AHPs as agents of change in health and social care - The National Delivery Plan for the Allied Health Professions in Scotland, 2012 - 2015

4. Supporting early years

"It is particularly important to consider the need for effective AHP leadership within children and young people's services to drive forward the changes needed to ensure an equitable and sustainable service model in a planned and coordinated way across all sectors."
Dagmar Kerr, Area Coordinator for Greater Glasgow & Clyde,
Action for Sick Children, Scotland

AHPs have a significant responsibility in relation to services for children and ensuring that children have the best possible start in life. AHPs within children and young people's services focus upon maximising a child's potential, which is embedded in the Getting it Right for Every Child principles and the Early Years Framework. The AHP approach must therefore be comprehensive and holistic to facilitate social and health outcomes: essential to this is working in partnership with parents, families, education partners and other health care professionals and ensuring early and consistent access to AHPs within multidisciplinary teams.

The objective of the Early Years Change Programme is to accelerate the conversion of the high-level principles set out in the Early Years Framework into practical action. The expectation is that all partners will:

• consider how they can support universal services to deliver better outcomes for children in their early years and their families
• raise public awareness of the significance of the early years to children's healthy development and consider how they can build the capacity of families and communities to secure better outcomes for themselves
• deliver tangible improvement in outcomes and reduce inequalities for Scotland's vulnerable children
• put Scotland squarely on course to shifting the balance of public services towards early intervention and prevention
• sustain these changes.

AHPs have a vital role in the delivery of this agenda, facilitated by the moves to early intervention, anticipatory care, prevention and health promotion. Their inputs deliver not only positive benefits for children and families, but also realise economic gains. However, visible and effective professional leadership is essential to ensuring that AHPs remain empowered to deliver child- and family-centred approaches across all settings.

Achieving the services required for children and young people will require transformational change within many health boards. The need to assure children and young people's equity of access to AHPs is imperative and the work in establishing core services needs to be built upon. In particular, it will be essential to reduce the unnecessary variation in waiting times for AHP treatment between children and adult services and bring the former in line with the national guidelines on New Ways of Defining and Measuring Waiting Times (NHS National Services Scotland, 2007). Significant transferable learning should be drawn from work undertaken in child and adolescent mental health teams on the delivery of national waiting times over the last two years. Considerable local support and leadership will be imperative to ensure equity and consistency in improving access for children's services.

An integrated system of self referral will be of significant benefit to children and families and it is imperative that robust and equitable triage and demand management systems are also established to ensure that children can access the right services at the right time and from the right practitioner.

Strong leadership is needed to support this and the shift away from a predominantly "specialist" approach, following referral by another health care or education colleague. The appointment of an AHP lead for children and young people's services in several NHS boards has already made an impact on the implementation of Getting it Right for Every Child, integrated working and service planning. This inclusive model should be adopted by all NHS boards to support the sustainable development of AHP children and young people's services across all allied health professions.

In particular, consideration should be given to how to support children with communication difficulties to access the curriculum and to achieve their full potential through partnership approaches and creative working across agencies, including justice. The ability to communicate and connect with people is a vitally important life skill and is key in supporting educational attainment. Children's social and personal development and emotional and behavioural control can significantly impact on their quality of life, life experience and life chances.

Many young people who encounter the justice system as a result of offending behaviour have existing speech, language and communication difficulties; it is clear that there can be a connection between such difficulties in early years and the social and behavioural impact in later life. This important work should be reflected in the AHP children and young people's service plan set out in Action 4.1. The implementation of the Augmentative and Alternative Communications (AAC) (Scottish Government, 2012b) programme in partnership with local stakeholders should also be supported by professional leaders in speech and language therapy.

ACTION