Table of contents

  • Purpose and Summary Page 4
  • MCYP Commissioning Guidance Pages 6 - 18
  • Maternity (Pages 6 - 8)
  • Children and Young People (pages 9-14)
  • Children and Young Peopl’s Mental Health (Pages 15-16)
  • Transitionto Adult Services (Pages 17-18)
  • ReferencesPage 20

Purpose and Summary

The purpose of this paper is to provide commissioners of healthcare services across the South East Coast (Kent & Medway, Surrey and Sussex) with strategic commissioning advice in relation to Maternity,Children and Young People’s (MCYP) healthcare services. This is intended to support the production of Clinical Commissioning Groups (CCGs) 2015/16 commissioning intentions and is based on the MCYP SCN strategic work programme, which was developed during 2014/15 to support CCGs, direct commissioning and joint commissioners.

The MCYP SCN baseline review for maternity and CYP was produced in September 2013 and provided benchmarking detail across SEC to identify the unwarranted variation and local priorities which underpinned the development of the SCN work programme.

The SEC MCYP SCN work programme priorities have been grouped under and/or across the NHS outcome domains in order to demonstrate how the work of the SCN will support the delivery and achievement of these indicators.The SCN work programmes for each of the MCYP areasare outlined below:

Maternity:

  • To reduce perinatal mortality and morbidity
  • To promote high quality maternity care and experience

Children and Young People:

  • To reduce inappropriate paediatric attendances and admissions to secondary care delivered through a programme on moving the clinical care of children & young people from secondary to community and primary care settings (NHS at Home)

Transition from paediatric to adult services:

  • Transition best practice pathways

Information is also provided on key strategic work programme areas which will result in specific guidance on what good looks like either within 2015/16 or within the current 5 year lifespan of the SCNs to 2018.

All guidance produced by the MCYP SCN draws on wide stakeholder membership including clinicians, patients, carers, voluntary sector, commissioners, and local authority and public health colleagues. Where thedocuments are work in progress, they will be shared once complete.

Maternity, Children and Young People

Commissioning Guidance

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South East Coast Strategic Clinical Network - Maternity Children and Young People Strategic Commissioning Advice 2015/16. For Internal NHS use only

Maternity Work Programme

Maternity SCN Work Programme / Maternity SCN Project / National Priorities
and relevant Outcome Indicators / Maternity SCN Commissioning Guidance
Domain 1 – Preventing people from Dying Prematurely
To reduce perinatal mortality and morbidity / Agreed model of care to support the reduction of still birth (2015 – 16) / NHS Outcomes Framework*
1.6ii. Neonatal mortality and stillbirths
CCG Outcome Indicators
Reducing deaths in babies and young children.
C1.13. Antenatal assessments <13 weeks
1.4. Maternal smoking at delivery
1.5. Breast feeding prevalence at 6-8 weeks.
NHS England Business Areas
1. Prevention and early diagnosis
4. Patient experience
5. Patient safety
8. Equality and health inequalities
9. Maternity, children and young people
17. Data, digital and customer services
19. Citizen participation and empowerment / SCN recommendations are being produced with oversight from the Maternity Clinical Advisory Group. Recommendations will outline a best practice pathway for still birth across South East Coast (SEC). This work is currently in the early stages, to be rolled out in 2015/16.
SEC SCN Clinical Lead: Leila Frodsham. Email:
Agreed best practice pathway and associated case for change for pre-term birth (2015 – 16) / SCN recommendations are being produced with oversight from the Maternity Clinical Advisory Group. Recommendations will outline a best practice pathway for pre-birth across South East Coast (SEC). This work is currently in the early stage to be rolled out in 2015/16.
SEC SCN Clinical Lead: Lesley Roberts. Email:
Agreed best practice pathway for the reduction of perinatal mortality across the region, by addressing capacity issues within the maternity scanning workforce. / Baseline assessment of current capacity to be completed in partnership with HEKSS.SCN recommendations to be produced with oversight from the Maternity Clinical Advisory Group. This work is currently in the early stages and aligned to the national HEE programme of work.
Links with NHS Outcome Framework - Domain 5
5.5. Improving maternity services: Admission of full term babies to neonatal care

