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Integration of Care Co-ordination model within GIRFEC in the Scottish Borders

Integration of Care Co-ordination model within GIRFEC in the Scottish Borders. Dawn Moss Nurse Consultant Vulnerable Children & Young People. There’s so much to tell you…. A bit about the Borders The development of Care Co-ordination The need to change GIRFEC in the Borders Challenges

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Integration of Care Co-ordination model within GIRFEC in the Scottish Borders

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  1. Integration of Care Co-ordination model within GIRFEC in the Scottish Borders Dawn Moss Nurse Consultant Vulnerable Children & Young People

  2. There’s so much to tell you… • A bit about the Borders • The development of Care Co-ordination • The need to change • GIRFEC in the Borders • Challenges • Transition of moving Care Co-ordination into the Integrated Assessment Framework

  3. Scottish Borders • Population children & young people: 25,441 (23%) • Borders with Lothian, Dumfries & Galloway & Northumberland • NHS Borders Children & Young People’s Health Network • Scottish Borders Council – Integrated Children’s Services (Social Work and Education) • Integrated Assessment Framework

  4. In the beginning… • Referral criteria: • Children with complex needs needing coordination of care and services • Team around the child • Independent chair • Focus on child’s progress • Child and parents views • Action Plan • Key worker role v key point of contact

  5. A few years along the road… • Achieving aim of reducing duplication by ensuring that care is delivered in a consistent and co-ordinated way, with effective interagency working and sharing of information • Increasing numbers of referrals • Breadth of referrals • Evidence of good practice and multi professional working • Extend chairing role to other professionals

  6. Pausing for thought… • Is Care Coordination meeting the needs of children, young people and their and families? • Are actions agreed within meetings followed through? • Audit 2009 (parental and professional questionnaire)

  7. What professionals told us • 57% response rate (53 returned from health, education, social work & voluntary sector) • 77% thought Care Co-ordination was useful • 81% said they had been able to carry out agreed actions • Only 12 of the 53 respondents gave a definite commitment to chairing future meetings • Only 15% were certain the Care Co-ordination would still be needed once IAF was fully implemented with 62% saying they didn’t know • 32% felt Care Co-ordination could be improved

  8. What parents told us • 53% response rate (21 returned) • 76% knew who their named key worker was • 29% said that all of the actions agreed at the meeting had been followed thought whilst 38% felt that ‘most’ of them had whilst 5% felt ‘none’ of them had “Get rid of it or make sure it does what it is supposed to do and co-ordinate!”

  9. Reach for the stars • GIRFEC • Integrated Assessment Framework • Introduced to one locality in 2008 • Full implementation in Feb 2010 • Support from across the organisation and from all partner agencies • Integrated Children’s Services

  10. GIRFEC in the Borders • Tools to support the IAF process launched in February 2010 across all services (e.g. documentation, guidance, training) • Report to Children’s Reporter’s • Programme of training and workshops • Quality audit • Locality and central procedures and processes are being rewritten to incorporate IAF structures - including the Child Protection Guidelines • Learning from the Highland Pathfinder and links to the GIRFEC Scottish Government team

  11. Achievements • Common integrated assessment used by all agencies • Shift to locality structures to enable better-informed, more localised, timely decision-making • Information Sharing Protocol agreed between all agencies working with children, young people and families • Agreed process for obtaining and renewing consent within IAF • IAF process includes requirement for recording views of children, young people and families • All professional groups are supported to take on the Lead Professional role where indicated

  12. What - no problems? • Documentation • IT- knowledge, skills, systems, etc, etc • Role of chairing meetings – issues of skills and confidence • Locality v central services • Children with complex health needs – where are they in this new world?

  13. Onwards… • Transition of moving Care Co-ordination into Integrated Assessment Framework • No new referrals to Care Coordination since June 2010 • Team around the Child • Meetings Around the Child • Child’s Plan – outcome focused • Supporting staff

  14. To infinity and beyond How is IAF different to Care Co-ordination? • Shared language • Consent and information sharing • Building confidence in taking decisions and removing barriers to timely decision-making • Focus on outcomes - SHANARRI • Core documentation for health visiting, CCN Team, CAMHS

  15. Good luck!

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