our core values: ● we will be child-centred ● we will embed service user participation at every...
TRANSCRIPT
Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable.
Community Children’s Health Partnership
Care Pathways and Patient Stories
Matthew EllisCommunity Paediatrics Clinical Lead
Emily Roberts Children’s Services Manager Barnardo’s
Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable.
Community Children’s Health Partnership
Community Children’s
Health Partnership
A legal partnership between North Bristol NHS Trust and Barnardo’s
A service that is core value driven An integration of community child health and CAMHS
services into a single provider-employer Trust Reduction of variance to reduce inequality of access Clinical care pathway driven Performance monitored via an Outcomes Framework
Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable.
Community Children’s Health Partnership
Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable.
Community Children’s Health Partnership
Pathway Group (clinical effectiveness committee)
Key Stakeholders; GP rep, health visitor, school nurse, Therapist, community paediatrician, mental health team, CYPS
Identify two pathway champions
They lead pathway design process in consultation with key stakeholders
Bring the draft to the Group
Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable.
Community Children’s Health Partnership
Pathway Checklist
Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable.
Community Children’s Health Partnership
Care Pathways Impaired attention in the school age child Developmental Delay in the preschool child Impaired social communication Motor Coordination Difficulties in school age Urinary Continence Vision Problems Motor Disorders including Cerebral palsy Learning Difficulties Substance misuse in young people Emotional and Behavioural difficulties in children Complex mental health 5-12 year old pathway Eating Disorders in young people
Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable.
Community Children’s Health Partnership
Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable.
Community Children’s Health Partnership
Patient stories‘How do you want a patient friendly
version of the pathway?’
Semi structured interviews1. Before meeting with the service What was life like for you before you came into contact with the
service?2. First meeting with the service What happened the first time you met with the service?3. Further meetings with the service (within 18 weeks of referral from
community staff) What happened during the time that you met with the service?4. Ending with the service What happened when your meetings with the service ended?
Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable.
Community Children’s Health Partnership
decoration
Consulted and
informed
Child-initiated and directed
Increasing degree of participation
Non-participation
Ladder of Participation
Service User feedback used to inform and plan future services
Adding own criteria to a job description and involved in short listing process
People are present for a photo shoot but have little idea of what it is all about
Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable.
Community Children’s Health Partnership
Journeys
• NICE V Service User Experience
• Identifying your subjects in house and through other settings – stakeholders?
• Focus groups
• Questionnaires
• Face to face interviews
Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable.
Community Children’s Health Partnership
Findings – Eating Disorder Care Pathway
“On my fourth visit to the GP he said‘you have anorexia’and I was really knocked back by itI went home and hidin my room for ages” Young Person
I got the impression that they just wanted to shove a drug down her and feed her up without involving her and helping her with her mental health…you know they just feed them up and then they go down and that isn’t a solution” Parent
Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable.
Community Children’s Health Partnership
Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable.
Community Children’s Health Partnership
Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable.
Community Children’s Health Partnership
Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable.
Community Children’s Health Partnership
Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable.
Community Children’s Health Partnership
Barriers
Only the patient experiences the whole pathway
Initial buy in (80:20 rule)
Management involvement
Professional boundaries
Trust website/patient information branding
Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable.
Community Children’s Health Partnership
Implications for Practice
Participation is a potential vehicle for system wide change
Patient experience is helpful to inform ‘pathway’ design
Getting the voices of the YOUNG and PARENTS heard can be difficult
In the campaign to achieve service change genuine patient voices can provide leverage