Today’s publication of the new Children and Young People Secure Estate National Partnership Agreement ensures that there is a more fully integrated approach to the commissioning and delivery of excellent health services for some of the most vulnerable people in the community. NHS England’s Director of Health & Justice, Armed Forces and Sexual Assault Services Commissioning, explains its importance:
With today marking publication of the new Children and Young People Secure Estate National Partnership Agreement, it has been an honour to have overseen the improvements in the commissioning and delivery of health services within this area over the past five years.
Whilst there is a much reduced number of children and young people in the secure estate, they are over represented in terms of their physical, mental, neuro disability and substance misuse needs, often suffering from multiple health conditions. This includes those within and transitioning to and from the secure and detained estate on youth justice or welfare grounds; those in contact with the police, liaison and diversion, and / or specialist mental health services; and those presenting at sexual assault referral centres (SARCs).
Strong partnership working between NHS England, the Youth Justice Board and Public Health England since 2013 has helped us to reach the current position, however, I am very aware of the challenge our commissioners face in terms of ensuring that the needs of this complex and vulnerable group of children and young people are fully met.
We know that they show such high levels of complexity that whole systems of support are challenged, including systems in mental health, social care, youth justice and education. Furthermore, alongside these children and young people are another group, who although less complex, often have multiple needs that again require whole system support.
To date, it is clear that none of the different support systems have been able to effectively care for these children alone. From NHS England’s perspective, therefore, it is timely that the partnership has grown from three to six organisations with a core focus on supporting high quality outcome and evidence based health services for this patient group.
It is my view, and I hope one shared by many others working within this area, that the National Partnership Agreement for the Children and Young People Secure Estate, can help us develop a more fully integrated approach to commissioning health services for these children.
Our commitment to this, along with our partners, is shown most clearly in the implementation of a Framework for Integrated Care, which is based on psychological principles of attachment and trauma, across the children and young people secure estate.
In practice, this means day to day staff having a pivotal approach to joining together a child’s ‘story’; taking into account their life experience as a whole, and building a plan based upon this, rather than on any individual labels, diagnoses or issues. Central to this are focusing on elements that promote change to help reduce issues relating to the reasons for detention, as well as ensuring continuity of care as children and young people transition from the secure estate into other secure settings and community services.
I am excited about the potential change and impact on life outcomes this type of work can bring for some of the most vulnerable people in our community, and I am hopeful that as a group, we can build on this partnership, and continue to innovate. The test for success, however, will be the personal views and experiences of those children and young people who this is intended to benefit and the positive impact the partnership indirectly has on them.