A blog on a transformational journey across AHP CYP Services by Pauline Beirne National Lead AHP CYP Scottish Government.
As we have come to the end of the fabulous Year of Young People (#YOYP2018) it feels like a good time to reflect on the journey of change for AHPs in Children and Young People (CYP) services and the impact this has had for CYP
This blog is about what we have learned in trying to change the culture of practice in Scotland with the needs of our children and young people at the heart of everything and emphasis on what it takes to try to truly transform services.
The CYP AILP Programme has been a journey over the past 3 years since the launch of Ready to Act which set the direction of travel for Allied Health Professions working in CYP services.
And …… it is a journey, to a place that doesn’t exist yet but that requires commitment, compassion, motivation and courage to transform the way we think about every request for help, every decision about how best to meet CYP needs and the needs of those closest to them and every conversation with others asking for help.
True transformation has required a willingness to innovate and be radical in our thinking about how best to deliver services, with the resources we have and having a real understanding of what it means to deliver early intervention and prevention and to genuinely collaborate. It has required us to rethink what a ‘good service’ really is and from whose perspective!
We needed to create mutually beneficial partnerships within and between organisations, with single shared wellbeing outcomes as the focus, building effective relationships with colleagues and partners in meeting the needs of our CYP, and critically, having CYP voices at the heart of our work.
Where services collaborate and innovate in joined up ways to achieve shared outcomes, there is emerging evidence that change can be achieved (Northern Alliance Report 2018).
At the centre of effective collaboration is the need for strong compassionate leadership and relationships between individuals in teams and across agencies.
Where shared child centred decision making is practised across teams, young people can experience improved access to knowledge and support and to services where their story is heard once and acted upon and where resources can be used most effectively at the best place to meet need.
This requires a willingness to blur the boundaries between roles, consult with each other about how young people are impacted, respect each other’s contribution and ensure that those closest to young people are enabled to use practitioner knowledge as and when needed to maximum benefit and to jointly support young people in setting outcomes that impact on the their own lived experience.
This needs leaders and practitioners across and between agencies, to come together in making opportunities to build joint working strategies, develop and share skills and knowledge, and critically ensure that expertise is available as far upstream as possible to meet the needs of young people and those closest to them as and when needed. This is true early intervention and it is not just a nice to have it is a must do if we are to meet the needs of our CYP in Scotland. This is what it takes to deliver a culture shift and a whole systems approach to change.
One of the most important changes the CYP AHP work-stream has made, has been at the point of access to services. We have worked with NHS Education for Scotland (NES) to introduce effective decision making training at the point of referral. This has resulted in a move away from a problem based to an impact focus when requests for help are made, with initial conversations with CYP their parents and carers and others asking for help from AHP services, resulting in different actions and positive destinations, including reassurance, signposting to community support, education and training and working with the wider workforce. We have evidence that this has impacted not only on waiting times to access support but on reduced anxiety and increased reassurance for CYP and their families and carers.
Silo thinking and planning will not ensure that the well -being needs of young people are met. A traditional model of single service change and delivery will not achieve the outcomes that young people need to interrupt the intergenerational cycle of poverty and deprivation.
We need to be prepared to collaborate in innovative ways, and to recognise the critical place of relationships to effect change, to establish the co-operative development of interventions across targeted and specialist levels , responsive to both the needs of the environments young people live in and those of the individual young people themselves.
We need to come together to innovate and create new ways of working in a collaborative model of provision that will necessitate shared planning, improvement projects and shared funding.
Co-operative strategic support for collaborative working across education, health, community planning partnerships ,social care and the third sector is required to develop joint learning initiatives and improvement pilots.
We are required to collaborate to come alongside young people in their communities and facilitate them to do things differently by providing the resources, expertise support consistency and encouragement to effect real change (Elizabeth Gregory 2018) . None of the change that we have tried to effect in CYP AHP services would be possible without the passion for delivering to the needs of CYP exhibited by the AHP CYP workforce in Scotland .We are on a journey and there is much still to do. In 2018 we have worked closely with colleagues across and between agencies to close the attainment gap, interrupt the intergenerational cycle and change the lens of practice delivery to be trauma informed.
We are delivering to the ambitions of Realistic Medicine and committed to having a public health framework at the heart of practice ( see attached intergenerational collaborative framework). We are working to create a once for Scotland universal portal where all information and support for CYP their parents carers can be accessed. We are working across CYP and adult services to produce a national postural care strategy and training framework.
We have had to become accustomed to living with uncertainty, to testing and innovating and listening and learning from parents and CYP themselves about what they need from us . And most importantly to understand that as Suzanne Zeedyk would say “Relationships are the answer to whatever question’”.
If you want to hear more about our transformational CYP AHP journey you can watch our film Ready to Act in Action which is available on You Tube and download Ready to Act in Action 2018 the interim report on the implementation of the 5 ambitions of the AHP CYP Programme.