South East Coast Strategic Clinical Network - Maternity Children and Young People Strategic
Commissioning Advice 2015/16. For Internal NHS use only
Maternity,
Children and Young People
Strategic Commissioning Advice
2015-16
Authors: Jan Pathan, Lorraine Mulroney, Laura McGuinness, Charlotte Clow
Email: [email protected]
Web: www.secscn.nhs.uk
September 2014
1
Table of contents

Purpose and Summary
Page 4

MCYP Commissioning Guidance
Pages 6 - 18
o Maternity (Pages 6 - 8)
o Children and Young People (pages 9-14)
o
Children and Young Peopl’s Mental Health (Pages 15-16)
o Transition to Adult Services (Pages 17-18)

2
References
Page 20
Purpose and
Summary
3
Purpose and Summary
The purpose of this paper is to provide commissioners of healthcare services across
the South East Coast (Kent & Medway, Surrey and Sussex) with strategic
commissioning advice in relation to Maternity, Children and Young People’s (MCYP)
healthcare services. This is intended to support the production of Clinical
Commissioning Groups (CCGs) 2015/16 commissioning intentions and is based on
the MCYP SCN strategic work programme, which was developed during 2014/15 to
support CCGs, direct commissioning and joint commissioners.
The MCYP SCN baseline review for maternity and CYP was produced in September
2013 and provided benchmarking detail across SEC to identify the unwarranted
variation and local priorities which underpinned the development of the SCN work
programme.
The SEC MCYP SCN work programme priorities have been grouped under and/or
across the NHS outcome domains in order to demonstrate how the work of the SCN
will support the delivery and achievement of these indicators. The SCN work
programmes for each of the MCYP areas are outlined below:
Maternity:
 To reduce perinatal mortality and morbidity

To promote high quality maternity care and experience
Children and Young People:

To reduce inappropriate paediatric attendances and admissions to secondary
care delivered through a programme on moving the clinical care of children &
young people from secondary to community and primary care settings (NHS
at Home)
Transition from paediatric to adult services:
 Transition best practice pathways
Information is also provided on key strategic work programme areas which will result
in specific guidance on what good looks like either within 2015/16 or within the
current 5 year lifespan of the SCNs to 2018.
All guidance produced by the MCYP SCN draws on wide stakeholder membership
including clinicians, patients, carers, voluntary sector, commissioners, and local
authority and public health colleagues. Where the documents are work in progress,
they will be shared once complete.
4
Maternity, Children
and Young People
Commissioning
Guidance
5
South East Coast Strategic Clinical Network - Maternity Children and Young People Strategic Commissioning Advice 2015/16. For Internal NHS use only
Maternity Work Programme
Maternity SCN
Work Programme
Maternity SCN Project
National Priorities
Maternity SCN Commissioning Guidance
and relevant Outcome
Indicators
Domain 1 – Preventing people from Dying Prematurely
Agreed model of care to
support the reduction of still
birth (2015 – 16)
NHS Outcomes Framework*
1.6ii. Neonatal mortality and
stillbirths
Agreed best practice
pathway and associated
case for change for pre-term
birth (2015 – 16)
CCG Outcome Indicators
Reducing deaths in babies and
young children.
C1.13. Antenatal assessments <13
weeks
1.4. Maternal smoking at delivery
1.5. Breast feeding prevalence at
6-8 weeks.
To reduce perinatal
mortality and morbidity
Agreed best practice
pathway for the reduction of
perinatal mortality across the
region, by addressing
capacity issues within the
maternity scanning
workforce.
NHS England Business Areas
1. Prevention and early diagnosis
4. Patient experience
5. Patient safety
8. Equality and health inequalities
9. Maternity, children and young
people
17. Data, digital and customer
services
19. Citizen participation and
empowerment
SCN recommendations are being produced with oversight from the Maternity Clinical
Advisory Group. Recommendations will outline a best practice pathway for still birth
across South East Coast (SEC). This work is currently in the early stages, to be rolled
out in 2015/16.
SEC SCN Clinical Lead: Leila Frodsham. Email: [email protected]
SCN recommendations are being produced with oversight from the Maternity Clinical
Advisory Group. Recommendations will outline a best practice pathway for pre-birth
across South East Coast (SEC). This work is currently in the early stage to be rolled
out in 2015/16.
SEC SCN Clinical Lead: Lesley Roberts. Email: [email protected]
Baseline assessment of current capacity to be completed in partnership with HEKSS.
SCN recommendations to be produced with oversight from the Maternity Clinical
Advisory Group. This work is currently in the early stages and aligned to the national
HEE programme of work.
Links with NHS Outcome Framework - Domain 5
5.5. Improving maternity services: Admission of full term babies to neonatal care
* https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/256456/NHS_outcomes.pdf
6
South East Coast Strategic Clinical Network - Maternity Children and Young People Strategic Commissioning Advice 2015/16. For Internal NHS use only
Maternity SCN
Work Programme
Maternity SCN Project
National Priorities
Maternity SCN Commissioning Guidance
and relevant Outcome Indicators
Domain 4 – Ensuring that people have a positive experience of care
Agreed maternity standards
and associated KPIs across
South East Coast
To promote high quality
maternity care and
experience
Agreed maternity dashboard
that supports both providers
and commissioners across
South East Coast
NHS Outcomes Framework
4.c. Friends and Family Test
4.5. Improving women and their families’
experience of maternity services
CCG Outcome Indicators
C4.2. Patient experience of hospital
care.[NHS OF 4b]
C4.9. Friends and Family Test for
inpatient acute and A&E. [NHS OF 4c]
Improvement Areas
C4.7. Friends and Family Test
NHS England Business Areas
1. Prevention and early diagnosis
4. Patient experience
5. Patient safety
8. Equality and health inequalities
9. Maternity, children and young people
17. Data, digital and customer services
19. Citizen participation and
empowerment
7
SEC SCN draft maternity standards and associated KPIs have been
produced and reviewed by the Maternity Clinical Advisory Group and
overarching SEC SCN MCYP Steering Group. Developed in line with RCOG
Standards recommendations:
http://www.rcog.org.uk/files/rcog-corp/uploadedfiles/WPRMaternityStandards2008.pdf
Final versions to be shared once completed.
A SEC maternity dashboard is currently in development. The pilot phase will
be rolled out in late 2014/early 2015. Full roll out across SEC will take place
in Spring 2015.
The introduction of a robust and valid maternity dashboard will allow all
maternity units within the South East to obtain a clear view of the quality and
safety of their own service. In addition the regional view will highlight areas
where there is variation in practice and provide valuable benchmarking to
facilitate improvement.
Final versions to be shared once completed.
South East Coast Strategic Clinical Network - Maternity Children and Young People Strategic Commissioning Advice 2015/16. For Internal NHS use only
Additional Information (Maternity)
Key deliverables for maternity
within the NHS England
Business Areas (2014 – 15) to
(2016 – 17)









