The purpose of this assignment is for the author to explore the NationalService Framework for Children, Young People and Maternity Services’ (NSF). TheNSF can be defined as setting guidelines and clear standards in which promotethe health and well-being of children and young people, and also providing highquality services which meet their needs (Department of Health, 2004). The NSFwas introduced in 2004 and was set to be a ten year programme however due tochanges in the government this lead to the NSF being archived in 2010. As ithas not been replaced, the standards of the NSF are still used in contemporarysociety. The inception of the NSF came from Serious Case Reviews such as VictoriaClimbie; Victoria was just eight years old when she tragically passed away.
Herdeath was caused by various factors including, multiple injuries as a result ofher receiving long term ill-treatment and abuse by her aunty and aunt’s partner(Parliament 2013). Furthermore, the failure of communicating effectively andtreating Victoria as the centre was lacked considering she had involvement witha range of services and professionals (Lindon et al, 2016). An inquiry tookplace, and the Laming report made recommendations in which would improveservices for children and ensure good practice becomes standard practice (Laming,2009) . Examples of some of the recommendations included: direct contact withthe child; Children’s Trusts must evidence all professions that have beeninvolved in the child’s life, evidence of any case histories and significantevents, liaison between hospitals and community health services, where there issuspicion that a child is being harmed, doctors should get the child’s account(Laming, 2009). The Every Child Matters agenda was created in correspondencewith Lord Laming’s Report and set out five outcomes which was considered toplay a significant role in children and young people’s well-being, theseincluded: being healthy, staying safe, enjoying and achieving, making apositive contribution and economic and well-being; everyone within the societyhas a reasonability in implementing these outcomes (Department for Educationand Skills, 2003). Another drive that brought in the NSF was the Bristol HeartScandal.
High mortality rates were of a concern after children had undergoneopen-heart operation which led to another public inquiry (Fox, 2001). TheKennedy Report highlighted that out of other centres in England, Bristol had ahigher mortality rate for open-heart surgeries on one year olds (Kennedy,2001). In addition, the report also emphasised that children were not apriority, there was a lack of appropriately trained staff and poor leadership.Thus leading to the reports urgency in developing a NSF in which wouldprioritise services for children and create positive changes. In response tothe concerns the report had introduced recommendations in which would overcomesuch tragedy from taking place again. Some of these recommendations included: havinga service which is well led as a result of developing a NSF, competenthealthcare professions and having public involvement which allows the point ofview of patients and members of the public to be taken into consideration (Kennedy,2001). Behind these recommendations is the expectancy of creating a betterhealth service for children and young people and families. In relations to theLaming Report and Kennedy Report a common theme which occurs is the lack ofcommunication, inappropriately trained staff and failure to put the child asthe centre focus.
In overcoming this the NSF, aims for better equality andfocuses on early intervention, improving access to services for all childrenand developing effective working partnerships where needs of children areconsidered (Department of Health, 2004). The NSF provides opportunities toensure that the child’s holistic needs are met from service developments(Lachman, 2004). However when looking at whether the NSF is working, it can bequestionable. Cases such as ‘Baby Pete’ shows that NSF is not working effectively.The failure in recognising the severity of Peter’s injuries tragically led tohis death, again the lack of effective multi-agency and ‘professionaljudgement’ was of question (Local Safeguarding Children Board, 2009).
Despitethe recommendations set out in the Laming report, the system failed yet anotherchild as a result of their reluctance in providing the best care for childrenand ensuring their safety. As part of this assignment, child friendly serviceswill be looked at and the ways in which the NSF has influenced the care ofchild and family in regards to it whilst critically analysing its application. Child friendly services can be defined as always meeting the needs andexpectations of the child and parent, as a result of good facilities andservices (Child Friendly Matters, 2015). It is important to have child-friendlyservices for a wide range of reasons. A main reason being regardless of a childand young person’s socio-economic, ethnic background and gender they all shouldbe able to have the same level of care. In having child-friendly services putin place this assures that all children, young people and their families haveaccess to the same quality of care and support.
