Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable. Community Children’s Health Partnership Care Pathways and Patient Stories Matthew Ellis Community Paediatrics Clinical Lead Emily Roberts Children’s Services Manager Barnardo’s

Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable. Community Children’s Health Partnership A legal partnership between North Bristol NHS Trust and Barnardo’s A service that is core value driven An integration of community child health and CAMHS services into a single provider-employer Trust Reduction of variance to reduce inequality of access Clinical care pathway driven Performance monitored via an Outcomes Framework

Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable. Community Children’s Health Partnership

Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable. Community Children’s Health Partnership Pathway Group (clinical effectiveness committee) Key Stakeholders; GP rep, health visitor, school nurse, Therapist, community paediatrician, mental health team, CYPS Identify two pathway champions They lead pathway design process in consultation with key stakeholders Bring the draft to the Group

Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable. Community Children’s Health Partnership Pathway Checklist

Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable. Community Children’s Health Partnership Care Pathways Impaired attention in the school age child Developmental Delay in the preschool child Impaired social communication Motor Coordination Difficulties in school age Urinary Continence Vision Problems Motor Disorders including Cerebral palsy Learning Difficulties Substance misuse in young people Emotional and Behavioural difficulties in children Complex mental health 5-12 year old pathway Eating Disorders in young people

Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable. Community Children’s Health Partnership

Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable. Community Children’s Health Partnership Patient stories ‘How do you want a patient friendly version of the pathway?’ Semi structured interviews 1. Before meeting with the service What was life like for you before you came into contact with the service? 2. First meeting with the service What happened the first time you met with the service? 3. Further meetings with the service (within 18 weeks of referral from community staff) What happened during the time that you met with the service? 4. Ending with the service What happened when your meetings with the service ended?

Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable. Community Children’s Health Partnership decoration Consulted and informed Child-initiated and directed Increasing degree of participation Non-participation Ladder of Participation Service User feedback used to inform and plan future services Adding own criteria to a job description and involved in short listing process People are present for a photo shoot but have little idea of what it is all about

Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable. Community Children’s Health Partnership Journeys NICE V Service User Experience Identifying your subjects in house and through other settings – stakeholders? Focus groups Questionnaires Face to face interviews

Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable. Community Children’s Health Partnership Findings – Eating Disorder Care Pathway “On my fourth visit to the GP he said ‘you have anorexia’ and I was really knocked back by it I went home and hid in my room for ages” Young Person I got the impression that they just wanted to shove a drug down her and feed her up without involving her and helping her with her mental health… you know they just feed them up and then they go down and that isn’t a solution” Parent

Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable. Community Children’s Health Partnership

Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable. Community Children’s Health Partnership

Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable. Community Children’s Health Partnership

Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable. Community Children’s Health Partnership

Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable. Community Children’s Health Partnership Barriers Only the patient experiences the whole pathway Initial buy in (80:20 rule) Management involvement Professional boundaries Trust website/patient information branding

Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable. Community Children’s Health Partnership Implications for Practice Participation is a potential vehicle for system wide change Patient experience is helpful to inform ‘pathway’ design Getting the voices of the YOUNG and PARENTS heard can be difficult In the campaign to achieve service change genuine patient voices can provide leverage