Section 6

Outcomes & Key Performance Indicators

Introduction

Achieving effective implementation of the HCP is dependent on local commissioners and providers working together so that the families they collectively support receive seamless, integrated care. Monitoring the effectiveness of the local system in providing integrated care will also require an integrated monitoring framework.

This section covers the work undertaken by the project workstreams to:

  • Developed a HCP specific vision for integrated commissioning and delivery.
  • Develop a set of shared principles that should underpin the delivery of integrated commissioning and delivery of the HCP which can be mapped to the relevant national outcomes frameworks.
  • Identify the current national ‘Must do’ KPI’s and how they map to both the HCP principles and national outcome frameworks.
  • Identify the areas of where outcomes are shared between services and where there are key gaps.
  • Identify a range of potential shared KPI’s that would address any gaps in the current HCP monitoring across the range of providers.

The integrated monitoring framework should enable service providers and commissioners to monitor and understand:

  • the contribution their service makes to achieving better health outcomes for children and families locally;
  • the effectiveness of their service in delivering service activities that should contribute to better health outcomes for child and families locally;
  • through the national outcome frameworks, the contribution their service makes to achieving better health outcomes for children and families nationally.

Definitions

It is clear from the work undertaken by the various workstreams that there are different understandings of what is meant by a KPI and a health outcome, it is therefore important to ensure a common understanding through the provision of broad definitions for both.

What is meant by an ‘outcome’?

When evaluating health interventions, outcomes have generally been defined as a change in health status or in the factors that influence health status as a result of a programme or intervention (from Donabedian 1980).

However, broader definitions of outcomes have also been adopted to include, for example, measures of health status in a population to allow tracking over time or between areas (Jee, M. and Z. Or, 1999), and the results of service activity.

The HCP integrated commissioning framework defines population health outcomes as:

"the anticipated benefits in health status or determinants of health status resulting from HCP promotion, prevention and early intervention activities for the identified child population or child priority group"

What is meant by a KPI?

Key performance indicators (KPIs) are defined by the NHS Institute as indicators that help you define and measure progress towards organisational goals (NHS Institute, 2008) .

The HCP integrated commissioning framework defines KPIs as:

"service specific measures of input and activity that are used to monitor progress towards achievement of a population health outcome"

KPIs can also be considered as information collected to monitor progress towards achievement of a population outcome.

HCP Vision and Ambitions: what do we want to achieve for children?

In order to provide a shared understanding and common purpose for the local delivery of the HCP a shared vision and ambitions have been developed to provide a framework that can underpin both integrated commissioning and delivery of services. These are:

Vision

Every child is nurtured and supported so they can achieve their full potential throughout their life course. We recognise that the foundations of good health throughout life lie in early childhood.

Ambitions

icn-ambition-lifestyle.png#asset:428 All families are supported to live healthy lifestyles and make healthy choices.
icn-ambition-support.png#asset:430 All parents and families have access to support that allows them to provide positive parenting for their child.
icn-ambition-emotional.png#asset:426 All children are supported to achieve positive physical and emotional developmental milestones.
icn-ambition-health.png#asset:427 Children do not suffer from ill health that is potentially preventable nor die from potentially avoidable causes of death.
icn-ambition-safety.png#asset:429 All children and families will be provided with services that effectively address family situations that adversely affect the safety of the child.
icn-ambition-wellbeing.png#asset:431 The health and wellbeing of all children is protected and promoted with the greatest improvements seen in those children in greatest need so that health inequalities are reduced.

Principles of Care

In addition to the above a large scale project was previously undertaken by the Strategic Network for Child Health and Wellbeing in the East of England with users of children’s services, to identify a set of principles that should define both the commissioning and delivery of services.