The NSF has influenced child friendly services in various ways. Firstly,standard 1 of the NSF sets out; in delivering a co-ordinated programme ofaction, the health and the well-being of children and young people is promoted(Department of Health, 2004). The standard implements The Health PromotionProgramme, this is offered to all children who use suitable settings such aschildren centres, schools, and general practices and so on.
The idea behindthis is to promote good health as a result of prevention and earlyinterventions (Department of Health, 2004). As part of this programme it can beseen as influencing child friendly service as programmes are created in orderto meet the individual’s needs. The Harrow and Hillingdon Early InterventionService is just one example which shows that this standard is being achieved. Thisservice is designed for those who are of the ages 14-35 and have experiencedtheir first episode of psychosis. Some of their aims include: early detection,treatment which is effective in relieving symptoms, focused interventions andworking in partnership with other services (Central and North West London NHSFoundation Trust, 2018). In regards to this service it can be seen as cateringto the well-being of young people who are suffering from mental health andworking in order to ensure that their health is promoted. Standard 3 of the NSF sets out that children and young receive highquality care which is focused around their individual needs as well as theirfamilies; it has a vision of attempting to the see the world through the eyesof children and young people (Department of Health, 2004).
Within this standardit poses that staff have the appropriate training and development in order tokeep children safe. Primary Care Trusts and Local Authorities introduce stafftraining programmes to ensure that common core skills, knowledge andcompetences are shared with staff within all organisations. These can includepromoting the welfare of children, listening to children and involving themalongside working with the family.
In addition to this the standard also issuesthat staff depending on their role need to be competent in ensuring that thechild’s environmental factors such as the community respond to their needsappropriately. This reflects child-friendly services as staff are expected tohave the correct level of training in ensuring children’s safety whilst alsocentring them. However despite this, 5% of acute emergency departments failedin having sufficient cover for paediatric emergencies in the daytime and 16%out of hours was reported in 2007 (Services for Children in EmergencyDepartments, 2007). This illustrates similar patterns which emerged in theBristol Heart Scandal and can potentially cause risks for children using theemergency service which in turn does not create a child-friendly service as thecorrect cover for children accessing the emergency department was lacked. Incontrast to this, the standard also addresses that children and young people requirecare and support in which meets their developmental needs and ensures that theyhave the opportunity to achieve or maintain their optimal standard of health,development and well-being despite their individual circumstances (Departmentfor Health, 2004). This shows that all children are entitled to care andsupport regardless of their situation. An example which demonstrates this isbeing achieved is Acorns which is a registered charity. Acorns is a hospicedesigned for children and young people who provide care and support for thosewho have life limiting/life threatening conditions and associated complexneeds; using a network of specialist palliative nursing (Acorns, 2010).
Thisshows that despite the child and young person’s condition(s), their health,development and well-being is still being promoted in collaboration withwell-trained staff. Thus corresponding with what the standard sets out. Furtherdemonstrating the influences that the NSF has had on child-friendly services. Child friendly services are also influenced by Standard 6 of the NSF.
Itsets out to ensure that effective services in which addresses children andyoung people’s health, social, educational and emotional needs who are ill orthought to be ill (Department for Health, 2004). Despite the outcomes set inthis standard, there are evidence to show that this is not being achievedentirely, 70% of trusts had obtained an overall score of ‘fair’; many staff hadinsufficient training in regards to children needs in the areas of childprotection, communication and play, assessing pain and life support (HealthcareCommission, 2007). In contrast to this therequirements of the standard also promotes a child friendly service. Examplesof this includes: Ambulance Trusts are required to ensure that transportvehicles include child-friendly features in the interior design of vehicles(Department for Health, 2004). Despite ambulances not having child-friendlyinteriors inside them, it is illustrated in different ways, paper work forchildren contain designs which are child-friendly, in addition picture booksare used in order to aid communication, and this promotes child friendlyservices. An example of this is having a child who is disabled and not able tocommunicate verbally, they can use the book as a way of communicating with thestaff (Communication People, 2018). Furthermore, Birmingham Heartlands Hospitalis an example of creating child-friendly services for children and youngpeople. When having a blood sample it is no longer required for those undersixteen to visit the outpatient department, thus leading to a paediatric-trainedphlebotomist taking their blood in a child-friendly environment (Heart ofEngland, 2013).
