Children’s Strategic Clinical Network - Overview Tracy Parr SCN Lead Children and Maternity Children England December 10 th 2013 London Strategic Clinical Networks

What is a Strategic Clinical Network (SCN)? Area requiring large scale change Resistant to previous attempts to improve Strategic approach Contrast with Operational Delivery Networks 2

Clinical areas covered by SCNs 3

London’s Children Population of London 7.8 million (ONS 2011) 2,049,576 children aged 0 – 19 in London Approx 1.7 million children in Kent Surrey Sussex, and East of England many of whom access specialised services in London 134,186 live births in London 2012 (ONS) 4

Why a Children’s SCN? UK has a higher all-cause childhood mortality rate compared with Sweden, France, Italy, Germany and Netherlands 5

London has higher than expected mortality for 1 – 19 year olds 6 Data courtesy of London Health Programmes

Hospital mortality for children in London is rising compared to other areas of UK 7

Nearly half of children are not reviewed by a consultant surgeon within 12 hrs of admission 8

At weekends this worsens to less than 30% consultant review within 12 hours 9

Over 50% of hospitals do not have a paediatric anaesthetist available 10

Attendance at A & E by children is very high in London London boroughs have A and E attendance higher than the national average for children Data courtesy of ChiMat

Some boroughs have high rates of admission to hospital for asthma 12

Solutions to the care of children 13 “Children’s services should be seen as a whole system, designed within a framework of pathways and networks which enable the right things to be done, at the right time and place, using teams that work together within a managed network.” RCPCH 2013

Issues across healthcare systems 14 “It is clear that in relation to service failure, problems often occur at the borders between one organisation or team and another” Learning from Investigations Healthcare Commission February 2008

Initial work 15 Implement networks of care across all children's providers Identify standards of care within the networks building on existing standards: Service specifications for specialised services All existing standards for children in-hospital care (eg RCPCH, London Health Programmes, RCA, RCS) General practice outcome standards

PATHWAYS London Strategic Clinical Networks December 2013 Children’s Strategic Clinical Network Children’s Commissioning Group Strategic Clinical Leadership Group Patients and public SCN Oversight Group Governance Clinical Senate Assurance Children’s Network STANDARDS Primary care Tertiary care Secondary care Cardiology Pathway Group Chair: Owen Miller SCN Lead: Andy Martin Neuroscience Pathway Group Chair: TBC SCN Lead: Andy Martin Diabetes Pathway Group Chair: Peter Hindmarsh/Martha Ford- Adams SCN Lead: Sara Nelson Nephrology Pathway Group Chair: Lesley Rees SCN Lead: Sara Nelson Surgery Pathway Group Chair: Simon Eccles SCN Lead: Suzanne Sweeney Critical Care Pathway Group Chair: Duncan MaCrae SCN Lead: Andy Martin Oncology Pathway Group Chair: Julia Chisholm/Darren Hargrave SCN Lead: Caroline Moren Asthma Pathway Group Chair: John Moreira SCN Lead: Sara Nelson Gastrointestinal Pathway Group Chair: Ian Sanderson SCN Lead: Suzanne Sweeney Neonates Pathway Group Chair: Sandy Calvert SCN Lead: Suzanne Sweeney Patient and Public Involvement (PPI) SCN Lead: Andy Martin Mental Health SCN Lead: Andy Martin Health in the Justice System SCN Lead: Sara Nelson Commissioning SCN Lead: Sara Nelson Immunisation, Healthy Child and Safeguarding SCN Lead: Suzanne Sweeney Data and Information SCN Lead: Andy Martin Programme Management SCN Lead: Andy Martin Information Technology SCN Lead: Sara Nelson Education & Workforce SCN Lead: Sara Nelson Communications SCN Lead: Suzanne Sweeney Community care Collaborating with: ► Academic Health Science Networks ► Clinical Commissioning Groups (CCGs) ► Health and Wellbeing Board ► Local Education and Training Boards ►Public Health England ► Regulatory bodies ► Royal Colleges ► Voluntary sector PATHWAYS ENABLERS

Linking with other organisations 17 Networks Establishment of a Regional CYP&F voluntary and community sector network Regional networks and resources on engaging with health & schools Supporting local networks and effective representation Briefings on effective engagement and representation

Patient and Public Involvement in SCN Critical part of our work Challenges Options Discussion 18