1. Support Early Intervention and Prevention
Working Together to…
Support Early Intervention and Prevention
Insert CPP / Health Board Logo
Carol Carpenter; Senior Health Visitor, NHS Thistleton
The 27 – 30 month universal child health review is a core element of the current National Child Health Programme. The reviews provide an opportunity to work with parents/carers to assess children’s development and wellbeing; provide age appropriate health promotion advice and anticipatory guidance; build parenting capacity; identify needs for support and facilitate early access to effective interventions. NHS Thistleton and Anywhere Council are working to streamline the formal process of sharing information between health visitors and early years establishments. In order to do this, we had to increase the uptake of the review first.
Aim: By June 2018, increase the uptake of the 27 – 30 month review in Thistleton from the baseline score of 75% to 85%.
Method
Results
This chart shows a shift in improvement in ‘the percentage of uptake at 32 months’ for 1 of our teams.
As a Health Board, we noticed that there was variation in the uptake of the review, with high numbers of children not being seen within the month timeframe. We wanted to support our teams to work collaboratively and achieve consistency. Creating a Process Map was a way of helping us do this. This allowed us to see where the focus of our improvement was required.
Process Change
This chart shows that we were able to increase uptake across a number of teams on a phase by phase basis.
Our first change was ensuring that we had a clear plan / project charter and driver diagram. This would allows us to always remembered the ‘bigger vision’ and give us something to work towards. A change that we felt would support our teams was to build capacity and capability for quality improvement in the workforce by creating ‘Improvement Champions’. This allowed staff to work collaboratively and share ‘what works’. We also felt that it was important to involve teams from the start, particularly health colleagues, other agencies and senior leaders at all levels, as they would support us in our project.
Conclusions
“It’s great to see that through working together and having a clear process that we’ve managed to increase the uptake in our area.” (P Bennett; Health Visitor, Team 1)
“I’ve really enjoyed being part of this project. It’s made me think about the small changes that I’ve made to my practice that’s had a massive impact on children. (W Burns; Health Visitor, Team 4)
We were able to achieve our aim and are already beginning to think about how we carry the key learning forward to the next part of the month review.
Achievements
Implementation is a permanent change to the way work is done and, as such, involves building the change into the teams everyday practice.
Agreeing job remit for admin staff
Using data on a weekly basis to inform practice and makes changes on a real-time basis.
Next steps
Scaled- up: From the chart above, you can see that we’ve already scaled-up the learning from one team to six teams.
Spread: We want to improve communication of the month review information between Health Visitors and the Named Person. This will support transition to Early Years establishments.
Spread: There is key learning that can be spread from NHS Thistleton to other boards, who may have similar issues with uptake.
Key Learning Points
Ownership – Health Visitor buy-in empowered them to take ownership of the project and to make the fundamental changes that were required. This also helped us to ensure that the project was not person dependent.
Change ‘Bundle’ – We created a change ‘bundle’ that meant that learning could be spread from one team to another.
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