Child Health Commissioners’ Meeting Minute – 3 December 2015
Present
Mandy Brotherstone – Chair, NHS Borders
Lorraine Currie- CHC, NHS Grampian
Sally Egan – CHC, NHS Lothian
Lorna Watson- CHC, NHS Fife
Catherine Goodall – CHC, NHS Forth Valley
Geraldine Queen – NHS Lanarkshire
Katherine Collins – NSD
Rachael Wood – ISD
Neil Ferguson – NHS Greater Glasgow & Clyde
Dr Pat Carragher – CHAS
Maureen McAteer- National Third Sector GIRFEC Project
Scottish Government
John Froggatt – Child and Maternal Health
Jenny Hamilton – Person Centred and Quality Team
Elaine Cruickshank - Looked After Children Unit
Emily McLean – Child and Maternal Health
Apologies
Kay Fowlie – CHC, NHS Tayside
Louise Wilson - CHC, NHS Orkney
Dr Sarah Taylor – CHC, NHS Shetland
Sally Amor – CHC, NHS Highland
Emelin Collier - CHC, NHS Western Isles
Gary Dover –NHS Greater Glasgow & Clyde
Pauline Beirne - AHP Clinical Lead for Children and Young People
Dr Kate McKay - Senior Medical Officer, Scottish Government
Julia Egan - Nursing & Midwifery Policy Unit, Scottish Government
Welcome, apologies and previous minutes
1.1 The Chair welcomed the Group and the minutes of the previous meeting (17 September) were agreed as accurate. The actions set from the previous meeting were also discussed.
1.2 Sally Egan updated the Group on her role as chair of the Community Children’s Nursing Review Group, which is discussing, as part of its remit,the future role of school nurses. It was raised that the long-term conditions agenda and who is responsible for this needs consideration. Sally will share the finalised remit of this group with the Child Health Commissioners’ Group when it is completed.
1.3 Some of the Child Health Commissioners raised a question regarding health assessments in Local Authorities where they had taken refugees. Arrangements for Health Assessments for refugees were discussed, as well as some of the potential health needs they may have, such as mental health needs (e.g. trauma). It was asked whether there would be any funding for sending families out with the local authority to get treatment. There is a specific article (article 22) within the UNCRC which states that refugee children are entitled to the same medical treatment as other children.
Action – Emily to speak to Susan Gallagher regarding who leads on public health, regarding refugees.
1.4 The Group was updated that the LAC responses around LAC mental health have been collated and circulated. There was a discussion around health assessments and children being placed out of area. It was raised that some children are being placed outside the local area with the local area not being informed.
To note: There is a section on out of area placements (cross boundary and cross border placements) in theGuidance on Health Assessments for Looked After Children in Scotland (May 2014)
1.5 It was raised that in one area they are finding it difficult to get Kinship Carer Assessments undertaken. One area has employed a G.P. to do these.
1.6 It was suggested that LAC should be a standing item on the Child Health Commissioners’ Group agenda.
1.7 A LAC Data Strategy was published in November,
1.8 It was raised that LAC have been considered in the procurement of the national Child Health Systems by the National Child Health Systems Group.
Action- Emily to find out whether a LAC MCN is being setup.
Action – Emily to ask whether the LAC update produced for the Children and Young People’s Health Support Group can be shared with the Child Health Commissioners’ Group.
Action – Emily to invite someone to update the Group on LAC
2.) Discussion on the future role and remit of the Child Health Commissioners’ Group
2.1 The Group needs to consider its role as the landscape has changed since the CEL on the role of the Child Health Commissioner (CEL 19, 2011) was published. Resources are now different and some members of the Group now have additional roles. Health and Social Care Integration and Integration Joint Boards (IJBs) also need to be considered in the Group’s role.
2.2 The Chair thanked the Group for their contributions regarding the questions on CEL19 and informed the Group that the responses have been collated and circulated to the Group. There was discussion about updating the previous CEL.
2.3 It was said that there is some confusion around what the term Child Health Commissioner means in Scotland.
2.4 The Child Health Commissioner has a fundamental advocacy role within Health Boards.
2.5 Areas for the Group to consider include: quality improvement, early intervention, UNCRC, good practise, Children and Young People’s (Scotland) Act 2014, regional planning and Care Inspectorate reports.