This work resulted in the identification of 6 key principles and underpinning indicators/evidence that would reflect achievement of the principles (see appendix 2). The 6 key principles were:

Principles

icn-principle-people.png#asset:418 PRINCIPLE 1 Child & Family Focussed
We will ensure the voices of children and young people are heard throughout the health care system and their needs drive planning and delivery in collaboration with clinical expertise.
icn-principle-apple.png#asset:414 PRINCIPLE 2 Health Promotion
We will prioritise investment and resources to improve the health and wellbeing of our children and young people.
icn-principle-butterfly.png#asset:415 PRINCIPLE 3 Transformation
We will invite children, young people and families to be active participants in the review and future design of services.
icn-principle-house.png#asset:417 PRINCIPLE 4 Settings
We will offer children, young people and their families’ services in settings where they feel welcome, comfortable and accepted and cause as little disruption to family life as possible.
icn-principle-chat.png#asset:416 PRINCIPLE 5 Information & Communication
We will share the best information and intelligence between professionals and with children, young people and their families to allow the best possible healthcare.
icn-principle-search.png#asset:419 PRINCIPLE 6 Evidence based & sustainable
We will commission and deliver services to consistent standards, informed by best practice and available evidence. All children and young people will have equitable access to services to meet their needs.

Current national requirements for quality assurance and monitoring of the HCP

A number of national quality assurance and monitoring mechanisms are already in place to monitor elements of the HCP. These are:

  • Public Health Outcome Framework (PHOF)
  • NHS Outcome Framework (NHSOF)
  • CCG Outcome indicator set (CCGOIS)
  • Health visitor dashboard (HV DBd)
  • UK National Screening Committee KPIs (UK NSC)
  • Ofsted Framework

These national monitoring requirements, the ‘Must do’ KPIs and health outcomes, were mapped against the HCP pathways to provide an overview of how they relate to local service commissioning and delivery.

The following pages provide an overview of:

  • how current national KPIs map to HCP activities provided by services at different stages of a child’s development and;
  • how the service-level KPI’s link to the HCP Ambitions and population health outcomes.

Potential Areas to Address (Additional KPI’s)

Having reviewed and mapped the current service KPI’s, the contributors to this project felt that there were a number of areas that needed to be addressed and for which additional KPI’s should be considered if local systems are to effectively monitor the integrated impact and delivery of the desired outcomes. The need to develop local impact measures such as programme coverage, in addition to national key indicators, is also a view supported within the HCP.

The following pages identify a range of potential areas and potential indicators identified by the contributors to this project.

Implementing integrated monitoring of the HCP locally

Governance and Quality Assurance

Given the co-dependence of the services involved in the delivery of HCP, multi-agency oversight is essential to ensure services are working effectively together to collectively support local children and families. The local Health & wellbeing board is the forum where key leaders from the local health and care system work together to improve the health & wellbeing of their local population and reduce health inequalities.

Health and Well Being Board members will require assurance that the Healthy Child Programme is being commissioned and delivered effectively so that local children and families are appropriately supported in the crucial early years. Therefore commissioners and providers need to ensure that effective mechanisms for multi- agency oversight of the HCP are in place through the implementation of a local integrated monitoring framework. This multi-agency group will need to link to existing inter-agency groups including the Local Safeguarding Children Board and Child Death Overview Panel.

Key issues that the multi-agency oversight group will wish to ensure are addressed are:

  • Clarity amongst both commissioners and providers regarding the level and nature of services being delivered in support of the local HCP.
  • Clarity amongst commissioners and providers regarding the contribution individual services make to the delivery of the local HCP child health outcomes.
  • Shared ownership and accountability for the delivery of local HCP child health outcomes, recognising that no-one commissioner or provider has control over all the inputs required to successfully deliver the local HCP outcomes.
  • Transparent availability and joint review of performance data between the various commissioners and providers involved in the local delivery of the HCP. This could include the development of an a single system wide HCP performance dashboard which can be used by joint commissioners to plan, evaluate and improve the quality of the HCP. This could include the development of, locally sensitive, integrated performance dashboards for each Children’s Centre.
  • Effectiveness of information sharing and partnership working between services including:
    • Health Visitor is a member on the Children’s Centre Board;
    • Robust links with maternity and school nursing services;
    • Implemented learning from Family Nurse Partnership Programme Sites.
  • Agreement on an annual HCP pathway audit programme, for example:
    • Audit of a sample of children who have a 2 – 2 1/2yr assessment to review:
      • Proportion of children receiving Universal, Universal Plus or Universal Partnership Plus and whether this is similar to expected levels;
      • Levels of adherence to national good practice guidance such as that recommended by NICE.
    • Compliance with neonatal bloodspot screening and effective communication with midwifery services.
    • Audit of effectiveness of communication of findings from school entry assessments communicated to the School Nursing Team.
    • Audit of effectiveness of user involvement in service commissioning and delivery.

