The (Department for Education and Skills, 2003). Another drive

The purpose of this assignment is for the author to explore the National
Service Framework for Children, Young People and Maternity Services’ (NSF). The
NSF can be defined as setting guidelines and clear standards in which promote
the health and well-being of children and young people, and also providing high
quality services which meet their needs (Department of Health, 2004). The NSF
was introduced in 2004 and was set to be a ten year programme however due to
changes in the government this lead to the NSF being archived in 2010. As it
has not been replaced, the standards of the NSF are still used in contemporary
society. The inception of the NSF came from Serious Case Reviews such as Victoria
Climbie; Victoria was just eight years old when she tragically passed away. Her
death was caused by various factors including, multiple injuries as a result of
her receiving long term ill-treatment and abuse by her aunty and aunt’s partner
(Parliament 2013). Furthermore, the failure of communicating effectively and
treating Victoria as the centre was lacked considering she had involvement with
a range of services and professionals (Lindon et al, 2016). An inquiry took
place, and the Laming report made recommendations in which would improve
services for children and ensure good practice becomes standard practice (Laming,
2009) . Examples of some of the recommendations included: direct contact with
the child; Children’s Trusts must evidence all professions that have been
involved in the child’s life, evidence of any case histories and significant
events, liaison between hospitals and community health services, where there is
suspicion that a child is being harmed, doctors should get the child’s account
(Laming, 2009). The Every Child Matters agenda was created in correspondence
with Lord Laming’s Report and set out five outcomes which was considered to
play a significant role in children and young people’s well-being, these
included: being healthy, staying safe, enjoying and achieving, making a
positive contribution and economic and well-being; everyone within the society
has a reasonability in implementing these outcomes (Department for Education
and Skills, 2003). Another drive that brought in the NSF was the Bristol Heart
Scandal. High mortality rates were of a concern after children had undergone
open-heart operation which led to another public inquiry (Fox, 2001). The
Kennedy Report highlighted that out of other centres in England, Bristol had a
higher mortality rate for open-heart surgeries on one year olds (Kennedy,
2001). In addition, the report also emphasised that children were not a
priority, there was a lack of appropriately trained staff and poor leadership.
Thus leading to the reports urgency in developing a NSF in which would
prioritise services for children and create positive changes. In response to
the concerns the report had introduced recommendations in which would overcome
such tragedy from taking place again. Some of these recommendations included: having
a service which is well led as a result of developing a NSF, competent
healthcare professions and having public involvement which allows the point of
view of patients and members of the public to be taken into consideration (Kennedy,
2001). Behind these recommendations is the expectancy of creating a better
health service for children and young people and families. In relations to the
Laming Report and Kennedy Report a common theme which occurs is the lack of
communication, inappropriately trained staff and failure to put the child as
the centre focus. In overcoming this the NSF, aims for better equality and
focuses on early intervention, improving access to services for all children
and developing effective working partnerships where needs of children are
considered (Department of Health, 2004). The NSF provides opportunities to
ensure that the child’s holistic needs are met from service developments
(Lachman, 2004). However when looking at whether the NSF is working, it can be
questionable. Cases such as ‘Baby Pete’ shows that NSF is not working effectively.
The failure in recognising the severity of Peter’s injuries tragically led to
his death, again the lack of effective multi-agency and ‘professional
judgement’ was of question (Local Safeguarding Children Board, 2009). Despite
the recommendations set out in the Laming report, the system failed yet another
child as a result of their reluctance in providing the best care for children
and ensuring their safety. As part of this assignment, child friendly services
will be looked at and the ways in which the NSF has influenced the care of
child and family in regards to it whilst critically analysing its application.

Child friendly services can be defined as always meeting the needs and
expectations of the child and parent, as a result of good facilities and
services (Child Friendly Matters, 2015). It is important to have child-friendly
services for a wide range of reasons. A main reason being regardless of a child
and young person’s socio-economic, ethnic background and gender they all should
be able to have the same level of care. In having child-friendly services put
in place this assures that all children, young people and their families have
access to the same quality of care and support.

