Government Consultation On Continuing Care For Children With Complex Needs: A Social Work Perspective

Defining the scope of continuing care

Discuss and write a response to either a live government consultation and also dicuss This critique of a piece of social policy will relate to social work practice?

The clinical commissioning groups (CCGs) have the legal role in securing to a reasonable degree the health care that a person needs and the consultation are on the process that is to be followed for delivering health services to the children and young people having complex needs (Drummond et al. 2015). The framework health care was published in March 2010 and has been supporting good practices in health care locally. The principles underpinning it are relevant. Changes brought about in the consultation are according to structures of NHS created by Health and Social Care Act 2012 (Lowes and Hulatt 2013). In particular, when a child or a young person has a disability or special need, the CCGs along with the local authorities are to endeavour to bring coordination in the assessment of the continuing care, as an element of the process of developing children’s education and health care plan. This is a response to consultation of the Department of Health on a national framework for providing guidance for local authorities and (CCGs) on the procedure of carrying out assessment, decision-making and clinical evaluation for continuing care for children and young people who have complex needs and thereby cannot be met by specialised and universal services (Gov.uk 2015). Seeking views on the process for assessing, deciding and agreeing continuing care for children with complex health needs is the main aim. This response is made as the voice of nursing workforce and as a result of nursing interests on the wide spectrum of consultations taken up for a betterment of health and well-being of patients and common people.

The first aspect that would be given focus on is whether the framework defines the scope of children and young people in continuing care. The opening statement of the framework in clear. It has been stated that the consultation is useful when considering continuing care for young people and children. It has been stated that a child’s need are such complex that the only means of meeting them are through a complete set of continuing care. It is known that in cases of children with disabilities and complex needs, the specialist rule is to be applied in the case of universal rule (Whiting 2014). Moreover, the framework states that definition of challenging behaviour causes confusion in meetings for professional reasons and therefore there is a need of pointing the fact that for children with a special needs different approach for care has to be taken (Houtrow et al. 2014). The framework sets out clear process. The points mentioned in number 10 to 25 are comprehensive and clear and therefore well-read. One aspect of enquiry is whether there is a possibility of using flow diagram to cover the stages of the process.

Guidance on assessing children with disabilities

The framework provides clear guidance on the means of assessing needs of the children with disabilities. In this relation, the discussion needs to be done on whether there are adequate details in practice. Points 57 and 58 states that a rapid pre-assessment process is essential for giving best delivery care for patients. This is true in relation to the fact that there is a necessity to carry out a full continuing care assessment (James, Nelson and Ashwill 2014). Point 59 is also justified as it states that the follow up clock should initiate when the referral is accepted. This is the appropriate approach and also realistic. Point 61 is justified as medical officers must be in a position to give sufficient information regarding continuing care to the present local partners (Jeroen et al 2015).

However, point 66 contradicts the points made in 57 and 58. This is because every child may not get a complete and comprehensive assessment that depends on the suitable pre-assessment check. Point 72 is a valid point due to the fact that there is a presence of examples of health assessors to be assessing young people and children who have emotional needs and complex behavioural needs (Requejo et al. 2015). It is to be agreed with point 76 that carers assessment must be offered to every carer of young people and children for continuing care, and it must consider the capacity of the family for resilience. The point 77 is not much clear in the concept. Points 81 to 84  also needs more details.

Concerns lie with the decision support tool regarding the appropriateness. It is felt that focus must move away from the child, and the outcomes, and the unmet needs to the measuring of the need of priority.  A child-centered approach in continuing care would be beneficial (Cohen et al 2012). The health domains can be used as a guiding tool for taking up discussions on child care. However, instead of making a rating of the child on the level of needs that the child has, there is a requirement of examining the actual needs, how to meet the needs and what interventions and working facilities are to be made for facilitating the unmet needs. The primary health needs advancement, complexity, intensity and unpredictability can be used for undertaking an examination of the level of skill required for caring for the child, training of people responsible for taking risk management decisions and whether tasks are being completed safely (Hockenberry and Wilson 2014). The short but concise summary of the need would include the appropriate action plan for feeding into the multiagency care plan for the child. A child becomes eligible for continuing care solely when all the specialist and universal services have been thoroughly explored. The next topic of analysis would be the role of the assessor. Point 73 and 74 indicate that skills required for a health assessor must always be high.