Figure 7 below provides an overview of how an integrated monitoring framework might work in practice, showing how individual service activities contribute to the shared child population health outcomes, underpinned by a common service-wide understanding of local child health needs.

Figure 7
Figure 7

Key Performance Indicators

Service Specific Measures (HV, maternity, children centre, GP/primary care).

Pre-conception Care

No KPIs relating to the provision of pre-conception care could be identified.

Antenatal

Current national KPI KPI Source KPI Ref. Project Ambitions Population Outcomes

Midwifery

Antenatal Early Booking Visit
Percentage of mothers receiving a booking visit and completion of appropriate screening and Family of Origin Questionnaire (FOQ) by 8-10 weeks UK NSC
Reduction of perinatal mortality and infant mortality (NHSOF, PHOF)
Percentage of mothers seen before 13 weeks. CCG Outcome Indicator Set 2013/14 C1.13
Reduction of perinatal mortality and infant mortality (NHSOF, PHOF)
Antenatal Infectious Disease Screening
HIV coverage: The percentage of pregnant women eligible for infectious disease screening who are tested for HIV, leading to a conclusive result PHOF, UK NSC PHOF 2.121 and ID1
Reduction of perinatal mortality and infant mortality (NHSOF, PHOF)
Syphilis, hepatitis B and susceptibility to rubella uptake: The percentage of women booked for antenatal care, as reported by maternity services, who have a screening test for syphilis, hepatitis B and susceptibility to rubella leading to a conclusive result PHOF, UK NSC PHOF 2.11ii, ID2
Reduction of perinatal mortality and infant mortality (NHSOF, PHOF)
Antenatal Sickle Cell & Thalassaemia screening
The percentage of pregnant women eligible for antenatal sickle cell and thalassaemia screening for whom a conclusive screening result is available at the day of report. PHOF, UK NSC PHOF 2.21iii, ST1
Reduction of perinatal mortality and infant mortality (NHSOF, PHOF)
The proportion of women having antenatal sickle cell and thalassaemia screening for whom a conclusive screening result is available by 10 weeks' gestation. UK NSC ST2
Reduction of perinatal mortality and infant mortality (NHSOF, PHOF)
The proportion of antenatal sickle cell and thalassaemia samples submitted to the laboratory which are supported by a completed Family Origin Questionnaire (FOQ). UK NSC ST3
Reduction of perinatal mortality and infant mortality (NHSOF, PHOF)
Antenatal support for stopping smoking
Number of pregnant women as a percentage of total booking appointments who are reported as smoking at the time of booking. NICE quality standard Reduction of perinatal mortality and infant mortality (NHSOF, PHOF)
Antenatal support for healthy weight
Number of women as a percentage of total booking appointments, who are categorised as obese at booking. NICE quality standard
Reduction of perinatal mortality and infant mortality (NHSOF, PHOF)
Antenatal Downs syndrome screening
The proportion of laboratory request forms including complete data prior to screening analysis, submitted to the laboratory within the recommended timeframe of 10+0 to 20+0. UK NSC FA1

Health Visiting

Antenatal contact at 28 weeks
Percentage of mothers notified as being pregnant that receive an antenatal visit at 28 weeks. National HV Dashboard HV SR (NHS E) 6
Health improvement, improving the wider determinants of health, infant mortality (NHSOF, PHOF)

Children's Centre

Health Start Vitamin Distribution
Total number of mothers receiving vitamins via the children's centre. DH quarterly return
Health improvement, health protection (NHSOF, PHOF)

General Practice

Provision of Appropriate Immunisations
Population immunisation coverage. DH quarterly return
Reduction of perinatal mortality and infant mortality (NHSOF, PHOF)

Post-natal (0 - 6 weeks)

