Integrated Working
Successes, challenges and
next steps
Dr Gill Turner
Consultant Paediatrician
Chair of RCPCH Young People’s Health SIG
 Young People’s Health
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Policy
Strategy
Specific needs of YP acknowledged
Psychosocial and physical
Prevention, resilience
Services
– never been a better time
 Young People’s Health
The only thing that really makes a difference to
large numbers of young people is local
implementation - multi-agency and integrated.
– never been a more challenging time
Outline
“Getting it together”
 Northumberland
– Background
– Teenage health demonstration site
– What we’ve learned
 Challenges
 Current context
 Next steps
“Healthy”
What are we aiming for?
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Valued
Respected
Resilient
Emotionally intelligent
Skilled and confident in
– finding solutions
– relationships
– conflict resolution
 Enthusiastic and excited about challenge and
change
Northumberland - History
 CYP Strategic Partnership
 Northumberland Young People’s Health
Project – relationship with schools
 Community Health Trust
 Care Trust
 Family and Children’s Trust 2006
Northumberland
 Integrated teams
– school nurses, HVs, EWO, SW etc
 Large, varied county
 Strong locality identity
– Urban south east, Blyth, Ashington
– West, rural Hexham, Haydon Bridge
– North, rural Berwick, Alnwick
Northumberland
Teenage Health Demonstration Site
 People
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specialist “adolescent” nurse practitioner
GP
Consultant Paediatrician
many others
 Time
 Focus
 Co-ordination
Northumberland
Teenage Health Demonstration Site
 Clinical
– nurse outreach into residential and secure unit
– health drop-in at FE college
– community paediatric 12-19 years YP clinics
 Participation
 Rural
 Peer support (healthy schools)
 Emotional wellbeing and mental health
 Substance misuse services
Working together?
Participation of young people
 “Empowering young people umbrella group”
– public health, youth work, paediatrics, LA
– began 1997
 FACT monthly leadership group
 FACT weekly leadership and management
team
Participation
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Meaning? Meaning? Meaning?
Health / LA / schools / youth work / VCS
Which young people?
Which issues?
Which arena?
Style
Control and honesty
The Journey
 Vision
 Strategy
Attitudes, attitudes, attitudes
 Implementation
Turning up the Volume
 Participation Strategy Group
 Participation Operational Group
 Children and young people
 Parents
 Communities
Implementation of Strategy
 Annual reporting to FACT Board
– representation of VCS,
Northumberland Strategic Partnership,
child health commissioner
 Six monthly troubleshooting to FACT
leadership team
What’s worked?
What have we learned?
 Shared vision
 Relationships
 Trust
 Local integrated teams
 Management
 Leadership
Shared Vision
 We can make things better together
 Young people deserve
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respect
confidentiality
choice
to participate and influence
support wherever they choose to access it
“no wrong door” vs. referral
Challenges - Northumberland
 Organisational change
– Unitary authority April 09
– Public health – becoming North of Tyne
– World class commissioning
 Economic climate
– anxiety
– attention to service provision rather than prevention
– narrower focus rather than partnerships
Challenges
- young people
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Politically disenfranchised
“Vulnerable” / “at risk of poor outcomes”
Support vs. punishment
Participation
– all young people
– honesty
– timescale
Challenges to real change
- from narrow to eliminate the gap!
 Going for BIG change raises BIG issues
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Inequality
Poverty
Power
Control
Current Context
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Every Young Person Matters
Aiming High for Young People
Children’s Trusts
Duty of schools / PCTs to co-operate
Children’s workforce development
Current Context
 Integrated services for young people and
targeted youth support
 Healthy lives, brighter futures: Strategy for
children and young people’s health
 World class commissioning
 14 – 19 strategy, LSC funding to LAs
 Local community involvement
Next Steps
 Children’s Trusts
– creating and keeping a focus on young people
 Young people’s participation
 National indicator set
 Tell us survey
Next Steps
 Commissioning
– understanding of multi agency YP’s services
– prevention, resilience
– emotional wellbeing
 Excellent services for young people as
assessed by young people
– You’re Welcome quality criteria
Association of Young People’s
Health
“getting it together”
 Children’s Trusts
– focus on young people
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Young people’s participation
Achieving excellent services
Commissioning
Outcome measures
Young People’s Health
Where are we now?
 We have the vision
 We have the strategies
 Local implementation
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relationships
trust
doing it together
persistence
Thank you
www.yphsig.co.uk
[email protected]