Key contact details for
maternity within South East
Coast Strategic Clinical
Network
8




New maternity commissioning guidance for CCGs will be produced by September 2015. This will include the
NICE definition of a named midwife and support CCGs in offering choice where appropriate. All women booking
for maternity care from March 2015 will have access to a named midwife.
Best practice guidance to support the implementation of the suite of recommendations from reviews across
maternity and children & young people services will be produced by April 2015.
Development and delivery of a pathway to support women with postnatal mental health problems will be
produced by March 2015.
Professional nursing & midwifery guidance to support high quality commissioning for maternity services will be
produced by September 2014.
A leadership model for clinical frontline staff which ensures high quality decision making to reduce stillbirths and
minimise negligence in maternity services will be developed by June 2014 and fully delivered by October 2015.
Development of a Maternity and Perinatal National Clinical Audit ensuring the chosen option has adequate detail
to support specification development with the commissioning process began in July 2014 and the contract will
be awarded and work underway by May 2015.
Evidence for best practice models for preventing still births and publish guidance with key partners will be
reviewed and collated by March 2015.
Implementation of the maternity and child health datasets
Link: http://www.england.nhs.uk/wp-content/uploads/2014/04/ppf-1415-1617-wa.pdf
Laura McGuinness - Quality Improvement Lead (Maternity)
Email: [email protected]
Telephone: 01138 248981
Website: http://secscn.nhs.uk/
South East Coast Strategic Clinical Network - Maternity Children and Young People Strategic
Commissioning Advice 2015/16. For Internal NHS use only
Children and Young People (CYP) Work Programme
The CYP programme is aligned to the following frameworks: NHS Outcomes Framework,
Public Health Framework, CYP Outcomes Framework, Future NHS and PHE Frameworks
indicators for 2015/16 and NICE quality standards.
The overall Programme output is to produce an agreed children’s community nursing service
model and associated service specification and guidance for best practice pathways for out
of hospital care based on the forthcoming Department of Health Guidance
In the 2011 report Improving Children and Young People’s Health Outcomes: a system wide
response, the Government recognised the role that failures of care have played in poor
outcomes for children and young people, and pledged to better suit the NHS Outcomes
Framework towards achieving these goals wherever possible. The CYP Forum’s Work Plan
for 2014 can be found at:
https://www.gov.uk/government/publications/improving-children-and-young-peoples-health
The CYP Programme is essential to support the CCG’s 5 YEAR PLAN specifically for the
following areas:
East Sussex: The SCN Programme can support the following areas identified in the 5 year
plan -Phase 2
 To review the assumptions made on impact of change in East Sussex on Maternity
and Paediatrics services in Brighton and Hove and West Sussex
 To identify further changes which may be necessary across Sussex, bearing in mind
changes to Maternity and Paediatrics in hospitals outside Sussex e.g. SASH, Epsom
 To improve services provided to children and their families/ carers at home, school or
in the community, and reduce dependencies on hospital services for acute care.
Surrey: There are no defined plans for CYP within the 5 year plans, however we are working
with the CCG’s on their local programmes of work.
Kent: The SCN Programme can support the following areas identified in the 5 year plans:
 New joint commissioning models for disabled children, young people aged
between 0-25 and their families, as part of the reforms identified in the Children
and Families Act for disabled children, new integrated assessment processes,
new ways of providing information and providing personal health budgets
 working in partnership with local Hospices’ Children and Young People’s Service
to provide an effective model of care for children with palliative care needs and
their families
 Out of hours advice and support has led to a higher number of families benefiting
from the right care and advice at the right time and in the right place, rather than
an admission to hospital using improved Acute Care pathways .
 Increasing number of children with highly complex health needs being discharged
from hospital requiring specialist multi-agency support and children’s continuing
care packages
9
South East Coast Strategic Clinical Network - Maternity Children and Young People Strategic Commissioning Advice 2015/16. For Internal NHS use only