2.6 Geraldine Queen has created a template summarising Care Inspectorate reports which will be shared with the Chair.
2.7 The link between the Child Health Commissioners’ and the Children and Young People’s Health Support Group was discussed. It was raised that the relationship needs to be strengthened and a reporting mechanism needs consideration.
2.8 Geraldine Queen advised that she will become the Child Health Commissioner for NHS Lanarkshire formally at some stage.
Action- The Group to review its terms of reference and create a workplan
Action – Emily to find out if the Group can see the minutes of Children and Young People’s Health Support Group meetings
3.) National Third Sector GIRFEC project- Maureen McAteer
3.1 Maureen McAteer gave a presentation on the National Third Sector GIRFEC Project. She explained that Sally Egan chairs the management group of the project and that the project is coming to the end of its three year funding cycle.
3.2 The project was launched by the Minister for Children and Young People in 2014 with 3 years funding until March 2016. It is a Public Social Partnership between Barnardo’s Scotland, Voluntary Action Scotland, Improvement Service with support from CCPS. The ambition of the project is to contribute to a reduction in inequalities for children, young people and families by creating, nurturing and enabling partnerships, within and between the Third Sector and statutory sectors to ensure the best use of resources.
3.3 The project works on both locally and nationally. Local work has involved a self-evaluation approach which has led to local partners developing local shared action plans. National work involves contributing to key strategic groups, hosting national learning events and promoting the contribution made by the Third Sector to children’s outcomes.
3.4 From April 2017 Local Authorities and Health Boards will need to produce joint 3 year Children’s Service Plans, which cover targeted and universal services. Children’s Service Plans will ensure services promote wellbeing of children and young people, increase prevention and early intervention, improve integration between providers and make the best use of all the available resources.
3.5 Maureen gave context to some of the issues that the Third Sector organisations face, including the impact of austerity and the increasing demand for services. The project seeks to promote and support preventative approaches, very much building on the ambitions of the Christie Commission, the Children and Young People’s (Scotland) Act 2014 and other current policy.
3.6 GIRFEC has changed landscape for the Third Sector. Many smaller, community based organisations are delivering GIRFEC but would not necessarily describe it as GIRFEC themselves.
3.7 The importance of involving Third Sector organisations in dialogue, enabling them to participate in the shaping of childrens services was highlighted.
3.8 there are 3 outcomes of the project:
1.) Promote the Third Sector, reminding people that they need to be celebrated and supported. This includes thinking about how we can keep the Third Sector healthy and share good practice, especially in the current environment when many are under so much pressure.
2.) Support, working with organisations to ensure people have the resources they need to plan and deliver resources for children and young people.
3.) Collaborate with each other, building capacity, sharing knowledge, learning and expertise.
4.) Realigning Children’s Services
4.1 Realigning children’s services is a programme of work between CPPs, Scottish Government and Children and Familieswhich supports improvement in joint strategic planning and commissioning of services. It has a focus on collaboration, partnership and co-production. It builds on work previously undertaken in 5 CPPs.
4.2 Elaine Cruickshank explained that the programme can provide opportunities for raising attainment for all children, increased early engagement/ intervention with children and their families, improved health outcomes, identifying overlap/gaps in services and improved reporting on children’s outcomes and decision making. It also helps to justify decisions.
4.3 Evidence collection includes: mapping children’s services & associated investments, 3 wellbeing surveys (parent survey of children ages 0-8, pupil survey p5-p7 and pupil survey s1-s4); which are linked to SHANARRI domains, and survey data linkage with service administration data. The questionnaires will help CPPs be aware of children’s wellbeing and how well children are doing in school. Children are not always being appropriately identified as ‘in need of’ services and the programme can show gaps in provision. Other data available to be considered alongside RCS data includes, for example, the 27-30 month review.
4.4 The programme includes a three day structured development programme, along with on-going tailored support, consultancy, facilitated workshops, critical friend role and learning exchange sessions.
4.5 The key programme principle is that partnership is central and that the Third Sector and community involvement are crucial. The programme adopts the philosophy of, ‘nothing about you without you.’
4.6 The Scottish Government provides the resource for Realigning Children’s Services development, consultancy and evidence collection programme. It also funds the p5-p7 wellbeing survey and s1-s4SALSUS boost survey, along with the analysis and reporting.
