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A new partnership for our most vulnerable children and young people

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.

Kate Davies

Kate Davies, OBE, is NHS England’s Director of Health & Justice, Armed Forces and Sexual Assault Services Commissioning.

As such she oversees three areas of direct commissioning services across England for healthcare for serving personnel and their families and veterans’ mental health and prosthetics; sexual assault referral centres (SARCs); health and justice healthcare services in prisons, secure children’s homes and training centres, immigration removal centres; and the development of the national liaison and diversion programme and street triage.

This national role is to assure quality, consistent and sustained services with a strong focus on health inequalities and outcomes for patients and their families.

Kate has developed and led the national partnership agreement between the Ministry of Defence for Armed Forces commissioning, Ministry of Justice for prisons and children and secure settings and the Home Office for immigration removal centres.

Previously, Kate was the Executive Lead for Prison, Detainee and SARCs Healthcare Commissioning for East Midlands and led the healthcare commissioning for prison and offender health.

From December 1995 to May 2009, Kate was the Strategic Director of the award winning Nottinghamshire County Drug and Alcohol Action Team, co-ordinating and delivering the government’s national drug strategy.

From 2003 to 2010, Kate was also seconded to the University of Central Lancashire, International School for Communities Rights and Inclusion as Director of Black and Ethnic Minority Community Engagement, focussing on the health and social care of diverse groups who experience discrimination and/or disadvantage and directing the national community engagement programme.

Kate has been a Non-Executive Director on the National Treatment Agency Board in England between 2000 and 2013. She was also a member of the government’s Independent Board for the Prison Drug Treatment Strategy Patel Review, which implemented the substance treatment service and strategy and delivery across England and acted as an Ambassador for Diversity in Public Appointments for the government Public Appointments Commission.

Kate worked in the probation service and was a qualified Probation Officer from 1986 to 1995, before joining the NHS. She was awarded an OBE in 2009, for services for ‘work with disadvantaged people’.

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