*

Maternity SCN Work Programme / Maternity SCN Project / National Priorities
and relevant Outcome Indicators / Maternity SCN Commissioning Guidance
Domain 4 – Ensuring that people have a positive experience of care
To promote high quality maternity care and experience / Agreed maternity standards and associated KPIs across South East Coast / NHS Outcomes Framework
4.c. Friends and Family Test
4.5. Improving women and their families’ experience of maternity services
CCG Outcome Indicators
C4.2. Patient experience of hospital care.[NHS OF 4b]
C4.9. Friends and Family Test for inpatient acute and A&E. [NHS OF 4c]
Improvement Areas
C4.7. Friends and Family Test
NHS England Business Areas
1. Prevention and early diagnosis
4. Patient experience
5. Patient safety
8. Equality and health inequalities
9. Maternity, children and young people
17. Data, digital and customer services
19. Citizen participation and empowerment / SEC SCN draft maternity standards and associated KPIs have been produced and reviewed by the Maternity Clinical Advisory Group and overarching SEC SCN MCYP Steering Group. Developed in line with RCOG Standards recommendations:

Final versions to be shared once completed.
Agreed maternity dashboard that supports both providers and commissioners across South East Coast / A SEC maternity dashboard is currently in development. The pilot phase will be rolled out in late 2014/early 2015. Full roll out across SEC will take place in Spring 2015.
The introduction of a robust and valid maternity dashboard will allow all maternity units within the South East to obtain a clear view of the quality and safety of their own service. In addition the regional view will highlight areas where there is variation in practice and provide valuable benchmarking to facilitate improvement.
Final versions to be shared once completed.
Additional Information (Maternity)
Key deliverables for maternity within the NHS England Business Areas (2014 – 15) to (2016 – 17) /
  • New maternity commissioning guidance for CCGs will be produced by September 2015. This will include the NICE definition of a named midwife and support CCGs in offering choice where appropriate. All women booking for maternity care from March 2015 will have access to a named midwife.
  • Best practice guidance to support the implementation of the suite of recommendations from reviews across maternity and children & young people services will be produced by April 2015.
  • Development and delivery of a pathway to support women with postnatal mental health problems will be produced by March 2015.
  • Professional nursing & midwifery guidance to support high quality commissioning for maternity services will be produced by September 2014.
  • A leadership model for clinical frontline staff which ensures high quality decision making to reduce stillbirths and minimise negligence in maternity services will be developed by June 2014 and fully delivered by October 2015.
  • Development of a Maternity and Perinatal National Clinical Audit ensuring the chosen option has adequate detail to support specification development with the commissioning process began in July 2014 and the contract will be awarded and work underway by May 2015.
  • Evidence for best practice models for preventing still births and publish guidance with key partners will be reviewed and collatedby March 2015.
  • Implementation of the maternity and child health datasets
  • Link:

Key contact details for maternity within South East Coast Strategic Clinical Network /
  • Laura McGuinness - Quality Improvement Lead (Maternity)
  • Email:
  • Telephone: 01138 248981
  • Website:

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South East Coast Strategic Clinical Network - Maternity Children and Young People Strategic Commissioning Advice 2015/16. For Internal NHS use only

Children and Young People (CYP) Work Programme

The CYP programme is aligned to the following frameworks: NHS Outcomes Framework, Public Health Framework, CYP Outcomes Framework, Future NHS and PHE Frameworks indicators for 2015/16 and NICE quality standards.

