Integrated Systems, conception to five eif.org.uk The Early Intervention

Integrated Systems for EI -conception to five What makes an effective integrated system? OBR review, effective systems Initial review on programmes Outcomes Data collected by completion of template, follow up calls, three deep dives 18 Places identified this as a priority 14 returned completed templates/accepted offer of a phone interview Account- ability Commissioning planning Delivery Support Systems WorkforceUserProgrammes

Integrated Models Range of models Children Centre based, a number are reviewing commissioning of CC Locality teams Virtual/co-located Workforce / Management Structures VCS, EI, family support, HV,MH support, Job centre plus in CC Most of HV now based in community, Worcestershire currently based in GPs surgeries Swindon - Single management structure, HV, FNP, SALT, SN, education welfare, Ed Psych, TAMHS, families first. Locality teams

Delivery Identification & Assessment All Places had the basis of a CAF process to assesses need across partner agencies Birth data Essex, Herts, Solihull - 2 year entitlement Essex – developed CAF to Family Facilitated Meeting Hertfordshire – Team Matters Meeting to discuss CAFs Westminster review families of concern at a monthly meeting between health and CC, including 2 year development review 2 Places referred to the quality assessment of CAF process Access to Interventions TAF approach to integrated interventions Single point of access Essex - Early Help Hub

Support Systems Current position Integrated information IT sharing systems very limited 9 Places had local information sharing agreements and processes in place to share live birth data Individual info shared through CAF process was more common Examples of promising practice Herts - use of NHS number by CCs for 2,3, and 4yr olds free place Swindon - access to IT systems Dorset - locally developed eCAF Islington - additional info shared with CC on housing and benefits

Lessons learnt – What Places have told us Communication Culture Leadership Time Data sharing is crucial “Hearts and Minds” careful consistent communication across teams Build professional trust, team building, acknowledge expertise persistently revisit and define basic principles of integration e.g. shared outcomes, governance, tools, protocols and user pathways. Common vision and outcomes Effective partnership Leadership, commissioning, operational Manage independencies when with whole system change Cultural change takes time

Barriers Data sharing Present accountability and governance arrangements predominantly drive organisations and reduces focus on integration Capacity of workforce limited joint training opportunities Capacity for development and evaluation Fragmentation of commissioning, Range of employers Financial remodelling required ICT Difficulties arising from co-location in some areas such as H&S issues for infection control Lack of GP involvement in 0-5 integration During health transition 2012 a number of previous agreements lost, info sharing, commissioning and some co-location