Children
and Young
People SCN
Work
Programme
Children and Young
People SCN Projects
National Priorities
and relevant Outcome Indicators
Children and Young People SCN
Strategic Commissioning Advice
Across all Domains
Domain 1 – Preventing people from Dying Prematurely
Domain 2 – Enhancing Quality Of Life For People With Long Term Conditions Domain 3 – Helping People To Recover From
Episodes Of Ill Health Or Following Injury Domain 4 – Ensuring That People Have A Positive Experience Of Care Domain 5 –Treating And Caring For People In A Safe Environment And
Protect Them From Avoidable Harm
THE Overall SCN CYP Programme
The SCN has produced a Baseline Audit of existing NHS at Home models (using Sussex Audit as basis). The final draft slide set will be signed off by the next Clinical Advisory Group
in November 2014. This will be shared once completed. The SCN suggests that it will be a useful baseline and tool for all CCG’s and Joint Commissioners in comparing their
area to other CCG’s. There are GAPS across SEC and there is a need to agree a set of standards based on the awaited guidance form the Department of Health Scoping Project
and Guidance over the next 3-4 months.
To
reduce
inappropriate
paediatric
attendances
and admissions
to
secondary
care
Delivered
through
a
programme on
moving
the
clinical care of
children
&
young
people
from secondary
to
community
and
primary
care
settings
(NHS at Home)
Please note all Indicators in this section apply across the whole programme
Project 1
Acute and Short Term
Conditions - working to
reflect a Model of
Acute Care alongside
the emergency and
urgent care theme.
Phase 1 Timeline
June 2014-Dec 2014
NHS Outcomes Framework*
NHS 2.3.ii
Unplanned hospitalisation for asthma, diabetes and epilepsy (under 19s).[
NHS 3.2
Prevent lower respiratory tract infections (LRTI) in children from becoming serious –
emergency admission for Children with LRTI
NHS 4
Improving Children and Young People Experience of healthcare
Friends and Family Test in progress
5.6 Delivering of safe care to children in acute settings - incidence of harm to children
due to failure to monitor
CCG Outcome Indicators
C 2.7- Unplanned hospitalisation for asthma, diabetes and epilepsy (under 19s).
C 3.4- Prevent lower respiratory tract infections (LRTI) in children from becoming
serious – emergency admission for Children with LRTI
June 2014-Sept
2015
Includes what good looks like for1. High Volume Pathway Implementation across the Urgent Care system
2. Primary and Community Care Education
3. Monkey Tools for children
4. Primary and Community Services acute short term conditions models -7 days
The SCN recommends the CCG’s embed the use of High Volume pathways for children
within primary community and secondary care. The 5 High volume pathways for Fever, D
and V, Bronchiolitis, Minor head injury and Acute Wheeze are being shared across SEC
from the originating West Sussex work. This includes NICE Guidance and SIGN Guidance.
Data has been produced via the Quality Observatory across CCG’s on High Volume
conditions.
The Urgent and Emergency Care review has included CYP. The SCN recommends that
the CCGs engage with the SCN working groups and SCN clinical advisory group
when planning around Urgent Care work streams for CYP. This can support the
management of minor illnesses in the community through increasing children’s community
nursing provision and reducing variation in services (primary care and OOH too)
The SCN is also working on a “PACE-Setter Award”. This is a “Quality Mark” Award
scheme for primary and community care providers to encourage them to reflect on their
service to Children and Young People (CYP) within their local population and implement doable improvements.
Area Teams Direct commissioning of primary care could consider the prime ministers
challenge for improving access for CYP. http://www.england.nhs.uk/ourwork/qualclin-lead/calltoaction/pm-ext-access/
SEC SCN Clinical Lead: Tim Fooks. Email: [email protected]
Final versions of pathways and PACE Setter Award will be shared once complete
10
South East Coast Strategic Clinical Network - Maternity Children and Young People Strategic Commissioning Advice 2015/16. For Internal NHS use only
To
reduce
inappropriate
paediatric
attendances
and admissions
to
secondary
care
Delivered
through
a
programme on
moving
the
clinical care of
children
&
young
people
from secondary
to
community
and
primary
care
settings
(NHS at Home)
Please note all Indicators in this section apply across the whole programme
SCN recommendations for asthma are in the process of being produced with the East of
England which is leading the national work. Locally the work will focus on:
PUBLIC HEALTH OUTCOMES FRAMEWORK Domain 1: Improving The Wider Determinants Of Health

