children’s strategic clinical network - overview
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London Strategic Clinical Networks. Children’s Strategic Clinical Network - Overview. Tracy Parr SCN Lead Children and Maternity Children England December 10 th 2013. What is a Strategic Clinical Network (SCN)?. Area requiring large scale change Resistant to previous attempts to improve - PowerPoint PPT PresentationTRANSCRIPT
Children’s Strategic Clinical Network - Overview
Tracy ParrSCN Lead Children and MaternityChildren EnglandDecember 10th 2013
London Strategic Clinical Networks
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What is a Strategic Clinical Network (SCN)?
• Area requiring large scale change
• Resistant to previous attempts to improve
• Strategic approach
• Contrast with Operational Delivery Networks
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Clinical areas covered by SCNs
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London’s Children
• Population of London 7.8 million (ONS 2011)
• 2,049,576 children aged 0 – 19 in London
• Approx 1.7 million children in Kent Surrey
Sussex, and East of England many of whom
access specialised services in London
• 134,186 live births in London 2012 (ONS)
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Why a Children’s SCN?
UK has a higher all-cause childhood
mortality rate compared with Sweden,
France, Italy, Germany and Netherlands
London has higher than expected mortality for 1 – 19 year olds
6Data courtesy of London Health Programmes
Hospital mortality for children in London is rising compared to other areas of UK
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Nearly half of children are not reviewed by a consultant surgeon within 12 hrs of admission
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At weekends this worsens to less than 30% consultant review within 12 hours
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Over 50% of hospitals do not have a paediatric anaesthetist available
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Attendance at A & E by children is very high in London
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ACCIDENT & EMERGENCY attendances, ages 0-17, London 2010-11
Source: PHE ChiMat using HES Data
0 100 200 300 400 500 600
BarnetHavering
HarrowCity of London
Richmond upon ThamesRedbridge
Barking and DagenhamBexley
Waltham ForestBromley
Kingston upon ThamesCamden
HillingdonLONDON
SuttonLambeth
Kensington and ChelseaCroydon
Hammersmith and FulhamIslington
EalingNewham
SouthwarkTower Hamlets
MertonBrent
HounslowEnfield
LewishamGreenwich
Westminster, City ofHackneyHaringey
WandsworthEngland
Accident & Emergency attendances, rate per 100,000 population aged 0-17
Accident & Emergency attendances, rate per 100,000 population aged 0-17, England LAs, 2010-11
96.6 - 243.9
244.0 - 301.9
302.0 - 336.9
337.0 - 413.9
414.0 - 880.6
National quintilesrate per 100,000
0
100
200
300
400
500
600
700
800
900
London - lowest
London average
England average
London - highest
26 London boroughs have A and E attendance higher than the national average for children
Data courtesy of ChiMat
Some boroughs have high rates of admission to hospital for asthma
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ASTHMA Emergency hospital admissions, ages 0-18, London 2011/12
Source: DMIT using HES Data
0 50 100 150 200 250 300 350 400 450
WestminsterWandsworth
Richmond and TwickenhamHavering
EnfieldBarnet
KingstonGreenwich
Kensington and ChelseaHillingdon
Tower HamletsHounslow
BromleySutton and Merton
HaringeyBexley
CamdenHammersmith and Fulham
LONDONNewham
BrentCity and Hackney
SouthwarkHarrow
RedbridgeEaling
LewishamBarking and Dagenham
LambethIslingtonCroydon
Waltham ForestEngland
Emergency hospital admission rate per 100,000 population aged 0-18
Emergency hospital admission rate per 100,000 population aged 0-18, England PCTs, 2011/12
74.8 - 142.0
142.1 - 162.0
162.1 - 210.0
210.1 - 262.0
262.1 - 495.7
National quintilesrate per 100,000
0
50
100
150
200
250
300
350
400
450
500
London - lowest
London average
England average
London - highest
Solutions to the care of children
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“Children’s services should be seen as a whole system, designed within a framework of pathways and networks which enable the right things to be done, at the right timeand place, using teams that work together within a managed network.”
RCPCH 2013
Issues across healthcare systems
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“It is clear that in relation to service failure, problems often occur at the borders between one organisation orteam and another”
Learning from InvestigationsHealthcare Commission February 2008
Initial work
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• Implement networks of care across all children's providers
• Identify standards of care within the networks building on existing standards:• Service specifications for specialised services• All existing standards for children in-hospital care (eg
RCPCH, London Health Programmes, RCA, RCS)• General practice outcome standards
PATH
WAY
S
London Strategic Clinical NetworksDecember 2013
Children’s Strategic Clinical NetworkChildren’s Commissioning Group
Strategic Clinical Leadership GroupPatients and public
SCN Oversight Group
GovernanceClinical Senate
Assurance
Children’s Network Children’s Network
Children’s Network Children’s NetworkSTA
ND
AR
DSSTA
ND
AR
DS
Primary care
Tertiary care
Secondary care
Cardiology Pathway GroupChair: Owen MillerSCN Lead: Andy Martin
Neuroscience Pathway GroupChair: TBCSCN Lead: Andy Martin
Diabetes Pathway GroupChair: Peter Hindmarsh/Martha Ford-AdamsSCN Lead: Sara Nelson
Nephrology Pathway GroupChair: Lesley ReesSCN Lead: Sara Nelson
Surgery Pathway GroupChair: Simon EcclesSCN Lead: Suzanne Sweeney
Critical Care Pathway GroupChair: Duncan MaCraeSCN Lead: Andy Martin
Oncology Pathway GroupChair: Julia Chisholm/Darren HargraveSCN Lead: Caroline Moren
Asthma Pathway GroupChair: John MoreiraSCN Lead: Sara Nelson
Gastrointestinal Pathway GroupChair: Ian SandersonSCN Lead: Suzanne Sweeney
Neonates Pathway GroupChair: Sandy CalvertSCN Lead: Suzanne Sweeney
Patient and Public Involvement (PPI)SCN Lead: Andy Martin
Mental HealthSCN Lead: Andy Martin
Health in the Justice SystemSCN Lead: Sara Nelson
CommissioningSCN Lead: Sara Nelson
Immunisation, Healthy Child and SafeguardingSCN Lead: Suzanne Sweeney
Data and InformationSCN Lead: Andy Martin
Programme ManagementSCN Lead: Andy Martin
Information TechnologySCN Lead: Sara Nelson
Education & Workforce SCN Lead: Sara Nelson
CommunicationsSCN Lead: Suzanne Sweeney
Community care
Collaborating with:► Academic Health Science Networks► Clinical Commissioning Groups (CCGs)
► Health and Wellbeing Board► Local Education and Training Boards
►Public Health England► Regulatory bodies
► Royal Colleges► Voluntary sector
PATHW
AYSEN
ABLERS ENAB
LERS
Linking with other organisations
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Networks• Establishment of a Regional CYP&F voluntary and community sector network
• Regional networks and resources on engaging with health & schools
• Supporting local networks and effective representation• Briefings on effective engagement and representation
Patient and Public Involvement in SCN
• Critical part of our work
• Challenges
• Options
• Discussion
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