4.7 CPPs are required to agree to support and engage with the programme fully and to provide a local project manager and fund the parent survey.
4.8 Link to the Realigning Children’sServices website.
5.)Creating a Healthier Scotland
5.1 The National Conversation on Creating a Healthier Scotland looks beyond 2020, inviting the public and professionals to have their say on what a healthier Scotland should look like in the next 10 to 15 years.
5.2 There are three broad questions: what support do we need in Scotland to live healthier lives?,what areas of health and social care matter most to you? and thinking about the future of health and social care services, where should our focus be? The Conversation is taking place through events across the country and online via Twitter, Facebook and its website, . The Conversation was launched in August 2015 and the findings will be available in March in March 2016.
5.3 A partner led approach is being used for facilitated events, many of which are open to the public and following a conversation café style format. Partners include the Alliance, Health Scotland, Carers Coalition, Young Scot, Scottish Centre for Learning Disabilities, etc. The Voluntary Action Fund will support small organisations wanting to hold events to discuss these questions, the deadline for making applications to the fund is 11 December. Members of the group were asked to advise networks they knew of that may be interested in the fund.
5.4 Emerging issues will be posted online during January. So far these have included: prevention and health, the importance of early years, mental health (with a focus on wellbeing), the wider role for G.P.’s surgeries and poverty and social issues.
5.5 A Fairer Scotland conversation is also taking place.
5.6 Other work which has taken place or is taking place that could feed into this conversation was discussed, for example : the Neonatal Services Review, the Scottish Health and Social Attitudes surveys, the National Maternity survey and a consultation which was undertaken in Fife.
5.7 The Children and Young People’s Health Support Group held a Conversation workshop in November, focusing on the key priorities for children. A paper will be circulated to the Child Health Commissioners for comment, before it is submitted formally to the National Conversation.
6.) CHAS Research
6.1 Dr Pat Carragher spoke to the Group about the Children in Scotland Requiring Palliative Care: Identifying Numbers and Needs (The ChiSP Study). The report was published on 4 November 2015, by University of York, and was financed by the Scottish Government through the Managed Service Network for Children and Young People with Cancer, where CHAS had acted as the ‘find-holders’. Its objectives were to:
- To identify the number of children and young people with life-shortening limiting conditions in Scotland;
- To describe this population in terms of their ages, conditions/diagnoses, geographical locations and ethnicity;
- To generate evidence of their psychosocial needs.
6.2 The report gives information on the number of babies, children and young people with life-limiting and life-threatening conditions. Additionally, it also offered a greater understanding than at any time before in terms of what their underlying conditions are, where they live, and their ages, as well as their gender and ethnicity. Specifically the research provides new information such as the numbers in each individual health board as well as the level of prevalence being higher in the most deprived areas. The report involved an extensive literature review and it gives both qualitative and quantitative information. The report gives 10 recommendations. (See link to the report )
6.3 The highest prevalence in those needing palliative care is for those under 1 years of age. There is a higher proportion of children and young people with life-limiting conditions living in areas of higher deprivation. The majority of children with a life-limiting condition die in hospital (73%). The prevalence of babies, children and young people with life shortening conditions is rising. In 2013/14 there were 6,661 babies, children and young people with life-shortening conditions, under the age of 25 years. In 2009/10there were 4,334.
6.4 The report recommends further improvements are needed across the health and social care sector. These include looking at specialist psychological and emotional care for all family members and age specific palliative services should be developed for the 16-25 year age group. Those under the age of 1 should be a priority group for improved palliative care provision.
7.) A.O.B.
7.1 The CHAS Funding discussion which was on the agenda for this meeting will be picked up on the agenda for the next meeting of the Group.
Action: Emily to arrange the CHAS Funding discussion for the next meeting with Kay Fowlie.
7.2 The group were informed that the Paediatric Epilepsy Surgery Service is being reviewed.
Action: Emily to ask Mary Sloan that when published the work of the Child Death Review Steering Group is shared with the CHCs.
7.3 A paper on the physical punishment of children by the Faculty of Public Health was brought to the attention of the Group.
The Chair thanked the Group and advised that the arrangements for the 2016 meeting would follow.
Action: Emily to send out dates for 2016
The next meeting will be Thursday 10th March 2016