Melanie Clements. The East of England improving standards across the East of England. Deputy Medical Director NHS England, Midlands & East (East)

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1 03 Melanie Clements Deputy Medical Director NHS England, Midlands & East (East) The East of England improving standards across the East of England Transforming London s health and care together 1

2 Developing Children and Young People's Assessment Unit Standards and Peer Review across the East of England Dr Melanie Clements Deputy Medical Director NHS England, Midlands and East, East March

3 CYP Assessment Service Standards

4 What do Children, Young People and families want?

5 Standards for Children & Young People in Emergency Settings 1. Integrated Systems 2. Environment 3. Patient management 4. Staffing 5. Safeguarding 6. Mental health, substance & alcohol misuse 7. Major Incidents 8. Death of a Child 9. Information System & Data Analysis 5

6 Peer Support & Challenge Year /12 Visit to all 17 Acute units Bench Mark against EoE CAU Assessment Standards Year Revisit Update & Bench mark against Standards for Children in Emergency Settings 6

7 Process Trusts bench mark against standards Peer review visit Walk Emergency & Urgent care pathway Presentation from Trust Feedback from visiting team Share good practise Raise profile of CYP in Trust & CCG 7

8 What we ve seen: Hospital X Successful reconfiguration of Children s Services Committed team with a future vision Streamlined, Emergency, Elective & inpatient services 6 RN (child) with PENP qualification Children OPD services with adults Inpatient environment: dated, tired & cramped Limited capacity within Children s ED & Assessment unit area Limited Community Children s Nursing capacity 8

9 Good Practise we would like to share Successful reconfiguration: a case study write up would be valuable for other sites to benefit from your approach Well developed ambulatory model of care Play Specialist service that is supported by volunteers many have been there for years 9

10 Opportunities Use Paediatric ENP s Consultants to cover peak periods/rcpch Facing the Future Review of CCN workforce & invest in development Engage CYP & families in service design & delivery e.g. You said..we did Benchmark against You re welcome standards Review OPD environment, consider safeguarding Visits to other areas e.g. Watford 10

11 Opportunities Whole system working: with primary care, HV s, Children s Centres etc. Develop high volume pathways across primary & secondary care with consistent patient information. Identify Executive lead for Children within the Trust. Develop children s board to bring together internal & external partners. Invite Children s Lead from Clinical Commissioning Group. 11

12 15 Step Challenge

13 Patient reported experience measures 3 versions 1. Ambulance services 2. GP Surgeries 3. ED Departments/Walk in Centres Parental Assistance (0-7 years) Child (0-16 years)

14 Primary School Lesson planner Rolled out to over 19,000 Primary and Special Schools in England. Educating a minimum of 735,000 children and their families about NHS services and how to use services wisely and provide feedback and participate in service development. Empowering a minimum of 40,000 teachers with information about health and the NHS. If this pack prevented just one Emergency Department (ED) attendance per Primary School (at 75 per ED attendance) savings to NHS England would be over 1.4 million. 14

15 Network/Share & Celebrate 15

16 Whole System Approach 16

17 Key Messages Good Practice & Challenges everywhere ED s not designed for C&YP Insufficient nursing staff in ED (8/12/23) Few Co-Located Assessment & Observation units Paediatric Consultant presence at peak periods of activity Develop nursing staff CANP/CENP/Children s Community nurses Unnecessary attendances Triage times 17

18 What would I do differently? How can we maximise impact? Involve Children s commissioner/clinical lead for CYP in all visits. Brief report to each trust and CCG? Amalgamated report to Quality surveillance group? Use CQC standards?

19 Let Your Ideas Go! An Idea held in an open hand can evolve Nilofer Merchant / HBR Blog June