Service Transformation

We work with whole health and care systems to help them shape and transform services.  Here’s a few examples of our work:

Transformation of Children and Young People’s Emotional Wellbeing and Mental Health Services (CAMHS)

Following our in-depth review, our report and recommendations lead to an intensive programme of system-wide work to redesign and transform mental health services for children and young people in Norfolk & Waveney.

Fourteen workstreams were established as part of a mobilisation phase involving hundreds of partners and stakeholders. We steered the recommendations from that phase through the governance process of both the NHS and Local authorities which lead to the sustained work of those workstreams, agreement on a new service model (THRIVE), financial arrangements and an alliance commissioning approach across what was previously 6 individual commissioning bodies.

The key decision-making bodies agreed to:

  • endorse the emerging service model (THRIVE) and agree the proposed age range for core CYPMH services (0-25) (an approach that encourages early intervention and that all children and young people are viewed as being within the model at all times)
  • agree to develop an Alliance approach to commissioning and providing the future model of CYPMH (which will see all partners collaborate to deliver a single set of shared outcomes)
  • agree to establish a cross system Alliance Board (to act as the focal point for all future decision making about CYPMH)
  • agree in principle to the development of an expanded Section 75 agreement encompassing all relevant CYPMH expenditure
  • note the importance of effective engagement and communications to the programme, and the potential requirement for consultation on the service model

 

Review of NHS all-age Neuro-Developmental Disorder Pathways

The Norfolk and Waveney NHS Clinical Commissioning Groups and Norfolk County Council commissioned us to conduct a review of the NHS Neuro-Developmental Disorders diagnostic pathway across Norfolk and Waveney for adults and children.

We mapped the commissioning landscape; the current system; the national context and the specific requirements of the NHS long term plan. Our key findings and recommendations detailed a granular blueprint of the current and future state for: system level issues; adults and children’s pathways; commissioning arrangements; data and performance; provision; workforce planning; funding and diagnostic processes for people with co-morbid conditions.

We worked with commissioners and other stakeholders to deliver a comprehensive report detailing: immediate priorities for change (0 to 6 months); longer term transformation (6 to 18 months); the relationship between CAMHS and NDD services and implementation.

The scope of the review was to focus specifically on the following:

  • Diagnostic pathways for children and adults
  • Pre diagnostic support
  • Post diagnostic support
  • The requirements for specialist provision in key associated services – mental health – and the relationship with key interface services: primary care, learning disability services & wider children’s services

An all-age approach does not mean a single service and universal pathway for all ages, but that diagnostic services should be available for all – regardless of age – and that these pathways adhere to a common set of principles. During the course of the review we used the following principles to guide our work:

  • All age approach
  • Equitable service offer
  • NICE compliant
  • Minimal waits
  • Purposeful watchful waiting

The approach to undertaking the review included:

  • Meetings and interviews with key stakeholders in the system involved with the pathway: commissioners, providers, clinicians, users, 3rd sector
  • Professionals’ workshops: two to map the CYP current pathway and adults’ current pathway (respectively), and a third to inform what a good all age service would look like and what this would take to deliver
  • Review of key documents and data

Targeted insight work with people with NDD, carers, families and others (including professionals) exploring their experience of current services and their views on priority areas for improvement. The commissioned scope was to convene 2 focus groups (one for adults and one for children); 20 interviews. The review actually included 3 focus groups and 41 interviews. We found people were very willing indeed to talk to us about NDD, their experiences and how it impacted their lives.

 

Transforming Care Technology

Essex County Council has been using assistive technology to support independent living over several years and in a variety of ways. This work has been undertaken alongside wider initiatives – often locally driven by other parts of the system – to establish Careline services; essentially using alarms and other types of analogue technology so that people can raise alerts to monitoring services if they need urgent help in their own home, particularly if they have fallen. In recent years ECC has invested in some in-house expertise to support the take-up and use of technology-enabled care by social workers and service users; a TEC team has been established and TEC Champions (people with day jobs but with some additional capability around the use of care technology) have also been in place.

There were a number of factors pushing the council to move at pace on setting a vision and strategy for care technology in Essex, and to provide leadership and co-ordination with a wider set of partners to come together to shape a co-ordinated offer for people living locally.

We provided:

  • Strategic and delivery support to drive the programme forward, working alongside the internal project team and building on the market review by SOCITM
  • Support for developing effective partnerships
  • Communications and engagement support for key stakeholders

Development of a sustainable digital inclusion offer for professionals and service users as an embedded part of the forward model.

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