Hilary Ellam - DH Care Networks

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					Children’s Trusts –
integrating children’s

Hilary Ellam and Andrew Turnbull
Regional Children’s Trust Coordinators
DfES /DH Joint Children’s Trusts Team
    Presentation aims

•   To give an over view of children’s trusts

•   To look at the interface between children’s and adult

•   To begin to look at the possible implications of the
    white paper for children’s trusts
What is the thinking behind children’s
                    Series of high profile cases /

                    Multiple funding streams

                    Multiple assessments

                    Multiple gatekeepers

                    Multiple planning streams

                    Multiple initiatives
    For example:

       £3           £300        £?        £100      £350    £300         £500         £1          £150
     billion       million    million    million   million million      million     billion      million
                                                                                  LEA special
     Social                                         Youth               Connex                  Children’s
                    YOT         PCT       EWS                CAHMS                educational
    Services                                       Service               -ions                    Fund

                    Youth                  Ed                 Child     Connex     SENCO &
     Social                    Health             Youth
                  offending              welfare             psycho-     -ions    Ed Psycho-
     Worker                    visitor           workers
                    team                 officer              logist       PA       logist

Children    At risk           Risks to                       Conduct              Statement
                    ASSET                                                APIR
in need    register           parents                        disorder               of SEN

                                                                                                = agency
                                                                                                = worker
                                                                                                = assessment
For a child with complex needs it meant
this…       Hospital
           Social Work Paediatric
       Social         Dept      Dept        Radiotherapy
                                               Dept          Surgical
       Worker                                                 Dept

  Social                                                                  Specialist
 Services                                                                  Centre
Home Help

 Social                                                                      District
 Service                                                                     Nurses
 Respite                         Family
  DSS                                                                        School
 Benefits                                                                    Health
  Office                                                                     Service

   LEA                                                                        FPC

 Child’s                                                                     GP
                                Voluntary        Voluntary   Voluntary/
            Family    Hospice    Project        Home Help     Support
            Minster             Funding          Schemes      Groups
35 Pathfinders

July 03 – March 06

£60,000, option to bid for
addition £40,000

Chosen because all
sizes & models
With budgets of £48,000 -

Common theme was the
integration children’s
Children’s Trusts

      for children &
      young people
                   School cluster

      Multi agency Teams

      CAF Sharing information
         Service directory

   Children & Young People Plan
Joint Commissioning- pooled budgets

          Children’s Trust Board
                                                    What could this look like on the ground?

      Director Children’s Service
         The wider strategic perspective of
         Integrated Children’s Services
                                           Inter-Agency Governance

                                                 Integrated Strategy

                                                                                    LEA special
 Universal   Sure                                              Social                               Extended       All Other
                       CAMHS            YOT      Connexions               EWS       educational
Healthcare   Start                                            Services                               Schools       Agencies

             Early                     Youth                              Educ.       SENCO &
Healthcare              Child                    Connexions    Social                               Education      All Other
             Years                   Offending                           Welfare     Educational
  Staff              Psychologist                    PA       workers                                 Staff      Practitioners
             Team                      Team                              Officers   psychologists

                                       Integrated Processes and Tools
   Information Sharing Skills,         Framework (CAF)            Information           Children Missing         Service
    Knowledge and Practice           Common Assessment           Sharing Index             Education            Directory

                                    Lead Professional
                                                                                          Outcomes for
     Front-Line                       Multi-Agency
                                                                                        children & young
     Service                                                                                 people
     Delivery                           services
What does it mean for young people
moving to adult services?
Which young people? Those with:
• Complex Needs
• Mental health issues (Learning Disabilities / Autism)
• Looked After Children
What is happening on the ground?
• Identification of who they are, leading to earlier
  preparation – person centred planning….direct
  payments…improved assessments / knowledge of
  professionals involved linked to CAF / key
  workers….emergence of transition staff / teams as in
  Bolton / with CAMHs South Tyneside… re shaping of
  existing services eg partnerships with housing
    What is government doing to support this
Children Act 2004
• Appointment of a Director of Children’s Services and a
  Lead Member for Children
• Duty to cooperate

•   Single Children and Young People’s Plan – April 06
•   Local Area Agreements – LPSA Targets
•   Outcome focused – framework based around ECM five
•   Inspection process – Joint Area Reviews / Annual
    Performance Assessment
Questions raised by the pathfinders re
pending changes in the health sector.
Practice based commissioning

• How will the needs of high cost low volume complex need
    children be commissioned in the future?
•   Possible uncoordinated approach to service development
•   Possibility of the Children’s agenda being lost – not a priority
•   Possible threat to existing pooled budget arrangements
•   Concern that GP’s will want to commission their own
    community nursing services, including Health Visitors,
    possibly school nurses – threat to staff located in Children’s
•   There is the possibility of developing new ways of working,
    which embrace children’s trust model.
•   The identification of resources/costs for children - money will
    follow the child, may make sharing resources easier in future.
  Questions raised by the pathfinders re
  pending changes in the health sector. 2
Merger of PCTs
• How will they manage financial deficits / existing sec.
  31s ?
• What is the risk of potential asset stripping?
• That established relations / understanding, may be
  under threat.
• Progress may come to a halt until decisions made.
• Staffing concerns especially those seconded.
• Some PCT’s will become coterminous with their LA.
• Possible increased capacity -clarity of roles
   Questions raised by the pathfinders re
   pending changes in the health sector. 3

The possible wider issues:

• The LAA: health LPSA targets are around obesity and teenage
  pregnancy – could this possibly re focus the health agenda?

• How will they meet the individual area JAR requirements?

• What will be the future role of the Strategic Health Authority?
If we don’t join up potentially…………..

    bubble      Children’s
                Trusts         GP
  To think about?
• Integrating children’s services is a complex agenda, in
  a changing health community, will their be sufficient
  people in the new arrangements with the knowledge to
  keep it a priority? Make it happen?

• Is there anything we can learn from adult services?
  Given that children’s services are commonly seen as
  at least a tripartite arrangement?

• How do we ensure we are prepared?
         Thank you

      For further information:


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