The overall Programme output is to produce an agreed children’s community nursing service model and associated service specification and guidance for best practice pathways for out of hospital care based on the forthcoming Department of Health Guidance

In the 2011 reportImproving Children and Young People’s Health Outcomes: a system wide response,the Government recognised the role that failures of care have played in poor outcomes for children and young people, and pledged to better suit the NHS Outcomes Framework towards achieving these goals wherever possible. TheCYP Forum’s Work Plan for 2014 can be found at:

The CYP Programme is essential to support the CCG’s 5 YEAR PLAN specifically for the following areas:

East Sussex: The SCN Programme can support the following areas identified in the 5 year plan -Phase 2

To review the assumptions made on impact of change in East Sussex on Maternity and Paediatrics services in Brighton and Hove and West Sussex

To identify further changes which may be necessary across Sussex, bearing in mind changes to Maternity and Paediatrics in hospitals outside Sussex e.g. SASH, Epsom

To improve services provided to children and their families/ carers at home, school or in the community, and reduce dependencies on hospital services for acute care.

Surrey: There are no defined plans for CYP within the 5 year plans, however we are working with the CCG’s on their local programmes of work.

Kent:The SCN Programme can support the following areas identified in the 5 year plans:

New joint commissioning models for disabled children, young people aged between 0-25 and their families, as part of the reforms identified in the Children and Families Act for disabled children, new integrated assessment processes, new ways of providing information and providing personal health budgets

working in partnership with local Hospices’ Children and Young People’s Service to provide an effective model of care for children with palliative care needs and their families

Out of hours advice and support has led to a higher number of families benefiting from the right care and advice at the right time and in the right place, rather than an admission to hospital using improved Acute Care pathways .

Increasing number of children with highly complex health needs being discharged from hospital requiring specialist multi-agency support and children’s continuing care packages

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South East Coast Strategic Clinical Network - Maternity Children and Young People Strategic Commissioning Advice 2015/16. For Internal NHS use only

Children and Young People SCN Work Programme / Children and Young People SCN Projects / National Priorities
and relevant Outcome Indicators / Children and Young People SCN
Strategic Commissioning Advice
Across all Domains
Domain 1 – Preventing people from Dying Prematurely Domain 2 – Enhancing Quality Of Life For People With Long Term Conditions Domain 3 – Helping People To Recover From Episodes Of Ill Health Or Following Injury Domain 4 – Ensuring That People Have A Positive Experience Of Care Domain 5 –Treating And Caring For People In A Safe Environment And Protect Them From Avoidable Harm
THE Overall SCN CYP Programme
The SCN has produced a Baseline Audit of existing NHS at Home models (using Sussex Audit as basis). The final draft slide set will be signed off by the next Clinical Advisory Group in November 2014. This will be shared once completed.The SCN suggests that it will be a useful baseline and tool for all CCG’s and Joint Commissioners in comparing their area to other CCG’s. There are GAPS across SEC and there is a need to agree a set of standards based on the awaited guidance form the Department of Health Scoping Project and Guidance over the next 3-4 months.
To reduce inappropriate paediatric attendances and admissions to secondary care
Delivered through a programme on moving the clinical care of children & young people from secondary to community and primary care settings (NHS at Home)
June 2014-Sept 2015
To reduce inappropriate paediatric attendances and admissions to secondary care
Delivered through a programme on moving the clinical care of children & young people from secondary to community and primary care settings (NHS at Home)
June 2014-Sept 2015
To reduce inappropriate paediatric attendances and admissions to secondary care
Delivered through a programme on moving the clinical care of children & young people from secondary to community and primary care settings (NHS at Home)
June 2014-Sept 2015
To reduce inappropriate paediatric attendances and admissions to secondary care
Delivered through a programme on moving the clinical care of children & young people from secondary to community and primary care settings (NHS at Home)
June 2014-Sept 2015 / Project 1
Acute and Short Term Conditions - working to reflect a Model of Acute Care alongside the emergency and urgent care theme.
Phase 1 Timeline
June 2014-Dec 2014 / Please note all Indicators in this section apply across the whole programme
NHS Outcomes Framework*
NHS 2.3.ii
Unplanned hospitalisation for asthma, diabetes and epilepsy (under 19s).[
NHS 3.2
Prevent lower respiratory tract infections (LRTI) in children from becoming serious – emergency admission for Children with LRTI
NHS 4
Improving Children and Young People Experience of healthcare
Friends and Family Test in progress
5.6 Delivering of safe care to children in acute settings - incidence of harm to children due to failure to monitor
CCG Outcome Indicators
C 2.7- Unplanned hospitalisation for asthma, diabetes and epilepsy (under 19s).
C 3.4- Prevent lower respiratory tract infections (LRTI) in children from becoming serious – emergency admission for Children with LRTI
Please note all Indicators in this section apply across the whole programme
PUBLIC HEALTH OUTCOMES FRAMEWORK -
Domain 1: Improving The Wider Determinants Of Health
  • Sickness absence rate. (Indicated here in relation to acute or chronic health/mental health issues).
  • Pupil absence
  • Children in poverty – (Indicated here in relation to health outcomes after a period of acute or chronic illness)
  • Killed or seriously injured causality on England’s roads.
Domain 2: Health Improvement
• Hospital admissions caused by unintentional and deliberate injuries in under 18
NHS England Business Areas
1 –Asthma, 5 - Participation Package, 7- 6C CCN , 9 - Pledge & Best Practice, 14 - Specialised Services,19 - Personal Budgets
Via the Women and Children’s programme:
Best practice guidance children & young people services produced by April 2015.
Develop guidance for CCGs to ensure children with SEN have access to services in their care plan based on a single assessment across health, social care and education by March 2015.
Identify gaps in delivery of the transfer of responsibility for special educational needs commissioning from the current series of national events and develop support for CCGs by March 2015
Develop an implementation plan for the Children and Young People Pledge and implement key aspects of the Pledge on behalf of the organisation by March 2015.
Review existing guidance on providing care for acutely ill children by June 2014.
Implementation of the child health datasets.
Refer to Page 30-32

