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 Transition of moving Care Co-ordination into the Integrated Assessment Framework

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

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

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

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)

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

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!”

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

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

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

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?

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

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

Good luck!