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The NSF has influenced child friendly services in various ways. Firstly,
standard 1 of the NSF sets out; in delivering a co-ordinated programme of
action, the health and the well-being of children and young people is promoted
(Department of Health, 2004). The standard implements The Health Promotion
Programme, this is offered to all children who use suitable settings such as
children centres, schools, and general practices and so on. The idea behind
this is to promote good health as a result of prevention and early
interventions (Department of Health, 2004). As part of this programme it can be
seen as influencing child friendly service as programmes are created in order
to meet the individual’s needs. The Harrow and Hillingdon Early Intervention
Service is just one example which shows that this standard is being achieved. This
service is designed for those who are of the ages 14-35 and have experienced
their first episode of psychosis. Some of their aims include: early detection,
treatment which is effective in relieving symptoms, focused interventions and
working in partnership with other services (Central and North West London NHS
Foundation Trust, 2018). In regards to this service it can be seen as catering
to the well-being of young people who are suffering from mental health and
working in order to ensure that their health is promoted.

Standard 3 of the NSF sets out that children and young receive high
quality care which is focused around their individual needs as well as their
families; it has a vision of attempting to the see the world through the eyes
of children and young people (Department of Health, 2004). Within this standard
it poses that staff have the appropriate training and development in order to
keep children safe. Primary Care Trusts and Local Authorities introduce staff
training programmes to ensure that common core skills, knowledge and
competences are shared with staff within all organisations. These can include
promoting the welfare of children, listening to children and involving them
alongside working with the family. In addition to this the standard also issues
that staff depending on their role need to be competent in ensuring that the
child’s environmental factors such as the community respond to their needs
appropriately. This reflects child-friendly services as staff are expected to
have the correct level of training in ensuring children’s safety whilst also
centring them. However despite this, 5% of acute emergency departments failed
in having sufficient cover for paediatric emergencies in the daytime and 16%
out of hours was reported in 2007 (Services for Children in Emergency
Departments, 2007). This illustrates similar patterns which emerged in the
Bristol Heart Scandal and can potentially cause risks for children using the
emergency service which in turn does not create a child-friendly service as the
correct cover for children accessing the emergency department was lacked. In
contrast to this, the standard also addresses that children and young people require
care and support in which meets their developmental needs and ensures that they
have the opportunity to achieve or maintain their optimal standard of health,
development and well-being despite their individual circumstances (Department
for Health, 2004). This shows that all children are entitled to care and
support regardless of their situation. An example which demonstrates this is
being achieved is Acorns which is a registered charity. Acorns is a hospice
designed for children and young people who provide care and support for those
who have life limiting/life threatening conditions and associated complex
needs; using a network of specialist palliative nursing (Acorns, 2010). This
shows that despite the child and young person’s condition(s), their health,
development and well-being is still being promoted in collaboration with
well-trained staff. Thus corresponding with what the standard sets out. Further
demonstrating the influences that the NSF has had on child-friendly services.

