By Pauline Beirne
National Lead AHP CYP Scottish Government @NatLeadAHPCYP
What is the most important conversation we need to have for children and young people’s (CYP) health and wellbeing outcomes in Scotland? Three years on from the launch of Ready to Act (Scottish Government 2016) I feel a real sense of urgency. Urgency to inspire as many radical conversations as possible about improvement, innovation, challenge of the status quo & opportunities to forge as many trust based relationships with families and with our partners in making Scotland the best place for our CYP to grow up. This is a blog for AHP Day 2019 but in essence it’s a blog for everyone working to make a difference for CYP, whatever your profession, area of clinical expertise, organisation or agency. The most important conversation we need to have is
‘How do we truly deliver rights-based child centred services focused on shared wellbeing outcomes framed around the principles of GIRFEC?’
It feels like it’s time to challenge the status quo of how our services relate to each other about CYP, their families and carers? It feels like we need to change the conversation. What have we learnt from starting a change conversation about how to deliver the best possible AHP services for CYP?
Firstly, to start with the human! To begin this big change with listening appreciatively to what families want from us and what is important to practitioners. To make our AHP services as open as possible to those asking for support, enabling us to offer reassurance as early as possible (30% of those asking us for help are looking for reassurance) without having to make them wait. We need to change the language of referral and the conversation with those “bothered” about a CYP and asking us for support. This has been one of the most important changes we have made. Some areas have moved to totally paperless request for help where anyone “bothered” about a child or young person can call up and have a conversation with a person who is expert in their area of practice and can have an informed collaborative conversation about how best to meet the needs of the person asking for help.
Why are AHPs in CYP services in Scotland the missing link?
If we want to deliver to National Outcomes, AHPs can bring so much to enable changes in attainment, weight and nutrition, development, literacy, adversity and trauma informed environments, physical activity across Early Years and Primary and secondary as well as Criminal Justice.
We need be bold enough to challenge our siloed ways of working, retaining our knowledge and expertise as AHP’s but giving away our power to come together around the national framework Michael West (King’s Fund 2017) sets out key principles for this successful whole systems change (I’ve added some from our experience!)
Prioritising an inspirational vision. Repeated over and over at every possible opportunity in order to ensure confidence in those undertaking the change. Can we move away from individual service and profession visions towards a joined up vision where we all bring our expertise collectively around shared well- being outcomes
Enthusiastic team working and collaboration. Authentic engagement is the most important fact: start with the human and processes and strategy will resolve thereafter
Strategic alignment. AHP’ s in CYP services are acting to implement policy in practice across organisations and professions
A values based collective leadership strategy. Visible, authentic, joined up led by approachable leaders focused on relationships and creating spaces for safe conversations especially when there is dissent
Integrated approaches to prevention. We need real commitment to valuing what is possible through integrated collaboration across boundaries.
Measuring what is valuable. So many of our measures are based on input. We need to focus on being evaluated and accountable for our outcomes for CYP in enabling them to be their best possible selves.
Give away processes that get in the way of CYP getting support. Things like referral and eligibility criteria! It is counter intuitive but the more open our services are the better our access is the more confidence and self-resilience our CYP their families and carers and others asking us for help will be
Genuine collaboration: This cannot be over emphasised. This is how we will be evaluated in how well we have supported CYP in Scotland. Did we truly commit to working collectively around child centred well- being outcomes? Did we bring our collective knowledge and expertise into our communities to ensure equity? Did we support each other in delivering best possible outcomes through relationships based on trust?
So what is the most important conversation we need to have about AHP services in Scotland?
We need to have more conversations with families, parents, carers, CYP and in communities, about what they need from us to achieve their best possible well -being outcomes and we need to have explicit conversations based on expectation and outcome.
We need to be bold and radical in changing the culture of practice, to come out of our silos and work and plan together for CYP outcomes around the Getting it Right for Every Child principles.
We need to have conversations about what we are measuring to demonstrate value and to talk loudly about AHPs critical place in supporting others to achieve their outcomes for example with colleagues in education where we can be so powerful in addressing so many wicked problems including behaviour and exclusion and closing the poverty related attainment gap.
We need to share the amazing data emerging from our transformational activity showing the impact of increasing real early intervention offers on waiting lists and times.
We need to share what we have learned from truly opening our services and offering expertise advice and reassurance to families parent’s carers CYP and referrers as early as possible.
We need to blog and blog and blog about the work we are doing the challenges we have faced and where we are going next.
At our recent Children and Young Peoples Improvement Collaborative we made pledges about what we would do to support CYP in Scotland Here is Mine