The State of Child Health: Community paediatric workforce

New report, published the Royal College of Paediatrics and Child Health (RCPCH) and the British Association for Community Child Health (BACCH), highlights an alarming 25% shortfall in the number of community paediatricians.

The report raises concerns over the system failing to cope with growing demand and the unprecedented pressures faced by specialist community children’s doctors, who have a wide remit from child protection to managing children with disabilities and diagnosing those with conditions such as autism and ADHD.

The report makes a number of recommendations to turn the situation around. This includes an increase of 25% in the number of community paediatricians, equivalent to 320 more doctors, to meet recommended levels and reduce waiting times. It also provides extensive guidance and clear specifications for commissioners, clinicians and health care organisations, all with the aim of providing a high quality of care.

Download the State of Child Health: Community paediatric workforce

Read more about the RCPCH State of Child Health series

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Improving care and support for children and young people with mental health problems

Three Royal Colleges have jointly agreed five shared principles designed to improve care and support for children and young people with mental health problems.

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The Royal College of General Practitioners, The Royal College of Paediatrics and Child Health and The Royal College of Psychiatrists have issued a position statement saying that as well as the commissioning of specialist treatment, an effective child and young people’s (CYP) mental health system required:

  • acknowledgment that CYP mental health is everybody’s business and should be supported by a shared vision for CYP mental health across all government departments
  • a preventative, multi-agency approach to mental health across all ages, incorporating attention to education for young people and families, social determinants, and health promotion
  • a system of national and local accountability for population-level CYP mental health and well-being, delivered via integrated local area systems
  • training and education for the whole children’s workforce in their role and responsibilities for CYP mental health
  • more support, both from specialist services and other sectors, for professionals dealing with CYP who do not meet referral threshold to CAMHS.

Full document: Position statement on children and young peoples’ mental health

Tackling culture change to transform mental health services

Mandip Kaur for the King’s Fund Blog | 16th March 2017

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Traditionally, mental health services are delivered by Children and Adolescent Mental Health Services (CAMHS) up until the age of 16 or 18 – or when a young person leaves school or college – at which point they’re expected to transition to adult mental health services. It’s long been recognised that this is a poor boundary for service transition, often having a further detrimental effect on mental health.

Forward Thinking Birmingham delivers mental health services for children and young people aged up to 25, combining the expertise of Birmingham Children’s Hospital, Worcester Health and Care Trust, Beacon UK, The Children’s Society and The Priory Group. The partnership’s vision is that Birmingham should be the first city where mental health problems are not a barrier to young people achieving their dreams. The transformational changes to the service were driven by the need to address disjointed and fragmented care provision, complicated service models, long waiting lists and rising demand. The service operates a ‘no wrong door’ policy and aims to provide joined-up care, focusing on individual needs, with improved access and choice for young people.

Read the full blog post here

Improving outcomes for children and families

The Local Government Association has published Improving outcomes for children and families in the early years: a key role for health visiting services

This guide highlights the importance of health visitors and commissioners to work together to monitor and evaluate the impact of the health visiting service.

The report includes case studies demonstrating examples of innovation.

Effectiveness of an improvement programme to prevent interruptions during medication administration

Dall’Oglio, I. et al. (2017) BMJ Open. 7:e013285

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Objective: To assess the effectiveness of an improvement programme to reduce the number of interruptions during the medication administration process in a paediatric hospital.

Intervention: The interventions included a yellow sash worn by nurses during medication cycles, a yellow-taped floor area indicating the ‘No interruption area’, visual notices in the medication areas, education sessions for healthcare providers and families, patient and parent information material.

Conclusions: This bundle of interventions proved to be an effective improvement programme to prevent interruptions during medication administration in a paediatric context.

Read the full abstract and article here 

Improving oral health

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This toolkit is for commissioners and providers of supervised tooth brushing programmes in England.

In 2014, both NICE and PHE published documents that reviewed the evidence of effectiveness of oral health improvement programmes. They both recommended commissioning targeted supervised toothbrushing in early years’ settings. Read Improving oral health: an evidence-informed toolkit for local authorities.

Many local authorities in England already commission such programmes. This toolkit will help commissioners, public health teams and providers make sure their programmes are evidence-based and safe, and have clear accountability and reporting arrangements.

Access the full toolkit: Improving oral health: A toolkit to support commissioning of supervised toothbrushing programmes in early years and school settings

Improving the mental health of children and young people

Reports to support commissioners in improving the mental health and wellbeing of children and young people. | Public Health England

These reports describe the importance of mental health and wellbeing among children and young people and the case for investment in mental health. They also summarise the evidence of what works to improve mental health among children and young people in order to inform local transformation of services.

The mental health of children and young people in England

The mental health of children and young people in London

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Image source: http://www.gov.uk