1. www.healthiertogetherwessex.nhs.uk (Funded by Wessex SCN since April 2014) Dr Julian M Sandell Consultant Paediatrician 21 st May 2015

2. Febrile illness Respiratory illness Gastroenteritis Rash Abdominal pain Head injury Short Stay Paediatric Assessment Units, RCPCH January 2009. Paediatric illness: RCPCH “high impact” presentations

3. Increasing… ED presentations Unplanned admissions Ambulatory-care sensitive admissions e.g. URTI/LRTI/UTI/Gastro [4-hour target, changes to OOH provision, NHS-111 etc.] Very short term (<24 hour) admissions doubled over last decadeYET…  Child death rates 36% 1999 – 2010 E&W National Paediatric Headlines

4. Increasing… ED presentations Unplanned admissions Ambulatory-care sensitive admissions e.g. URTI/LRTI/UTI/Gastro [4-hour target, changes to OOH provision, NHS-111 etc.] Very short term (<24 hour) admissions doubled over last decadeYET…  Child death rates 36% 1999 – 2010 E&W National Paediatric Headlines

5. UK demographics: 62,000,000 people 12,000,000 children (1 million in Wessex; 85,000 in Bournemouth, Poole, Purbeck & East Dorset) 220,000 doctors 40,000 GPs 300 children per GP 48 million child GP appointments (130,000 per day) or 1200 child appointments per GP/year age: 0-5 years  6 GP visits/year age: 5-14 years  2 GP visits/year 5,500 ED Consultants 2,200 children per ED consultant 4.5 million child ED attendances or 800 child appointments per ED Consultant/year 8,000 Paediatric Consultants 1,500 children per paediatrician 1.4 million child admissions or 175 child admissions per Paediatric Consultant/year = 1,000 doctors The “mathematics” of child health

6. Sanjay Patel, Consultant in Paediatric Infectious Diseases (PROJECT LEAD) Lesley Ayling, Clinical Director for Children and Families, West Hampshire CCG Jason Barling, Paediatric ED Consultant, Southampton Sophie Clayton Baker, Parent Representative Lorraine Cole, GP Winchester / Southern Health Lesley Coles, Head of Nursing for Women and Children’s Services, Portsmouth Parvin Damani MBE, Senior Public Health Specialist Olivia Falgayrac-Jones, Education Commissioning Manager, Wessex Andrea Havey, Senior Commissioning Manager for Children and Maternity, SE Hampshire and Fareham &Gosport CCGs Becky Hepworth, Community Nursing Team, IoW Hilary Kelly, MCYP SCN Manager, Wessex SCN Karen Kirkham, CCG Programme Chair - Maternity and Family services, Dorset CCG Duncan Linning-Karp, Child Health Care Group Manager, Southampton Children’s Hospital Madeleine Litchfield, GP and Children’s Services Lead, SE Hampshire CCG Phil Lovegrove, Commissioner, Southampton Integrated Commissioning Unit Louise Millard, Clinical Director, Portsmouth Oliver Morris, GP with interest in paediatrics Mary O'Brien, Consultant in Public Health, Public Health England (Wessex) Julian Sandell, Consultant Paediatric Emergency Medicine, Poole Sally Stanley, Quality Improvement Lead, Wessex SCN Jo Wall, Quality Improvement Lead, Wessex SCN Peter Warren, Clinical Quality Assurance Lead, South Central Ambulance Service Project Steering Group

7. 1.Empower parents as to whether and when they need to access Healthcare. 2.Clear signposting for parents to appropriate healthcare services when required. 3.Practitioners, at every point of contact, clearly understand their own competence and know where to seek advice. 4.Consistent and appropriate advice given to parents across the whole urgent care system. 5.Clear local pathways should be in place across the whole acute care system which are understood by all practitioners. 6.Effective communication and information sharing between practitioners and services across the whole acute care system should be in place. Core Principles

8. User Views www.healthiertogetherwessex.nhs.uk

9. Empower parents with standardised resources on common childhood illnesses Wessex-wide guidance to manage common presentations Clarify local referral pathways for GP’s Survey’s themes Improving the Urgent Care Pathway

10. Collaboration

11. PARENTS Parent resilience – my child is hot/has a fever – coughs and colds – breathing difficulties & wheeze – tummy ache – head injury – sore throat – earache – rashes HEALTHCARE STAFF Pathways & safety netting – bronchiolitis – fever in children < 5 years of age – diarrhoea and vomiting – acute asthma/wheeze – abdominal pain – head injury Safeguarding Antibiotic guidelines … all with signposting to appropriate services Pathways and information sheets

12. Parental Information: web-based

13. Parental Information sheets

14. Parental Information sheets (2)

15. NHS Pathways

20. Involved: all acute Trusts in Wessex all GP clinical leads in Wessex Wessex ED network Consultation Process

21. Parents and carers symptom based health advice signposting Healthcare professionals Primary care staff Hospital staff Community nurses Other healthcare staff PHASE 1 launch: June 2015 www.healthiertogetherwessex.nhs.uk Wessex Healthier Together website

22. Website – “Keeping your child safe and healthy” – non-acute pathologies Best practice guidelines - Asthma/diabetes/sepsis Wessex-wide secondary care guidelines – Encephalitis – Empirical antibiotic guide Transition - "Ready, Steady, Go, Hello" programme CAMHS Education in schools Wessex Healthier Together Project: Phase 2

23. www.healthiertogetherwessex.nhs.uk Funded by Wessex SCN since April 2014