Sickness absence rate. (Indicated here in relation to acute or chronic
health/mental health issues).

Pupil absence

Children in poverty – (Indicated here in relation to health outcomes after a
period of acute or chronic illness)

Killed or seriously injured causality on England’s roads.
Domain 2: Health Improvement
• Hospital admissions caused by unintentional and deliberate injuries in under 18
Supporting the Programme to provide a proposed model of care with a case example.
Includes what good looks like for
CCN and Clinical Nurse Specialists Integrated community working models link
with School Nursing

Primary Care Education for Diagnosed Asthma (Inhaler and plan we come
together pledge and Monkey Tools )

Medicines in Schools- support Education and clarify role of School nurse.

National Review of Asthma Deaths in relation to CYP-See below
Project 2
Long Term Conditions
Phase 1 Model of Care
to Focus on Asthma
and Clinical Nurse
Specialist
Roles
across LTC and CCN
Teams
Phase 1 Timeline
June 2014-Dec 2014
NHS England Business Areas
1 –Asthma, 5 - Participation Package, 7- 6C CCN , 9 - Pledge & Best Practice
- Specialised Services,19 - Personal Budgets
June 2014-Sept
2015
, 14
Via the Women and Children’s programme:




Project 3
Disabilities &
Complex
conditions
Model of Care- SEND
&
continuing
healthcare across SEC
Phase 1 Timeline
June 2014-Dec 2014
11


Best practice guidance children & young people services produced by April
2015.
Develop guidance for CCGs to ensure children with SEN have access to
services in their care plan based on a single assessment across health, social
care and education by March 2015.
Identify gaps in delivery of the transfer of responsibility for special educational
needs commissioning from the current series of national events and develop
support for CCGs by March 2015
Develop an implementation plan for the Children and Young People Pledge and
implement key aspects of the Pledge on behalf of the organisation by March
2015.
Review existing guidance on providing care for acutely ill children by June 2014.
Implementation of the child health datasets.
Refer to Page 30-32
http://www.england.nhs.uk/wp-content/uploads/2014/04/ppf-1415-1617-wa.pdf
The SCN recommends that the CCG’s and Public Health REVIEW recent guidance
when reviewing the specialist nurses and the roles of CCN teams and school nursing
teams.
Inhalers in Schools
http://www.asthma.org.uk/schoolinhalers?utm_source=HCP+ENewsletter&utm_campaign=2106f18fe7IiS_HCP_guidance&utm_medium=email&utm_term=0_7109f09163-2106f18fe7-341104213
Health Education England are working on a GP Self-assessment tool for asthma and
supporting training requirements for primary care.
The SCN is reviewing the Recommendations in relation to CYP - National Review of
Asthma Deaths- 2014
https://www.rcplondon.ac.uk/projects/national-review-asthmadeaths
Why
Children
Die
2014
RCPCH
in
relation
to
CYP.
http://www.rcpch.ac.uk/news/rcpch-and-ncb-launches-report-why-children-die
SEC SCN Clinical Lead: Edwina Wooler Email: [email protected]
Final versions of Asthma Nursing model of care will be shared once completed. This will be
aligned with the Lead SCN.
Includes what does good look like for
Continuing HealthCare Models and Rapid Response Teams