This reflects child friendly services as some children have afear of hospitals, in creating an environment whereby children are able to haveblood samples without needing to visit the hospital outpatient departmentallows the child’s experience to be less distressing. This also correspondswith what the standard set out in using child-friendly methodology. In additionto the influences of child friendly services, hospitals such as BirminghamChildren Hospital embrace the importance of play during children and youngpeople’s stay. The service consists of different professions who work togethereffectively in order to assure the child and young person is able to partake ina range of activities varying from educational to recreational (BirminghamChildren Hospital, N.D). This has a link with the Convention on the Rights ofthe Child in that the child has a right to leisure to engage in play andrecreational activities (Department for Education, 2010). Piaget’s theory highlightedplay as a factor which contributes towards learning (Garwood, 1982).
In havinga play service within the hospital this demonstrates a child-friendlyenvironment and reflects what was set out in the standard in meeting the childand young person’s health and educational needs who are ill or thought to beill. Furthermore reflecting the Kennedy Report whereby it sets out to buildservices which are designed from the patient’s point of view. Inter-agency working is hugely influenced by the NSF in regards to childfriendly services. The standards of the NSF signify the importance ofinter-agency working, particularly standard 3. In order to promote childfriendly services inter-agency plays a huge role.
There are various legislationsand policies which enforce how professions should incorporate inter-agency intheir work. Examples of this includes the Working Together to SafeguardChildren Act 2015. It demonstrates that professionals must work in collaborationwith one another in order to achieve the best outcome for children and youngpeople. Furthermore, the Equality Act 2010, puts a responsibility on publicauthorities to ensure that discrimination does not take place, whilstreinforcing that no child is treated any less favourably than others inaccessing effective services which meet their needs (GOV, 2015). Almost quarterof all pupils in primary and secondary schools were from an ethnic minority(Shepherd, 2011).
This demonstrates that school services for children wereavailable to all children despite their backgrounds, reinforcing a childfriendly service. There are times whereby this might not always be the casedespite laws and regulations that are put in place to assure inter-agencyworking. Stafford Hospital Inquiry is an example which shows inter-agency waslacking and ineffective. A public inquiry was brought forward after thehospital’s mortality rate was of a concern in comparison to the rates of othersmaller trusts.
The inquiry brought the attention of how the system failedpatients, there were a lack of trained staff as well as taking theresponsibility for job roles which they were inexperienced in and the generalstandard of care was appalling (Francis QC, 2013). The failure in having aneffective inter-agency approach constituted to the negative outcomes for thepatients. Despite this there are other services which show good inter-agencywork whilst promoting child-friendly services.
Great Ormond Street Hospital is anexample which achieves this. The hospital has a range of staff from differenthealth professions which collaborate together in promoting the health andwell-being of children and young people. The hospital is involved with furthercollaboration with different research partners with the aims of providingexceptional clinical care, training and discovering new treatments (GreatOrmond Street Hospital for Children NHS Foundation Trust, 2018). This demonstrates without the use of otheragencies child-friendly services will not be successful as not just oneprofession can meet the needs of a child and young person.Inconclusion it can be seen that the NSF has influenced child-services in differentways. However there are times whereby child-friendly services are notconsistently being achieved and as a result demonstrates that the NSF is notalways working and effective. Despite this, research has shown that serviceshave come a long way in regards to what they were like prior to the public inquiryreports being introduced. In addition, services for children and young peopleare much more child-friendlier ensuring that the child is the centre of focusand their needs are met appropriately.
Inter-agency has shown to be crucial inensuring that child-friendly service stay child friendly.