Developing a community child health service for the 21st century
A report on a review of the community child health service in Scotland.
Annexe 9
DRAFT SERVICE SPECIFICATION (Reference Dr Fawzia Rahman)
Service |
Community Child Health and General Paediatrics in the Community |
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Commissioner Lead |
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Provider Lead |
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Period |
1. Purpose |
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1.1 Aims
1.2 Evidence Base Policy Guidance
Activity The following data should be collected as standard
Service Benefits
1.3 General Overview The Service will provide appropriate paediatric assessment, diagnosis and management of children and young people within the Service boundary according to agreed guidelines in collaboration with other members of the Team around the Child including:
1.4 Objectives
1.5 Expected Outcomes
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2. Scope |
2.1 Service Description The Service will provide:
2.2 Accessibility/Acceptability The Service will make provision to address any issues that are within its power to resolve to ensure that it is accessible to all families, children and young people for appropriate targeted support. Service will be provided according to agreed priorities
The service will work to its agreed waiting time standards (18 week RTT) where applicable. 2.3 Co-dependencies Stakeholders and co-dependencies will include:
2.4 Relevant Networks The service is expected to be involved in a wide range of multidisciplinary and multiagency networks based around its key network planning groups and professional leadership areas.
2.5. Training, Continuing Professional Development, Research and Audit In order to promote and maintain high professional standards and ensure RCPCH specialist competencies, the service will undertake a range of training and development activities including:
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3. Service Delivery |
3.1 Service Model The Service will be delivered generically by consultant-led locality teams of paediatricians working in the community. Specialist consultant clinical leadership will be provided for each of the network planning areas identified with a focus on equity of provision and access across Scotland, allowing for different workforce models to suit prevailing need both in terms of population requirements and geographical issues of, for example, remoteness. The service will specifically target vulnerable and disadvantaged children and those with complex health needs and will work closely with public health colleagues and managers to plan appropriate services. A lead consultant will take a lead role for ensuring that overall professional standards are set and maintained, that a cost effective in-service training programme is provided and that the service collects robust and effective activity information. There will be adequate support from the IT, administration and clerical services to meet Royal College guidelines and to support and assist the specialist functions described above. 3.2 Care Pathways Pathways may have been specified by SIGN or NICE or have been accepted by local consensus or have been drawn up by MCNs. Clinical care pathways that are likely to be followed in this Service include
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4. Referral, Access and Acceptance Criteria |
4.1 Geographic coverage/boundaries The Service will be available to all families, children and young people who are registered within the health Board area or sub-division of this area. 4.2 Location(s) of Service Delivery The Service is locality and community focussed and therefore should be delivered from appropriate locations and within suitable settings that will ensure an effective service to assess children and young people and their families. 4.3 Days/Hours of operation The Service will operate flexibly within normal working hours (as defined in national medical contracts ) for the majority of its services. Rapid response services will be provided outside normal working hours for child protection medical advice and urgent assessment of children who may have been abused or neglected, and will be covered by an on-call consultant service for agreed hours as part of the overall out of hours service for children and young people on a safe and sustainable basis . 4.4 Referral inclusion criteria and sources The service will see all children from birth up to their sixteenth birthday (or while still at school). For children in certain categories (those in special schools or involved in child protection processes) care will be provided until their eighteenth birthday. The General and Community Paediatric Service will prioritise referrals as follows: Statutory / dictated by Procedures (eg child protection procedures)
High Priority
Medium Priority
4.5 Referral route Referrals will be through a number of avenues including:
4.6 Response time & detail and prioritisation The Service will meet the following response times:
4.7 Equity Issues ( EIRA) It is the responsibility of the Provider to actively meet the requirements of the Equality Duties (Race, Disability and Gender). These include:
Equality Impact Risk Assessment ( EIRA) must be undertaken and documented as part of any service review process or if any change is made to the provision of the service which could impact on those in receipt of the service. All staff employed by this Service will recognise and respect the religious, cultural and social backgrounds of service users in accordance with legislation and local and national good practice. The Service will ensure that it has access to appropriate translation services/resources to enable equity of access and understanding. |
5. Discharge Criteria & Planning |
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6. Self-Care and Patient and Carer Information |
The service will support parents/carers in developing their capacity to reduce the health consequences of long term vulnerability in their children. This will include the appropriate provision of written materials and signposting to other support services. |
Quality Performance Indicator |
Threshold |
Method of measurement |
Consequence of breach |
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Infection Control |
100% Meets the required standards within NICE guidance |
% of staff trained at appropriate level No. of recorded incidents Infection Prevention & Control audit |
Improvement Plan required |
Service User Experience |
At least 50% return for surveys issued All dealt with under Provider complaints procedure |
User Survey Self reported User Experience Compliments No. of complaints received and resolved |
Alternative ways of obtaining service user experience Exception Report |
Improving Service Users & Carers Experience |
All actions to be met by deadline |
User/Carer Survey report highlighting areas for improvement and where experience has improved Time scaled Action Plan to address areas for improvement |
Exception Report |
Reducing Inequalities |
Baseline to be identified |
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Reducing Barriers |
Baseline to be identified |
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Improving Productivity |
Baseline to be identified |
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Access |
90% |
% of first appointments made within 12 weeks of referral receipt Profile of caseload - no. of:
By Locality Area (do not count any child twice but illustrate any multiples if a child can be categorized into two or more of the above) |
Exception Report |
Care Management |
Baseline to be identified |
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Indicators to evidence Outcomes |
Baseline to be identified |
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Activity Performance Indicators |
Threshold |
Method of measurement |
Consequence of breach |
Referrals |
Baseline to be identified |
No of referrals received for following groups of children:
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Initial Assessments |
Baseline to be identified |
(for above groups of children)
For each of the elements under 4.4 (Referral criteria & resources) above for Statutory, High and Medium Priority levels |
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Follow up appointments |
Baseline to be identified |
(for above groups of children)
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Children/young people discharged from/left service |
No. of children/young people who were discharged/left the Service (by reason/by area) |
Contact
- Mary Sloan mary.sloan@gov.scot
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