Spec Commissioning - LTV, Post Surgery

Personal Health Budgets /Short breaks

Special School Nursing

HCP and AHP link to CCN

Medicines in Schools

SEND Agenda Pledge and CCN
The SCN is using the guidance on SEND to look at the role of the CCN teams with
education and social care.
https://www.gov.uk/government/publications/send-guide-for-health-professionals
South East Coast Strategic Clinical Network - Maternity Children and Young People Strategic Commissioning Advice 2015/16. For Internal NHS use only
Guidance for Health and Wellbeing Boards for SEND
To
reduce
inappropriate
paediatric
attendances
and admissions
to
secondary
care
Delivered
through
a
programme on
moving
the
clinical care of
children
&
young
people
from secondary
to
community
and
primary
care
settings
(NHS at Home)
Project 3
Disabilities &
Complex
conditions
Model of Care- SEND
&
continuing
healthcare across SEC
Phase 1 Timeline
June 2014-Dec 2014
Please note all Indicators apply across the whole programme
NHS Outcomes Framework*
NHS 2.3.ii
Unplanned hospitalisation for asthma, diabetes and epilepsy (under 19s).[
NHS 3.2
Prevent lower respiratory tract infections (LRTI) in children from becoming serious –
emergency admission for Children with LRTI
NHS 4
Improving Children and Young People Experience of healthcare
Friends and Family Test in progress
5.6 Delivering of safe care to children in acute settings - incidence of harm to children
due to failure to monitor
CCG Outcome Indicators
C 2.7- Unplanned hospitalisation for asthma, diabetes and epilepsy (under 19s).
C 3.4- Prevent lower respiratory tract infections (LRTI) in children from becoming
serious – emergency admission for Children with LRTI
June 2014-Sept
2015
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/357447/DH_H
WB_children_s_guidance.pdf
NHS England Integrated Personal Commissioning (IPC) Programme- Includes children and
young people with complex needs, including those eligible for education, health and care
plans. Further details will follow on pilot areas.
The NHS at Home model will focus on the function as and roles of special school nurses.
The SCN recommends that the community nursing model is considered in the SEND
work streams.
HDU Audit recommendations for complex discharge care will be considered under
this project.
This working group will need to consider - Patient safety alert on risks arising from
breakdown and failure to act on communication during handover at the time of discharge
from secondary care http://www.england.nhs.uk/2014/08/29/psa-communication/
SEC SCN Clinical Lead: Trudy Ward. Email: [email protected]
Final versions of the Community Nursing Model of care will be shared once completed.
Latest data is available from http://www.hscic.gov.uk/ccgois
Project 4
Life
Limiting
Life
Threatening illness –
Supporting
1)
advanced
care
planning
2)
adoption
of
EPaCCS
(Electronic
Palliative care coordination system)
PUBLIC HEALTH OUTCOMES FRAMEWORK Domain 1: Improving The Wider Determinants Of Health

Sickness absence rate. (Indicated here in relation to acute or chronic
health/mental health issues).

Pupil absence

Children in poverty – (Indicated here in relation to health outcomes after a
period of acute or chronic illness)

Killed or seriously injured causality on England’s roads.
Domain 2: Health Improvement
• Hospital admissions caused by unintentional and deliberate injuries in under 18
Supporting the Programme to provide a proposed model of care with a case study Includes
what does good look like for1. Partnership working - Role of the CCN, Role of Hospices and medical workforce local and
regionally.
2.Implementation of Electronic Palliative Care Coordination System EPaCCS
3.Consistency Advance Care Planning Documentation and Process
The SCN recommends that the following publications are reviewed when considering
CYP. Commissioning children’s palliative care A guide for Clinical Commissioning Groups
Children’s palliative care: A guide for local authorities
http://www.togetherforshortlives.org.uk/about/our_policy_work/186_commissioning_children
_s_palliative_care_in_england
The following publication which links to the Neonatal Network
www.rcpch.ac.uk/news/palliative-care-neonatal-units-first-guidance-published-uk
SEC SCN Clinical Lead: Trudy Ward. Email: [email protected]
Phase 1 Timeline
June 2014-Dec 2014
12
Final versions of the Community Nursing Model of care will be shared once completed
South East Coast Strategic Clinical Network - Maternity Children and Young People Strategic Commissioning Advice 2015/16. For Internal NHS use only
To
reduce
inappropriate
paediatric
attendances
and admissions
to
secondary
care
Delivered
through
a
programme on
moving
the
clinical care of
children
&
young
people
from secondary
to
community
and
primary
care
settings
(NHS at Home)
Project 5
Children's Workforce joint with KSS HEE
across
4
projects
related to Strategic
planning of workforce
and models of care
Phase 1 Timeline
June 2014-Dec 2014
Please note all Indicators apply across the whole programme
NHS England Business Areas
1 –Asthma, 5 - Participation Package, 7- 6C CCN , 9 - Pledge & Best Practice
- Specialised Services,19 - Personal Budgets
Via the Women and Children’s programme:




