Case Studies

Helping the NHS commission better services for children and families

Added 20/12/2013


Early intervention and prevention to improve outcomes and development in children aged up to five was identified as a key priority for the NHS in the east of England following the launch of the healthy child programme. It became clear that commissioning effective and high quality services would play a key role in driving this improvement.
At the same time, the NHS was going through a major reorganisation, with responsibility for commissioning many services for the 0 to five age group transferring to new clinical commissioning groups.
Sustain was jointly commissioned by the NHS and local authorities to drive an important six-month project to develop an integrated commissioning and delivery toolkit for the healthy child programme 0 – 5. Its aim was to provide a methodology to address integrated commissioning while encouraging joint working across local government and the NHS to improve child and maternal health outcomes.

Key challenges
To realise our vision of developing an innovative and complete integrated commissioning and delivery toolkit, we seized the opportunity to work with clinical staff and commissioners to identify the best practice pathways and specific clinical outcomes necessary to measure the impact of both health and social care services. Whilst it was essential to place professionals at the heart of this process, it was equally important for the commissioners to clearly identify their priority areas.
Input from clinicians and the higher education institutions would also be vital in developing a workforce development model to support the delivery of the integrated pathways of care to children and their families. As a result, strong working relationships between all groups and a robust engagement plan would be crucial to the success of the project.

Main actions

It quickly became apparent that there was great enthusiasm for the project within both the NHS and local authorities across the east of England. More than 125 individuals expressed an interest in joining the project, representing all of the key professions and clinical services within providers as well as the commissioning organisations. Keen to capitalise on this, Sustain encouraged all groups to work constructively together to meet the challenging timelines set out in the initial brief.
We quickly established five workstreams, each with a clear focus on a particular area of need. All aspects of the project would be tested and developed within these workstreams before further work was carried out to ensure a shared understanding of exactly what would be required to deliver the objectives.
With our partners, we developed seventeen integrated best practice pathways and appropriate evidence-based clinical interventions. In addition, a workforce development model was created, along with a range of guidance for both commissioners and providers.
Sustain also developed a comprehensive suite of healthy child programme-specific outcome measures and key performance indicators to help local systems jointly identify key areas for development and provide more integrated performance management.

Outcomes and achievements
Through close and effective partnership working, Sustain created an integrated commissioning and delivery toolkit to support both commissioners and providers alike, along with a range of recommendations for its further refinement in the short, medium and long term. The project was delivered on time and on budget.
A report giving details of the toolkit and feedback on the project’s outcomes was presented to local health and wellbeing boards, where it was welcomed as an effective tool for assisting in the development of integrated commissioning and delivery.

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