Childrens Health
What did we say in Healthy Ambitions?*
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The Children’s Services Pathway Group recognised that the health of children in Y&H is amongst the worst in the country and that there were significant challenges to be overcome in future years – for example close to 1 in 5 boys and 3 in 10 girls in the region were expected to be obese by 2010. For girls this is nearly twice the national average.
They therefore recommended that:
- Comprehensive children’s primary care teams should be developed.
- There should be improved paediatric expertise in primary care.
- There should be a single phone line for advice on children.
- There should be a series of summits for our regional experts to improve the care of children with asthma and diabetes.
- Routine planned surgery for children should take place as locally as possible, specialist and emergency surgery to be concentrated where it will improve outcomes.
- There should be support for the recommendations in a number of other areas as they affect children (e.g. urgent care; planned care, staying healthy etc.).
Who is taking this work forward?
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Levels of delivery
PCTs across Y&H have worked with the SHA to agree which of the recommendations of the children’s pathway should be taken forward locally and which might need action at regional level. This is summarised in fig.2 on the next page.
* Full details can be found at: www.healthyambitions.co.uk/children.html.
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When is it happening?
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The actions to be taken forward in the first year of implementation for the pathway are shown in fig.3.
Local delivery
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PCTs have prioritised the recommendations in Healthy Ambitions in light of the needs of their local community and the current position of their services.
Working with local providers and other partners they have all set out the action that they will take to start to turn the recommendations in Healthy Ambitions into reality in their five year strategic plans.
An example of the action being taken in Doncaster is shown in fig.4.
How can you help make it happen?
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Everyone with an interest in improving health and healthcare can play a part in taking forward the recommendations in the children’s chapter of Healthy Ambitions.
In fig.5 we have set out some of the suggestions from staff about how people could help implement the recommendations. As an NHS publication – this section has just focussed on the roles that NHS Staff could play – but we very much recognise that our partners have a big contribution to make if we are to deliver the recommendations of the children’s chapter in Healthy Ambitions. We know that local authorities have a big part to play – e.g. in safeguarding children, helping to create a safe environment and promoting healthy lifestyles in schools. We are committed to working with our partners to help make this happen.
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Who will make sure that this work happens?
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There are a number of key leadership roles in the delivery of this pathway:
Locally
Each PCT Chief Executive is responsible for delivering recommendations in line with local priorities and strategic plans.
Collaboratively and Regionally:
Delivery will be overseen by a Pathway Delivery Board – as described in the chapter on governance arrangements.
For children the chair will be Chris Outram Chief Executive at NHS Leeds who will act as a sponsor of the children’s pathway within the wider chief executives forum. She will assist the clinical lead and SHA Director lead to promote implementation of the pathway, and partnership working between PCTs and local authorities.
The regional clinical lead is Ian Lewis, consultant paediatric oncologist at Leeds Teaching Hospitals Trust, who will oversee progress against of the Children’s pathway recommendations, act as a champion for the recommendations, advise on delivery processes and encourage colleagues to continue to focus and give priority to the children’s recommendations
Sue Proctor, Director of Patient Care and Partnerships, will oversee progress on implementation of the children’s pathway for the SHA.
How will we measure success?
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We have developed a "Healthy Ambitions Dashboard" based on a small number of key indicators which taken together can be used to start to measure the success of the Healthy Ambitions programme as a whole This is underpinned by trajectories which each PCT will set to reflect their local priorities and circumstances. It will show the measurable improvements they are making in each pathway area. This will supplement the “vital signs” indicators and trajectories which support delivery of the targets set out in the NHS Operating Framework and the selection of outcome measures which PCTs have included in their strategic plans. In many cases these measures are one and the same. All of these measures will feature in PCTs annual operating plans to be agreed with the SHA and be the basis for the SHA’s performance management regime.
Recognising that the pathway recommendations are many and various we intend to start by tracking progress against the key pathway pledge, which for the children’s pathway is to cut the number of hospital admissions for children with asthma.
We know that this doesn't tackle all of the priorities in this chapter. Childhood obesity, breastfeeding rates, children’s asthma and diabetes rates will be tracked through existing routes. Obesity in primary school children and infants breastfeeding are Vital Signs, whilst identification and support for diabetic children is a CQUIN measure.
The key indicators we will therefore track in the "Healthy Ambitions Dashboard" will be:
- Number of children <20 years admitted to hospital for asthmatic episodes (by 5 year age band)
- Readmission rates for children with asthmatic episodes within 3 months
- Average length of stay for asthma admissions and readmissions for under 19 year olds
Work has been undertaken to establish baselines for the pledge and by the end of March ’09 trajectories for improvement will have been agreed between the SHA and PCTs and will be reflected in annual operational plans.* We intend to publish progress against individual trajectories.
*More details can be found in chapter on performance and metrics.