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Abstract
Context There is an obligation on the local authority and its health partners to ensure these statutory health assessments take place in accordance with the timescales set. The looked after children’s health team delivers this responsibility on behalf the local authority. A significant portion live outside the borough boundaries. The multidisciplinary team comprises specialist nurses, community paediatricians and administrative team.
Issue Timely and thorough health assessments are vehicles for identifying and acting upon previously unmet health needs in this vulnerable population.
Assessment of issue and analysis of its causes:- The Change Management Framework
The ADKAR ® model of change was utilised. The team were aware of the need for change.The trust executive and management had a desire to support and participate in the change. We utilised the knowledge of the core team and additional expertise. We have also established a system of reinforcement to sustain the change.
The strategy To deliver on the changes needed a clear leadership strategy was in place.
It was purpose driven
Previous inspection reports, user feedback and performance indicators were used
Clear and constant two–way communication was employed
weekly performance huddles, and
Investment in people and infrastructure occurred
job plans developed, and increased training and development opportunities given
We demonstrated persistence to see the changes through
Improvements were shared on the ground at team meetings, at directorate level; and at Trust executive level. The changes were shared with the Service Improvement Board, the CCG Safeguarding executive and the local authority.
Measurement of improvement and impact:
In March 2018 100% of children accessing initial assessments were seen within 20 working days from referral; the graph (figure 1) shows the overall trend of improvement
There is now knowledge of where all LAC are in the pathway, including those that are being seen out of borough and those that are in secure accommodation
Improvement in staff morale measured by a fully established team, reduction in staff turnover rate and sickness levels.
Impact The next steps are:
Sustaining cultural and process changes in both the clinical and administrative team
Continue to work with social care to improve the referral process
Ensuring systematic oversight of the completion of health recommendations arising from assessment.
