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NHS leaders call on ministers to lead joining up of children's services

The NHS Confederation is calling on the children's and child health ministers to bring together decision-makers and leaders from children’s health services, education, social care, justice and wellbeing to agree a plan for joining up services in practice.

The organisation is urging children’s minister, Edward Timpson and child health minister, Dr Dan Poulter, to assemble all those in a position to make real and necessary improvements to their services for a face-to-face frank discussion about how they can improve joint working, and ensure children do not fall into gaps between departments and agencies.

Transformative action

The demand for action comes as the NHS Confederation publishes a report on behalf of seven leading health bodies. Children and young people’s health and wellbeing in changing times distils the learning from four events attended by 380 child health specialists into recommendations which will protect and improve children’s health services while the NHS undergoes significant reform.

The report’s main recommendation is that the Government must take transformative action to address the lack of policy coordination between different government departments and national bodies. This will smooth the path for joint working in local, regional and specialist services, now that child health services are commissioned by eight different bodies in the new system.

Dropping off the radar

This is an increase on the seven bodies which the NHS Confederation previously warned pose a high risk of service fragmentation. Transition points, such as moving from child to adult services or primary to secondary care, can risk service users ‘dropping off the radar’ of support agencies. Recent research in Walsall showed that 52 per cent of young people with type 1 diabetes were being lost from adult services following their transition.

The report includes examples of good practice which address service fragmentation:

  • In Southend-on-Sea, an asthma service for under-19s, which sees children in their own school or home, reduced A&E attendance by 15 per cent and hospital admissions by seven per cent in its first year of operation.
  • In Oxford, kidney transplants previously failed in 67 per cent of recipients following their transition to adult care. A programme developed in conjunction with young people reduced the transplant losses to zero.
  • In south Gloucestershire, a paediatric GP with special interest (GPwSI) service provides an email support and advice service for GPs, supporting management of more cases within primary care, providing more care closer to home and strengthening integration between services. The new service saved the PCT approximately £350,000 in one year.

Clearer guidance

The report also calls for the Department of Education and the NHS Commissioning Board to issue clearer statutory guidance on safeguarding of vulnerable children. This is so there is no ambiguity or lack of understanding about organisations’ or individuals’ responsibilities to protect the most vulnerable children from harm.

Improving connections between services

NHS Confederation interim director of policy Jo Webber said: “We have seen the worst consequences of what can happen when children and young people’s services fail to join up around the individual. Without clear action to improve the connections between services, we simply won’t be doing enough to keep our children and young people as safe and healthy as they deserve to be.

“For some time now, we’ve talked about the need to improve the seamlessness between children and young people’s care. By getting all the parties together, the government ministers in charge of children’s health and services can demonstrate just how high a priority this collaborative approach is for them.”

Find out more

Download the full report and key recommendations.

Find out more about the series of child health events and view our short films.

Find out more about our work on children's health.

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