North Bristol NHS Trust’s Community Child Health Services, part of Community Children’s Health Partnership (CCHP) services, have been rated as ‘Outstanding’ by the Care Quality Commission in its latest report.
CCHP was described by inspectors as an “example of outstanding service nationally” for its commitment to involving children, young people and their relatives in planning and making decisions about their care.
The service works in partnership with charity Barnardo’s and provides all community child health and child and adolescent mental health services for Bristol and South Gloucestershire.
It’s a model that’s unique nationally, says Dr Jane Schulte, the partnership’s director and a consultant community paediatrician.
“Most services that provide this type of care are delivered by different providers, for example social enterprises, mental health trusts or private providers,” says Jane, “but we are unusual in that we are partnered with a charity and overseen by an acute trust."
“There is almost no one else that provides the breadth of services that we do for 0 to 18 year olds. We have more than 850 staff and a huge number of teams spread across many sites and localities."
CCHP has multiple services and specialities, bringing together therapists, nurses, health link workers, paediatricians and psychiatrists, working closely with parents, carers, teachers and local authority staff to improve the wellbeing of children and adolescents. Central to its success, then, according to Jane, is CCHP’s ability to deliver a truly integrated approach.
“When you’re delivering a service of this scale, working with parents, carers, early years services, schools, and healthcare professionals, there has to be a joined up approach. We always work within teams and deliver the services around the child and what his or her individual needs are.”
One of its programmes described as an “example of outstanding practice” by the CQC is Be Safe, which provides holistic assessment and therapeutic intervention services for 8 to 12 year olds with problematic or harmful sexual behaviour. While the programme is currently undergoing research studies to prove its effectiveness, anecdotal evidence from parents is already indicating the programme is having a positive effective on their child.
Another unique project and “exemplar of good practice” is CCHP’s involvement in the Bristol BASE (Barnardo's Against Sexual Exploitation) Hub and Spokes Project. The project is a research-led approach to supporting sexually exploited young people across Bristol.
The model is clearly working. In 2013 it was recognised as a Centre of Excellence by the Department of Health for offering a one-stop shop integrated service with on-site mental health services and sexual health nurses for children and adolescents.
Jane adds: “Our ethos is to ensure children, young people and families are full partners in their care. We actively listen and involve them in the decisions we make. This approach means that not only is the care that’s provided by our skilled professionals having a positive impact, but, through participation, we are equipping them with important life skills in effective communication and relationship building, which are invaluable in improving their wellbeing.”
The service’s commitment to engaging with young people is perhaps best demonstrated in the development of its children and young people’s participation strategy 2014-2016. Through its HYPE – which stands for Helping Young People (and children and families) to Engage – service, young people were invited to form their own strategy group to take the lead on its development, which they then put together in conjunction with CCHP and Barnardo’s staff. It was a philosophy praised by the Care Quality Commission (CQC) for ensuring young people’s voices are heard.
Another initiative singled out for praise from the CQC is the inclusion of young people on interview panels. It’s another clear demonstration that their views are taken seriously, with young people demonstrating pride in having their say on such important matters.
“For every appointment that we can, we involve young people in the recruitment process,” says Jane. “That included my own appointment as partnership director some 18 months ago. Ultimately, they are the ones who are going to experience the service, so it’s only right that they should have an active participation in who is and isn’t employed by the partnership.”
But young people’s influence on the services doesn’t stop at recruitment and strategy. When CCHP’s community resource centre at Barton Hill opened in 2014, young people were involved in furbishing and decorating the settlement, and during this process they created a film for new staff members.
The service is commissioned using qualitative indicators and outcomes rather than numbers and target times alone. These include those from the Child Outcomes Research Consortium (CORC) for CAMHS services. A further indicator of success is a services ‘Young People Friendly’ status. The accreditation is derived from the Department of Health’s ‘You’re Welcome’ initiative, which sets out criteria to improve the quality of young person and adolescent care, with CCHP achieving the status for many of its services and working towards it for all.
The accreditation is given on evidence of quality outcomes, which Jane believes comes down to the service’s innovation and partnership with Barnardos.
“Our teams are constantly finding new and innovative ways we can increase children and young person’s participation in their care, and how this can improve their wellbeing. That’s what I’m most proud of about the service. We involve them at every stage.”
To find out how to get involved with HYPE, see the Barnardos website page.