Please note all Indicators apply across the whole programme
NHS Outcomes Framework*
NHS 2.3.ii
Unplanned hospitalisation for asthma, diabetes and epilepsy (under 19s).[
NHS 3.2
Prevent lower respiratory tract infections (LRTI) in children from becoming serious – emergency admission for Children with LRTI
NHS 4
Improving Children and Young People Experience of healthcare
Friends and Family Test in progress
5.6 Delivering of safe care to children in acute settings - incidence of harm to children due to failure to monitor
CCG Outcome Indicators
C 2.7- Unplanned hospitalisation for asthma, diabetes and epilepsy (under 19s).
C 3.4- Prevent lower respiratory tract infections (LRTI) in children from becoming serious – emergency admission for Children with LRTI
Latest data is available from
PUBLIC HEALTH OUTCOMES FRAMEWORK -
Domain 1: Improving The Wider Determinants Of Health
  • Sickness absence rate. (Indicated here in relation to acute or chronic health/mental health issues).
  • Pupil absence
  • Children in poverty – (Indicated here in relation to health outcomes after a period of acute or chronic illness)
  • Killed or seriously injured causality on England’s roads.
Domain 2: Health Improvement
• Hospital admissions caused by unintentional and deliberate injuries in under 18
Please note all Indicators apply across the whole programme
NHS England Business Areas
1 –Asthma, 5 - Participation Package, 7- 6C CCN , 9 - Pledge & Best Practice, 14 - Specialised Services,19 - Personal Budgets
Via the Women and Children’s programme:
Best practice guidance children & young people services produced by April 2015.
Develop guidance for CCGs to ensure children with SEN have access to services in their care plan based on a single assessment across health, social care and education by March 2015.
Identify gaps in delivery of the transfer of responsibility for special educational needs commissioning from the current series of national events and develop support for CCGs by March 2015
Develop an implementation plan for the Children and Young People Pledge and implement key aspects of the Pledge on behalf of the organisation by March 2015.
Review existing guidance on providing care for acutely ill children by June 2014.
Implementation of the child health datasets.
Refer to Page 30-32
/ Includes what good looks like for-