June 2014-Sept
2015
, 14


Best practice guidance children & young people services produced by April
2015.
Develop guidance for CCGs to ensure children with SEN have access to
services in their care plan based on a single assessment across health, social
care and education by March 2015.
Identify gaps in delivery of the transfer of responsibility for special educational
needs commissioning from the current series of national events and develop
support for CCGs by March 2015
Develop an implementation plan for the Children and Young People Pledge and
implement key aspects of the Pledge on behalf of the organisation by March
2015.
Review existing guidance on providing care for acutely ill children by June 2014.
Implementation of the child health datasets.
Refer to Page 30-32
http://www.england.nhs.uk/wp-content/uploads/2014/04/ppf-1415-1617-wa.pdf
Supporting the Programme to provide a proposed model of care with workforce no’s ,
educational needs and competencies. Includes what does good look like for1.Unique role of the CCN
2.Guidance and Tools to plan CCN workforce
3.Consider 0-25 years’ workforce
4.Other CYP workforce co dependencies
5.HEE Mandate Implementation KSS
6.Specialist and Generalist Roles
The SCN recommends that the CCG’s review the following publications
RCN New Publications (Nursing)
The Future of Children’s Communist Nursing Challenges and Opportunities
Specialists and Advanced Children and Young People’s Nursing Practice in Contemporary
Healthcare
http://www.rcn.org.uk/__data/assets/pdf_file/0009/581328/RCNguidance_community_childr
ens_WEB.pdf
http://www.rcn.org.uk/__data/assets/pdf_file/0009/580725/004579.pdf
The SCN recommends that the CCG’s consider the childrens nursing workforce in
their planning for service change.
SEC SCN Clinical Lead: Trudy Ward. Email: [email protected]
KSS HEE Lead – Jane Butler
Final versions of the Community Nursing workforce modelling will be shared once
completed
In Addition to
the Programme
Linked
with
London SCN
HDU Audit Links with
London Critical Care
Network
Phase 1 Timeline
June 2014-Dec 2014
The SCN recommends that the CCG’s Consider establishment of a surgical
network like other areas. This could be discussed via the CYP Commissioning
Forum -7th Oct.
In the East Midlands Maternity & Children SCN, they have been doing some work
around quality improvement in General Paediatric Surgery. Working with the Royal
College of Surgeons (RCS) and following their NICE accreditation process, they
established guidance development groups and have produced two commissioning
guidance documents:
1.
Management of emergency appendicectomy
2.
Management of orchidopexy for undescended testis
SCN recommends that the CCG’s consider the HDU Audit findings along with
Specialised commissioning. The core clinical group with specialised commissioning will
focus on both a vision and strategy for HDU provision throughout our region. Key challenges
have been identified - (nurses, training, and OOH medical cover). This will be essential for
CCG’s and specialised commissioning to engage in the outcomes. It also links to the work
that the senate is doing around com dependencies. There is to be a national strategy and in
the SEC we feed into the London critical care pathway group.
Final versions of the Audit and recommendations will be shared once completed
Clinical Director Lead Ryan Watkins Email: [email protected]
These draft documents are now out for wider national consultation via the RCS The
consultation closes on the 19th July 2014.
http://www.rcseng.ac.uk/healthcare-bodies/nscc/commissioning-guides/guide-topics
13
South East Coast Strategic Clinical Network - Maternity Children and Young People Strategic Commissioning Advice 2015/16. For Internal NHS use only
Additional information and useful Links (Children and Young People)
Child Death Series Sept 2014
Why Children Die Research
http://www.thelancet.com/series/child-death-in-high-income-countries
www.rcpch.ac.uk/index.php?q=child-health/standards-care/health-policy/child-mortality/child-mortality
Health Profiles
Marmott Indicators
Profiles LA
http://www.apho.org.uk/default.aspx?QN=P_HEALTH_PROFILES
https://www.instituteofhealthequity.org/uk/marmot-indicators-2014-supportingdocuments?utm_medium=email&utm_source=The+King%27s+Fund+newsletters&utm_campaign=4747961_HMP+2014-0926&dm_i=21A8,2TRJT,FLWRM1,A9GS6,1
CQC Inspections re CYP
