1. Children, Young People and Maternity Workstream

2. What and Why?
Building on a strong evidence base and solid partnerships, we are working to improve the health and care outcomes for City and Hackney children, young people and their families.
We will maximise our resources, integrating them where we can get best value for money and work on ensuring all our families have access to the care they need to be happy and healthy.
We will work on improving the quality, safety and accessibility of our health and care provision for families as our day job, and transform some key areas where we can make a difference together.

3. We want you to help us to:
Deliver transformational change for the better, on these three key areas:
Improve early support, transform CAMHS, and crisis
Improve emotional health and wellbeing
Improve health and wellbeing services for those with SEND and those who are in care
Reducing infant mortality, and improving experience of care
Strengthen our health offer for Vulnerable Groups
Improve the offer of care through Maternity and Early years

4. Child and Adolescent Mental Health Service (CAMHS)
Increasing the number of children who have a diagnosis of a mental health condition by increasing real time investment in CAMHS by £1.2m per year, until 2021
Placing CAMHS workers in 50% of schools with plans to roll out a universal offer to all schools by 2020 (pending successful evaluation), and promoting our 5tothrive wellbeing framework in schools, alongside developing our work with parents
Developing better links between CAMHS and Primary Care
Improving the transition of Children and Young People (CYP) in contact with CAMHS in to adult services when they reach 18. We are piloting a two year project with Family Action / Off-Centre to deliver a Transition Service for CYP who are in contact with CAMHS when they are approaching 18 (16-25 Service)
Reducing waiting times: our early intervention CAMHS (First Steps) will have an average wait time to enter treatment within six weeks by Q3 18/19
Continue to address inequalities through our Reach and Resilience work
Improve diagnosis and access to CAMHS by:
Improving Crisis Care by extending hours of Paediatric Psychiatric liaison in A&E to 10pm
Enhancing our eating disorders service to meet increasing demand for one of our most vulnerable groups of CYP
Continuing to improve our Neurodevelopmental pathways including increase funding for Autism diagnosis and aftercare to meet increase demand
Strengthen our offer for very vulnerable children and young people by:

5. Maternity and the Early Years
We want to ensure our families in City and Hackney have access to safe and effective maternity care:
In % of the women who delivered at Homerton were identified as having other medical needs that required more complex care. To make their experience as safe, effective and responsive as possible we will increase the numbers of women who book an appointment to see their GP or a midwife by 10 weeks of pregnancy, and improve continuity of care from their midwife
We will also review local services against “Better Births” which is the Five Year Forward Plan for Maternity, and develop a shared local plan that focuses on:
Personalised care and care planning
Improved postnatal care and perinatal mental health support
Choice and continuity of carer
Ensuring there is adequate local maternity provision that is women - centred and needs led.

6. Early Years – Maternity continued
Improving Pregnancy Outcomes:
Additional support for pregnant women who have Long Term Conditions (LTCs) or other specific medical needs through our GP Early Years Contract
Targeted preconception care for women with LTCs
Specific support for pregnant women with LTCs.
Encourage women to take folic acid, aspirin and healthy start vitamins for a healthy pregnancy and healthy growth and development of the child (Healthy Start vitamins are freely available to all City and Hackney pregnant women and children under four years)
Refer women early to local services when social or psychological risks are identified
Ensure there are clear services for women with a high Body Mass Index (BMI) through our strategic obesity pathways
Increase the number of women who receive Pertussis and Flu jabs during their pregnancy
Ensure pregnant women, partners and parents have the opportunity to provide feedback on their experience of using maternity services, and are kept informed on what steps have been taken to improve services through our Maternity Voice Partnership.
Reducing health inequalities – Support for vulnerable women:
Through joint working between our health and voluntary services, we will provide targeted support for women who may be socially vulnerable and who may struggle to access mainstream services through services such as:
Targeted antenatal classes and Bump buddies crisis and peer support in pregnancy service
Providing a pathway of care for vulnerable women to access services
Providing support for bereaved parents.
Perinatal mental health:
Building on current good practise, we will continue to provide support to women and their partners who have emotional and mental health needs during and after pregnancy, working closely with our North East London partners
We will contribute to strengthen work on improving emotional health in children under 5 years and provide support for parents to access mental health services in the perinatal period.

7. Special Educational Needs and Disability (SEND)
We know that families want clear, accessible information about:
We will ensure there is the right contribution to Education, Health and Care Plans (EHCP) from health – including joint planning, clear and accurate information in plans, and input to reviews
We are working with our education colleagues to ensure that children and young people with complex health needs, who may not have a learning need, still have access to the EHCP process and necessary provision
We have invested in a Designated Clinical Officer (DCO) to work with our Designated Medical Officer – to help us ensure we have the right processes in place, and families know how health can support them in EHCP planning
Families want primary care to be able to sign post them to local services; EHCPs are now being shared with practices, we have parent reps who are keen to ‘co-produce’ pathway and access information for families
We are working to integrate care planning wherever possible – for those with continuing care needs, school health plans, personal health action plans, personal budgets, and EHCPs
We will work with our partners to address the needs of specific cultural and vulnerable groups
We, with our partners, are committed to inclusion, not exclusion, through early identification of need and the offer of holistic services and support
Care coordination support available
Local services
Access and eligibility
The Local Offer websites