Integrated Systems, conception to five

eif.org.uk

The Early Intervention Foundation

@TheEIFoundation

Integrated Systems for EI -conception to five• What makes an effective integrated system?

• OBR review, effective systems• Initial review on programmes• Outcomes • Data collected by completion of template, follow up calls, three deep

dives

• 18 Places identified this as a priority • 14 returned completed templates/accepted offer of a phone interview

Account-ability

Commissioning planning Delivery Support

Systems Workforce UserProgrammes

Integrated Models

Range of models• Children Centre based, a number are reviewing commissioning of CC • Locality teams• Virtual/co-located Workforce / Management Structures • VCS, EI, family support, HV,MH support, Job centre plus in CC• Most of HV now based in community, Worcestershire currently based in GPs

surgeries • Swindon - Single management structure, HV, FNP, SALT, SN, education welfare, Ed

Psych, TAMHS, families first. Locality teams

Delivery

Identification & Assessment • All Places had the basis of a CAF process to assesses need across partner agencies• Birth data• Essex, Herts, Solihull - 2 year entitlement • Essex – developed CAF to Family Facilitated Meeting • Hertfordshire – Team Matters Meeting to discuss CAFs • Westminster review families of concern at a monthly meeting between health and CC,

including 2 year development review • 2 Places referred to the quality assessment of CAF process

Access to Interventions • TAF approach to integrated interventions• Single point of access• Essex - Early Help Hub

Support Systems

Current position• Integrated information IT sharing systems very limited• 9 Places had local information sharing agreements and processes in place to share live

birth data• Individual info shared through CAF process was more common

Examples of promising practice• Herts - use of NHS number by CCs for 2,3, and 4yr olds free place • Swindon - access to IT systems • Dorset - locally developed eCAF • Islington - additional info shared with CC on housing and benefits

Lessons learnt – What Places have told us

Communication Culture

Leadership Time

Data sharing is

crucial “Hearts and Minds” careful consistent

communication across teams

Build professional trust, team

building, acknowledge

expertise

persistently revisit and define basic principles of integration e.g. shared outcomes, governance,

tools, protocols and user pathways.

Common vision and outcomes

Effective partnership

Leadership, commissioning,

operational

Manage independencies

when with whole system change

Cultural change

takes time

Barriers

• Data sharing • Present accountability and governance arrangements predominantly drive organisations and

reduces focus on integration• Capacity of workforce • limited joint training opportunities• Capacity for development and evaluation • Fragmentation of commissioning, Range of employers • Financial remodelling required• ICT • Difficulties arising from co-location in some areas such as H&S issues for infection control • Lack of GP involvement in 0-5 integration• During health transition 2012 a number of previous agreements lost, info sharing,

commissioning and some co-location