www.cqc.org.uk/content/getting-inspections-right-children-and-young-people-0
NHS Outcomes 2014/15 Consultation
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/256456/NHS_outcomes.pdf
1. There are also implications within Domain five in relation to
prevention of avoidable harm for children and young people.
Consultation includes seeking views on the following areas related to CYP
1.
2. The Department therefore proposes to measure and highlight
the incidence of secondary dental procedures for young children.
3.Propose to Remove indicator 5.6 Incidence of harm to children
due to ‘failure to monitor
Public Health England and NHS Outcomes Framework
Effective ways of measuring patient experience or safety outcomes related to access to appropriate care for Children
and young people
2. Access to age appropriate care for children and young people- While few children under 14 years are now cared for
in adult wards across the UK, many 14–17 year olds are nursed with elderly adults and often exposed to
inappropriate risks.
3. Effectiveness of using the incidence of secondary dental procedures on under 10s to highlight issues with child safety
4. Long term direction that the Department is taking regarding indicators for children and young people in the Outcomes
Framework?
http://fingertips.phe.org.uk/profile/cyphof
Finger tips tool (2013/14)
Our Children Deserve Better: Prevention Pays
https://www.gov.uk/government/publications/chief-medical-officers-annual-report-2012-our-children-deserve-better-preventionpays
RCPCH Back to Facing the Future (April 2013)
http://www.rcpch.ac.uk/facingthefuture#BtFtF
CYP Outcomes Framework Annual Report
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/351629/Annual_report_2013_1.pdf?utm_medium
=email&utm_source=The+King%27s+Fund+newsletters&utm_campaign=4623954_HMP+2014-0909&dm_i=21A8,2R3V6,FLWRM1,A3WPO,1
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South East Coast Strategic Clinical Network - Maternity Children and Young People Strategic Commissioning Advice 2015/16. For Internal NHS use only
Child and young People’s Mental Health
Previous SCN Work- South East Coast Strategic Clinical Network has supported a Clinical Advisory Group (CAG) for CYP mental
health. There has been clinical leadership input from the SCN until June 2014, however this post is now vacant due to recruitment
controls. The CAG is still functioning and could be used for commissioners in obtaining advice on their local plans. The Local Crisis
Concordat Action plans for each area supersedes the work that the SCN supported on reviewing what was happening in Section
136 for CYP.
SCN Next Steps – Each area commissioning plans for CAMHS will be discussed at the commissioner’s forum on 7th October 2014.
National Update
information and useful Links (Children and Young People –Mental Health )
Review of Tier 4 CAMHS. NHS England
http://www.england.nhs.uk/ourwork/commissioning/spec-services/npc-crg/group-c/c07/
Parliamentary Inquiry
data.parliament.uk/writtenevidence/committeeevidence.svc/evidencedocument/health-committee/childrens-and-adolescent-mental-health-andcamhs/written/7646.pdf
After Enquiry- A taskforce will look at how to
improve the way children’s mental health
services are organized, commissioned and
provided and how to make it easier for young
people to access help and support, including
in schools, through voluntary organisations
and online.
The taskforce, co-chaired by Jon Rouse Director General, Social Care, Local Government and Care Partnerships at Department of Health and
Martin McShane NHS England’s director for people with long term conditions. It will bring together experts on children and young people’s
mental health services and people who know about wider system transformation from education, social care and health. It will commission
external advice from experts and others with experience in children and young people’s mental health.The taskforce will report both to ministers
and to the Children’s Health and Wellbeing Partnership, and will publish its findings next spring.
Transform children services and improve
transition between children services and adult
services
See Transition Section Below re Generic Specification. Other SCN are working on CAMHS and information can be shared when available.
The NHS OUTCOMES Framework 2015/16
Consultation
May include the following areas of interest following consultation feedback


