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

Social Media

@NorthNetworks #NEChildren

#YourVoiceYourNetwork

Camera Shy – let us know

Slido.com

#YourVoiceYourNetwork

Wifi code - BT Openzone

Who has joined us?

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

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”

-

Our ask of you today

• Listen to other perspectives

• Think Child over organisational boundaries

• Share your perspective

• Commit to help progress things

Dr Mike McKean

Our Journey so far…..

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……..

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

Messages to the network from young people

A Word on Wellbeing and the Arts

Eldridge Labinjo

Question Time

Purpose of a Network

System discussions around your table

theme

Heather Corlett

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

Quick Cuppa

Quick Refreshments

Back for a prompt start at 11.20

Don’t forget to Tweet!!

@NorthNetworks #NEChildren

#YourVoiceYourNetwork

Mike McKean

My Story

Michael Wood

How can we work together?

Doing our bit - How can we work together?

Michael Wood

Head of Health Economic Partnerships

NHS Confederation

25 June 2019

@NHSLocalGrowth

Cost Invest-ment

How do local partners see the health sector?

Is the NHS involved in local discussions about raising money or spending money?

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…

The productivity puzzle and ‘place’

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

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?

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?

• 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

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?

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?

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?

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?

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

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 Michael.wood@nhsconfed.org

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

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

Innovation Hub – Feedback from Young

People and Core Leaders

System discussions around your table

theme – Take 2

Heather Corlett

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

Neil Davidson and Helen Leonard

Coproduction

Sir Al Aynsley-Green

Where to now?

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.

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

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

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!

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:

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!

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

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

The Children’s Foundation: Brand and marketing

The initial image The ‘hub and spoke’ paradigm

Big obstacles!

• Meeting at Dryburn Hospital 1989

• Thumbs down!

• P&G Conflicts Officer

• Understanding antipathy

• Change in presentation and function

The ‘paradigm shift’ – a partnership network delivering mutual support through synergy

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!

Building a resource for the future - an academic centre to support research and teaching for children and families

Involving and giving benefit to schools

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?

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

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?

A vulnerable and entirely dependent newly born citizen

Remember who we are working and speaking for!

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

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?

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

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!

Child Health and Wellbeing

Network – Your Network Your

Voice

Third Regional Engagement June 25th

Mike McKean

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 necsu.childhealthandwellbeing@nhs.net

• Watch this space!

Ready to join our Journey?

69

It won’t be easy…..

….but it will be worth it!

In the words of Henry Ford

“Coming together is a beginning.

Keeping together is progress.

Staying together is Success.”