Decision support tool and child-centered approach

Support given to effective transition from child hood to adulthood needs to be explored. The consultation covers birth to 17 years of age. For adults, it is age 18 years and above. This implies that there lies a significant gap from the age of 17 years to 18 years and therefore there lies some dispute in cases where there is valuable importance of funding responsibilities. This is in particular to point 109 that states that at 18 years of age transition to adult continuing health care and to a specialist and universal services must be made. Young people must have their health care continued on an unchanged basis till a reassessment have been undertaken (De Sanctis et al. 2014). Clarification is required on this point regarding child’s services to be continued for providing and funding care. More clarification is related to adult services regarding the provision of funding and care.

The next question to be answered is done the framework give enough support for professionals leading on or participating in continuing care assessments. The framework introduces the meaning and definition of continuing care of young people and child. The process is mentioned in brief. The continuing care process has three parts in it. The first part is an assessment. The second phase is decision-making. The third stage is the development of a package of care. A multi-agency understanding of a child’s needs is laid out.

The next topic against which response is to be given is how the education, care and health plan process have relation with the continuing care process. The personal budget for health is mentioned in an effective manner. A step-by-step guide for continuing care process for continuing care process is mentioned in a suitable approach. This encompasses the timeline, identification, assessment, recommendation, decision-making, making informed, arrangement of provision, review and transition (Healey 2014).

The framework has a decision-making tool for young people and children. The tool is intended to deliver assessment information together in a consistent and concise manner. It makes sure that the needs are captured and assessed to the full extent. This provides a multi-dimensioned tools for the health professionals. This helps in a detailed analysis of the individual needs of continuing care. The information collected by this process would lead to multi-agency decision-making forum. This will inform the decision on whether a plan of continuing care is to be given. The support tool describes the needs of the children across ten domains of care. These are breathing, eating and drinking, mobility, tissue and skin viability, communication, seizures, challenging behaviours, emotional and psychological needs and medicines and drug therapies.  As per the points 26 to 33, it can be commented that quality assurance process is to be in line with other countries having similar kind of frameworks for the health care of children with complex and special needs. This is to ensure that national standards are maintained. One point of suggestion is that Deprivation of Liberty Safeguards is to be added.

Overall, the consultation on children and young people’s continuing care is of a high standard and sets out a complete guidance on how to give care to these children with special needs. The approach taken is justified and noteworthy.

References

Cohen, E., Berry, J.G., Camacho, X., Anderson, G., Wodchis, W. and Guttmann, A., 2012. Patterns and costs of health care use of children with medical complexity. Pediatrics, 130(6), pp.e1463-e1470.

De Sanctis, V., Soliman, A.T., Fiscina, B., Elsedfy, H., Elalaily, R., Yassin, M. and El Kholy, M., 2014. A practical approach to adolescent health care: a brief overview. Rivista Italiana di Medicina dell’Adolescenza-Volume, 12(1).

Drummond, M.F., Sculpher, M.J., Claxton, K., Stoddart, G.L. and Torrance, G.W., 2015. Methods for the economic evaluation of health care programmes. Oxford university press.

Gov.uk, (2015). Continuing care for children and young people with complex needs – Consultations – GOV.UK. [online] Available at: https://www.gov.uk/government/consultations/continuing-care-for-children-and-young-people-with-complex-needs [Accessed 24 Feb. 2016].

Healey, P., 2014. A continuing process. The Routledge Handbook of Planning Research Methods, p.5.

Hockenberry, M.J. and Wilson, D., 2014. Wong’s nursing care of infants and children. Elsevier Health Sciences.

Houtrow, A.J., Larson, K., Olson, L.M., Newacheck, P.W. and Halfon, N., 2014. Changing trends of childhood disability, 2001–2011. Pediatrics, pp.peds-2014.

James, S.R., Nelson, K. and Ashwill, J., 2014. Nursing care of children: Principles and practice. Elsevier Health Sciences.

Jeroen, T., Canfyn, S., Lieven, A. and Paul, G., 2015. Physician–hospital exchanges and extra-role behaviour of physicians: The moderating role of the chief medical officer. International Journal of Healthcare Management, pp.1-11.

Lowes, L. and Hulatt, I. eds., 2013. Involving service users in health and social care research. Routledge.

Requejo, J.H., Bryce, J., Barros, A.J., Berman, P., Bhutta, Z., Chopra, M., Daelmans, B., de Francisco, A., Lawn, J., Maliqi, B. and Mason, E., 2015. Countdown to 2015 and beyond: fulfilling the health agenda for women and children. The Lancet, 385(9966), pp.466-476.

Whiting, M., 2014. Support requirements of parents caring for a child with disability and complex health needs: In the second of three articles about the findings of a study into the experiences of families, Mark Whiting examines their perceptions of professional and familial support. Nursing children and young people, 26(4), pp.24-27.