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Should care settings be used as a measure of safety for children and people with mental illness in the NHS Outcomes Framework?
effective ways of measuring patient experience or safety outcomes related to access to appropriate care for Children and young
South East Coast Strategic Clinical Network - Maternity Children and Young People Strategic Commissioning Advice 2015/16. For Internal NHS use only


CMO Report on Mental Health Released 2014
people and Children and young people with mental health problems
Importance of including outcomes with a focus on children with mental health problems into the NHS Outcomes Framework?
How can children with mental health problems be better represented in the NHS Outcomes Framework?
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/351629/Annual_report_2013_1.pdf?utm_medium=email&utm_so
urce=The+King%27s+Fund+newsletters&utm_campaign=4623954_HMP+2014-09-09&dm_i=21A8,2R3V6,FLWRM1,A3WPO,1
Public Mental Health Priorities: Investing in the
Evidence
Atlas of Variation for mental health
http://www.centreforum.org/assets/pubs/atlas-ofvariation.pdf?utm_medium=email&utm_source=The+King%27s+Fund+newsletters&utm_campaign=4376558_HMP+2014-0708&dm_i=21A8,2LSZ2,FLWRM1,9JKAB,1
Enough is Enough A report on child
protection and mental health services
http://www.centreforsocialjustice.org.uk/UserStorage/pdf/Pdf%20reports/enough.pdf
Transforming Mental Health a Plan of Action
for London
http://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/transforming-mental-health-london-kingsfund-sep2014.pdf
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South East Coast Strategic Clinical Network - Maternity Children and Young People Strategic Commissioning Advice 2015/16. For Internal NHS use only
Transition from children and young people to adult services programme:
Transition Work
Programme
Agreed models of care
and smooth Transition
pathways from children
and young people to
adult services with
three long term
conditions asthma,
epilepsy and diabetes
Transition Project
National Priorities
Transition Commissioning Guidance
and relevant Outcome
Indicators
Domain 2 – Enhancing quality of life for people with long term conditions
Developing Transition
best practice pathways
for three long conditions
asthma, epilepsy and
diabetes.
NHS Outcome Domain 2:
2.1 ii - Reducing time spent in hospital
by people with long term conditions. ii
– unplanned hospitalisation for asthma,
diabetes and epilepsy in under 19s.
CCG outcome indicators Domain
C 2.7 - Unplanned hospitalisation for
asthma, diabetes and epilepsy (under
19s).
Public Health Outcome Framework:
Prevention of Ill Health – indicator 30
-Hospital admissions for asthma (under
19 years)
NHS England Business Areas
1. Prevention and early diagnosis
4. Patient experience
8. Equality and health inequalities
19. Citizen participation and
empowerment
20. Wider primary care provided at
scale
21. A modern model of integrated care
The Transition Clinical Advisory Group (CAG) is led by Dr Ryan Watkins (clinical
director) and suppored by two clinical leads, Dr Maggie Wearmouth and CNS Edwina
Wooler.
The Transition Clinical Advisory Group (CAG) has supported the development of
generic principles for Transition from children and young people to adult services and
develops best practice pathways for three long term conditions – asthma, epilepsy
and diabetes.
Three condition specific working groups have been established to develop Transition
best practice guidance for the commissioners for these long term conditions. It is
anticipated that Transition best practice pathways guidance draft will be shared with
the core stakeholders later in September/October 2014.
The Transition Clinical advisory group will aim to deliver Transition best practice
pathways guidance to the commissioners by spring or early summer in 2015.
NICE is developing guidance to help address the gaps in health care sometimes
experienced by young people as they move from children’s to adult services. This
guidance is in early stages of consultation with the anticipate date of publication in 18
months times. Transition clinical lead Edwina Wooler is representing SEC SCN on
this piece of work. Details of the NICE Transition guidance can be found by visiting:
https://www.nice.org.uk/News/Article/nice-guidance-to-help-tackle-transition-fromchildren%E2%80%99s-to-adult-services
South East Coast Strategic Clinical Network contact details for Transition: Jan Pathan - Quality Improvement Lead (MCYP)
[email protected]; Tel: 01138255312; Website: http://secscn.nhs
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South East Coast Strategic Clinical Network - Maternity Children and Young People Strategic Commissioning Advice 2015/16. For Internal NHS use only
Additional information (Transition)
Transition: Moving on Well (DH
2008)
Think transition - Developing the
essential link between paediatric
and adult care (Royal College of
Physicians
of
Edinburgh
Transition Steering Group, 2008).
Getting it right for children and
young
people.
Overcoming
cultural barriers in the NHS so as
to meet their needs - A review by
Professor Sir Ian Kennedy
(September 2010).
The process of transition should start while the child is being cared for by children’s services and may, subject to the
needs of the young person; continue for a number of years after the transfer to adult services. Thus, for young
people with complex continuing health needs and/or a disability, successful transition from childhood to
adulthood demands not only the engagement of the young person and their family, but also both children’s and
adult health services and the GP.
Download from: http://www.bacdis.org.uk/policy/documents/transition_moving-on-well.pdf
This guidance was designed to raise awareness of the important issues facing young people as they move from
paediatric to adult care, and to provide all concerned with
Practical support to improve their experiences. The College believes it will be of wide interest to clinicians of all
disciplines and in all healthcare settings and, of course, to young people and their families.
Chapter 1: Core Principles (Important read)
Download from:
http://www.cen.scot.nhs.uk/files/16o-think-transition-edinburgh.pdf
Sir David Nicholson asked Professor Sir Ian Kennedy to undertake this independent review amid widespread
concern about the services provided by the NHS to children and young people.
The review has uncovered many cultural barriers standing in the way of improving services for children and young
people. These were created, and operate, at a number of levels, from Whitehall, through regional and local
organisations, to contacts between individual professionals, and with children, young people and those looking after
them. Sir Ian makes several recommendations for improvement.
Download from:
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/216282/dh_119446.pdf
Generic Specification for
Transition
Dr Jackie Cornish, National Clinical Director Children, Young People and Transition to Adulthood, is developing
generic service specification for children and young people transitioning into adult services.
This document is currently in draft format and being reviewed by Clinical Reference Groups. This service insert is
intended to be applied in conjunction with the generic paediatric specification E03 and the individual paediatric and
adult service specifications where transition planning and support is an identified requirement.
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South East Coast Strategic Clinical Network - Maternity Children and Young People Strategic
Commissioning Advice 2015/16. For Internal NHS use only
References
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South East Coast Strategic Clinical Network - Maternity Children and Young People Strategic
Commissioning Advice 2015/16. For Internal NHS use only
References
The NHS Outcomes Framework 2014/15 (2013) Department of Health
Standards for Maternity Care (2008) Royal College of Obstetricians and Gynaecologists
Improving Children and Young People’s Health Outcomes (2011) Department of Health
Why Children Die (2014) Royal College of Paediatrics and Child Health
SEND: guide for health professionals (2014) Department for Education and Department of Health
Commissioning children’s palliative care (2013) Together for Short Lives
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