Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable.

Community Children’s Health Partnership

Care Pathways and Patient Stories

Matthew EllisCommunity Paediatrics Clinical Lead

Emily Roberts Children’s Services Manager Barnardo’s

Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable.

Community Children’s Health Partnership

Community Children’s

Health Partnership

A legal partnership between North Bristol NHS Trust and Barnardo’s

A service that is core value driven An integration of community child health and CAMHS

services into a single provider-employer Trust Reduction of variance to reduce inequality of access Clinical care pathway driven Performance monitored via an Outcomes Framework

Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable.

Community Children’s Health Partnership

Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable.

Community Children’s Health Partnership

Pathway Group (clinical effectiveness committee)

Key Stakeholders; GP rep, health visitor, school nurse, Therapist, community paediatrician, mental health team, CYPS

Identify two pathway champions

They lead pathway design process in consultation with key stakeholders

Bring the draft to the Group

Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable.

Community Children’s Health Partnership

Pathway Checklist

Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable.

Community Children’s Health Partnership

Care Pathways Impaired attention in the school age child Developmental Delay in the preschool child Impaired social communication Motor Coordination Difficulties in school age Urinary Continence Vision Problems Motor Disorders including Cerebral palsy Learning Difficulties Substance misuse in young people Emotional and Behavioural difficulties in children Complex mental health 5-12 year old pathway Eating Disorders in young people

Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable.

Community Children’s Health Partnership

Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable.

Community Children’s Health Partnership

Patient stories‘How do you want a patient friendly

version of the pathway?’

Semi structured interviews1. Before meeting with the service What was life like for you before you came into contact with the

service?2. First meeting with the service What happened the first time you met with the service?3. Further meetings with the service (within 18 weeks of referral from

community staff) What happened during the time that you met with the service?4. Ending with the service What happened when your meetings with the service ended?

Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable.

Community Children’s Health Partnership

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Consulted and

informed

Child-initiated and directed

Increasing degree of participation

Non-participation

Ladder of Participation

Service User feedback used to inform and plan future services

Adding own criteria to a job description and involved in short listing process

People are present for a photo shoot but have little idea of what it is all about

Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable.

Community Children’s Health Partnership

Journeys

• NICE V Service User Experience

• Identifying your subjects in house and through other settings – stakeholders?

• Focus groups

• Questionnaires

• Face to face interviews

Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable.

Community Children’s Health Partnership

Findings – Eating Disorder Care Pathway

“On my fourth visit to the GP he said‘you have anorexia’and I was really knocked back by itI went home and hidin my room for ages” Young Person

I got the impression that they just wanted to shove a drug down her and feed her up without involving her and helping her with her mental health…you know they just feed them up and then they go down and that isn’t a solution” Parent

Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable.

Community Children’s Health Partnership

Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable.

Community Children’s Health Partnership

Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable.

Community Children’s Health Partnership

Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable.

Community Children’s Health Partnership

Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable.

Community Children’s Health Partnership

Barriers

Only the patient experiences the whole pathway

Initial buy in (80:20 rule)

Management involvement

Professional boundaries

Trust website/patient information branding

Our Core Values: ● We will be child-centred ● We will embed service user participation at every level of service provision ● We will be outcome focussed and innovative ● We will make sure our services are accessible and equitable.

Community Children’s Health Partnership

Implications for Practice

Participation is a potential vehicle for system wide change

Patient experience is helpful to inform ‘pathway’ design

Getting the voices of the YOUNG and PARENTS heard can be difficult

In the campaign to achieve service change genuine patient voices can provide leverage