Child friendly services are also influenced by Standard 6 of the NSF. It
sets out to ensure that effective services in which addresses children and
young people’s health, social, educational and emotional needs who are ill or
thought to be ill (Department for Health, 2004). Despite the outcomes set in
this standard, there are evidence to show that this is not being achieved
entirely, 70% of trusts had obtained an overall score of ‘fair’; many staff had
insufficient training in regards to children needs in the areas of child
protection, communication and play, assessing pain and life support (Healthcare
Commission, 2007).  In contrast to this the
requirements of the standard also promotes a child friendly service. Examples
of this includes: Ambulance Trusts are required to ensure that transport
vehicles include child-friendly features in the interior design of vehicles
(Department for Health, 2004). Despite ambulances not having child-friendly
interiors inside them, it is illustrated in different ways, paper work for
children contain designs which are child-friendly, in addition picture books
are used in order to aid communication, and this promotes child friendly
services. An example of this is having a child who is disabled and not able to
communicate verbally, they can use the book as a way of communicating with the
staff (Communication People, 2018). Furthermore, Birmingham Heartlands Hospital
is an example of creating child-friendly services for children and young
people. When having a blood sample it is no longer required for those under
sixteen to visit the outpatient department, thus leading to a paediatric-trained
phlebotomist taking their blood in a child-friendly environment (Heart of
England, 2013). This reflects child friendly services as some children have a
fear of hospitals, in creating an environment whereby children are able to have
blood samples without needing to visit the hospital outpatient department
allows the child’s experience to be less distressing. This also corresponds
with what the standard set out in using child-friendly methodology. In addition
to the influences of child friendly services, hospitals such as Birmingham
Children Hospital embrace the importance of play during children and young
people’s stay. The service consists of different professions who work together
effectively in order to assure the child and young person is able to partake in
a range of activities varying from educational to recreational (Birmingham
Children Hospital, N.D). This has a link with the Convention on the Rights of
the Child in that the child has a right to leisure to engage in play and
recreational activities (Department for Education, 2010). Piaget’s theory highlighted
play as a factor which contributes towards learning (Garwood, 1982). In having
a play service within the hospital this demonstrates a child-friendly
environment and reflects what was set out in the standard in meeting the child
and young person’s health and educational needs who are ill or thought to be
ill. Furthermore reflecting the Kennedy Report whereby it sets out to build
services which are designed from the patient’s point of view.

Inter-agency working is hugely influenced by the NSF in regards to child
friendly services. The standards of the NSF signify the importance of
inter-agency working, particularly standard 3. In order to promote child
friendly services inter-agency plays a huge role. There are various legislations
and policies which enforce how professions should incorporate inter-agency in
their work. Examples of this includes the Working Together to Safeguard
Children Act 2015. It demonstrates that professionals must work in collaboration
with one another in order to achieve the best outcome for children and young
people. Furthermore, the Equality Act 2010, puts a responsibility on public
authorities to ensure that discrimination does not take place, whilst
reinforcing that no child is treated any less favourably than others in
accessing effective services which meet their needs (GOV, 2015). Almost quarter
of all pupils in primary and secondary schools were from an ethnic minority
(Shepherd, 2011). This demonstrates that school services for children were
available to all children despite their backgrounds, reinforcing a child
friendly service. There are times whereby this might not always be the case
despite laws and regulations that are put in place to assure inter-agency
working. Stafford Hospital Inquiry is an example which shows inter-agency was
lacking and ineffective. A public inquiry was brought forward after the
hospital’s mortality rate was of a concern in comparison to the rates of other
smaller trusts. The inquiry brought the attention of how the system failed
patients, there were a lack of trained staff as well as taking the
responsibility for job roles which they were inexperienced in and the general
standard of care was appalling (Francis QC, 2013). The failure in having an
effective inter-agency approach constituted to the negative outcomes for the
patients. Despite this there are other services which show good inter-agency
work whilst promoting child-friendly services. Great Ormond Street Hospital is an
example which achieves this. The hospital has a range of staff from different
health professions which collaborate together in promoting the health and
well-being of children and young people. The hospital is involved with further
collaboration with different research partners with the aims of providing
exceptional clinical care, training and discovering new treatments (Great
Ormond Street Hospital for Children NHS Foundation Trust, 2018).  This demonstrates without the use of other
agencies child-friendly services will not be successful as not just one
profession can meet the needs of a child and young person.

conclusion it can be seen that the NSF has influenced child-services in different
ways. However there are times whereby child-friendly services are not
consistently being achieved and as a result demonstrates that the NSF is not
always working and effective. Despite this, research has shown that services
have come a long way in regards to what they were like prior to the public inquiry
reports being introduced. In addition, services for children and young people
are much more child-friendlier ensuring that the child is the centre of focus
and their needs are met appropriately. Inter-agency has shown to be crucial in
ensuring that child-friendly service stay child friendly.