CYPIC case study: NHS Tayside

Improving Allied Health Professional Services for Families in Tayside

Source: Christina Kiddie, Child Health Physiotherapy Service Manager, NHS Tayside, August 2017

The Allied Health Professional (AHP) service in NHS Tayside sought feedback from families about the service they received. Families said they attended multiple appointments with multiple therapists and reported feeling overwhelmed and being asked too much from each individual therapist.

They also thought that expectations between them and the therapists were not always clear and that AHPs did not always listen and respect their views in terms of priorities for their child. This led families to feel lacking in confidence to self-manage the needs of their child.

To make services better and more helpful to families, Angus Children and Young People Improvement Collaborative supported AHPs to use quality improvement to test and measure a range of ways to make services easier for families to navigate. One of the ways to improve the service was to establish joint goal setting and review sessions for families when more than one AHP services was required.

The team used improvement methodology to test new ways of working to support joint sessions and also blur the roles between AHP services when giving advice and information to families.

This new way of working has ensured that in Tayside, 84 per cent of children and families seen between March 2015 and January 2016 experienced joint goal setting sessions within eight weeks. Recent feedback from families demonstrates that the service has improved which in turn, is helping to build their confidence and support their children. Parents said: "I'm always included", "Definite improvement recently", "She makes sure I understand what to do so I feel more confident" and "All work well for me, listen to me and do the best for my child".

AHPs now report an increase in confidence when delivering universal AHP advice and information whereas previously they had been working independently within their own specialism. The next steps are to spread this improved approach across NHS Tayside.

Christina Kiddie, Child Health Physiotherapy Service Manager, NHS Tayside said:

"We knew we weren't getting it right for the families and being able to identify what the problems were at the start allowed us to focus on the things we needed to change. Using QI helped us to achieve our aim more quickly.

"It gave us a structure and processes to test out the changes we wanted to make. The support from the Angus CYPIC and the Improvement Academy at NHS Tayside was invaluable. This enabled us to gain knowledge and understanding of QI as part of our daily work.

"By testing small, within one locality, we were able to ensure that the improvements we made would deliver the best outcomes for families, before we spread and embedded them across Tayside."