 2012-12-18 · to work -streams for IT...
Transcript of Partners in Paediatrics Annual Conference 12.10 · 2012-12-18 · to work -streams for IT...
Partners in Paediatrics Annual Conference
12.10.2012 The future for clinical networks – the
RCPCH perspective Dr Carol Ewing
RCPCH Workforce Officer
The future for clinical networks – the
RCPCH perspective • Current challenges
• RCPCH and other standards
• RCPCH and clinical network models - ‘Bringing networks to life’
• Links to Paediatric surgery
• Participation
• Next steps
The challenges ahead across the UK • NHS system - change and financial constraints - ‘children are not mini adults’
• Health and Social Care Bill and unclear education/training and workforce arrangements for England
• Poor outcomes , inconsistencies in, and fragmentation of care
• Obesity
• Safeguarding
• Transition from children’s to adult services
• Delivering care in the wrong place
• Too many in - patient units
• Middle grade shortages
OUTCOMES - All cause mortality in children aged 0-14 years in European countries
©2011 by British Medical Journal Publishing Group: Wolfe I et al. BMJ 2011;342:bmj.d1277
Children’s NHS Health Outcomes Forum Recommendations
Health Outcomes which matter most for children, young people and their families
4 new indicators :
• Time from first NHS presentation to diagnosis or start of treatment
• Integrated care - developing a new composite measure
• Effective transition for children’s to adult services
• Age – appropriate services – with particular reference to teenagers
Children and Young People’s Health Outcomes Forum report
• Putting CYPF at the heart of what happens
• Acting early and intervening at the right time-NNAP
• Integration and partnership – unique NHS number
• Safe and sustainable services
• Workforce , education and training – all GPs have validated CPD appropriate for CYPF care
• Knowledge and evidence – NHS Atlas
• Leadership, accountability and assurance
• Incentives for driving service improvements
STANDARDS
Facing the Future: A review of paediatric services
10 standards for acute care
Measurable, achievable, provider
• Who sees a child and how soon
• Consultant led handover
• Advice and availability
• Compliant rotas
• Access to child protection help
Facing The Future - Principles
1. All trainees will be WTR compliant
2. All trainees will have appropriate training/education (3 days per week)
3. Consultant delivered service with defined minimum safety standards
4. Reconfiguration - Maintaining locality services through SSPAUs
5. Increasing training places for GP Trainees
6. A sustainable consultant trainee ratio
Other Paediatric Service Standards/Policy context
• Intercollegiate standards for paediatric emergency care (2012)
• BAPM Neonatal standards( 2001/2010) • RCPCH - A charter for Paediatrician ( 2004) …A handbook
for Paediatricians • Improving services for children in hospital ( Health Care
Commission) 2007 • DH – Commissioning safe and sustainable Paediatric
services – a framework of critical interdependencies 2008 • RCPCH – Supporting reconfiguration – a framework for
standards ( 2008) • RCPCH Remote and Rural Standards 2011/2012 • MtF 1,2,3 ( 350 references) • Lack of subspecialty standards
RCPCH 2011 ‘Bringing Networks to Life’
A tool kit for paediatricians so that they can get involved in clinical networks
www.rcpch.ac.uk/networks
Local
• Regional
• National
Improving standards of kidney care, RCPCH 2011
Stepwise development of networks • Clinical association – sharing best practice
• Coordinated clinical forum – sharing audit and jointly agreed protocols
• ‘Developmental network’–operational models, links between organisations – no contract
• Managed (clinical) network – formal management structure, defined objectives, governance framework
Examples of clinical networks
• Audiology network – 2 London PCTs
Informal comprising clinical staff – doctors, health visitors and school nurses – training for all PCT staff – good communication
GM Paediatric Cerebral Palsy Network - aim to develop best practice across disciplines and 1ry, 2ry and 3ry care; using audit, outside speakers
Examples of networks
• South Wales Critical Care –driven by centralisation of services and need for education/support.
• No formal funding /management
• Good will
• Website to use as a resource for protocols and pathways
Examples of Networks
• Greater Manchester Children Young People and Families’ Network
• Making it Better www.makingitbetter.nhs.uk
• Large scale reconfiguration of children’s and maternity services – community nursing teams ;12 to 8 co-located paediatric/obstetric units( 5 SCBUs); 2 to 3 NICUs
• Implementation plan since 2007
Bolton
CMFT
Wythenshawe
Rochdale Bury
Wigan
Salford
Trafford Tameside
NMGH
Stockport
Maternity
Oldham
SCBU Children’s
Care
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Care closer to home
Care closer to home
RMCH
Booth
Hall
Neonatal intensive care
Children’s Surgical Forum - General Paediatric surgery
• 25% of the population are children • Managed Clinical Network model is essential • Standards for Children’s Surgery – CSF 2007 report
currently being revised • Interdependency with anaesthesia and paediatrics • On – site anaesthetists for resuscitation • All staff have safeguarding training and in the management
of pain (HCC reports) • Presence of/access to on – site paediatricians and if no
overnight inpatient services- need agreed service specification with links by video/telephone/access to paediatricians out of hours
• Ensuring the provision of GPS in the District General Hospital, CSF 2010
Participation
• www.rcpch.ac.uk/participationresources
• CYPF influencing child health research, policy and advocacy to improve child health and paediatric services
• Experts leading meaningful participation of CYP
• Young patients and families advising the RCPCH
• Young patients and families influencing training and education resources
Next steps for the RCPCH
• Re - scoping the numbers and types of networks across the
UK
• Developing, auditing and implementing standards e.g. FtF
• Outcomes –CYP Health Outcomes Framework, NNAP, National
Diabetes Audit, CHR-UK
• Developing clinical and network models for sub specialties -
working with CSACs, SIGs , using pathways, quality
dashboards
• Using our own databases – e.g. workforce census and linking
to work -streams for IT developments /NHS Atlas of Variation
• For England - working with NHSCB leads, Network leads ,
Specialist Commissioning ( CRGs), CCG leads, DH and other
stakeholders
• Using RCPCH Participation leads/Youth Forum
• Strengthening links with paediatric surgery