Current national KPI KPI Source KPI Ref. Project Ambitions Population Outcomes

Midwifery

Maternal Smoking at time of delivery
Number of pregnant women as a percentage of total deliveries who are reported as smoking at the time of delivery. PHOF , CCG OIS PHOF 2.3, C1.14
Reduction of perinatal mortality and infant mortality (NHSOF, PHOF)
Infant Feeding
Percentage of mothers that initiate breast feeding in the first 48 hours after delivery. PHOF PHOF 2.2i
Breastfeeding initiation (PHOF, CCGOIS)
NIPE - New baby Examination NP2 - Hips
Percentage of babies who, as a result of possible abnormality detected at the NIPE, undergo assessment by ultrasound within 2 weeks of birth. UK National Screening Committee NP2
Reduction of perinatal mortality and infant mortality (NHSOF, PHOF)
Post-natal screening - Newborn hearing screening
Percentage of babies for whom screening process is complete within 4-5 weeks corrected age. PHOF, UK NSC PHOF 2.21v, NH1
Early identification of potential long term conditions (NHSOF)
Percentage of referred babies receiving audiological assessment within 4 week of decision to refer. UK NSC NH2
Early identification of potential long term conditions (NHSOF)
Post-natal screening - Newborn Blood Spot
Percentage of babies who have a conclusive result recorded on the CHIS within 17 days of age. PHOF, UK NSC PHOF 2.21iv, NB1
Early identification of potential long term conditions (NHSOF)
Percentage of babies from whom it is necessary to take a repeat sample due to an avoidable failure in the sampling process. PHOF, UK NSC NB2
Early identification of potential long term conditions (NHSOF)
Percentage of new born bs results which are screened negative for all five conditions available for communication to parents within 6 weeks. PHOF, UK NSC NB3
Early identification of potential long term conditions (NHSOF)
Birth Weight
Number of low birth weigh babies (less than 2500g) delivered per month as a percentage of total births. PHOF PHOF 2.1
Early identification of potential long term conditions (NHSOF)

Health Visiting

New Birth Visit within 10-14 days
Percentage of births that receive a face to face NBV within 10-14 days by a Health Visitor. National HV Dashboard HVSR 7 (NHS E)
Health improvement, improving the wider determinants of health (NHSOF, PHOF)
Percentage of face-to-face NBVs undertaken after 14 days, by a Health Visitor. National HV Dashboard HVSR 8 (NHS E)
Health improvement, improving the wider determinants of health (NHSOF, PHOF)

6 weeks - 6 months

Current national KPI KPI Source KPI Ref. Project Ambitions Population Outcomes

Health Visiting

6-8 week check
Percentage of total number of infants aged 6-8 weeks who receive a 6-8 week developmental check. National HV Dashboard PHOF 2.3, C1.14
Health improvement, improving the wider determinants of health (NHSOF, PHOF)
6-8 week check - Breast Feeding
Percentage of infants for whom a breastfeeding status has been recorded at the 6-8 week developmental check. National HV Dashboard
Breastfeeding initiation (PHOF, CCGOIS)
Percentage of infants recorded as being totally or partially breastfed at 6-8 weeks. National HV Dashboard, CCG OIS C1.15
Breastfeeding initiation (PHOF, CCGOIS)
6-8 week check - Assessment of Maternal Mood
Percentage of mothers who received a Maternal Mood assessment, by the time the infant is aged 6-8 weeks, based on the month in which the infant reached 8 weeks of age. National HV Dashboard NHS E HV Return
Health improvement, improving the wider determinants of health (NHSOF, PHOF)

Children's Centre

Healthy Start Vitamin Distribution
Number of families/babies receiving vitamins via the children's centre. DH quarterly return PHOF 2.3, C1.14
Health improvement, health protection (NHSOF, PHOF)

Primary Care

6-8 week check
Percentage of total number of infants registered with a practice that receive a 6-8 week developmental check from their GP. DH quarterly return PHOF 2.3, C1.14
Health improvement, improving the wider determinants of health (NHSOF, PHOF)
Provision of Childhood Immunisations
Population immunisation coverage. PHOF
Health improvement, health protection (NHSOF, PHOF)

6-12 months

Current national KPI KPI Source KPI Ref. Project Ambitions Population Outcomes

Health Visiting

12 month review
Percentage of children who receive a 12 month developmental review based on the month in which a child reached the age of 12 months. National HV Dashboard HVSR 9 (NHS E)
Health improvement, improving the wider determinants of health (NHSOF, PHOF)

Children's Centre

Dental Care
Number of children and families that are known to be registered with a dentist. National HV Dashboard HVSR 10 (NHS E)
Healthcare public health and preventing premature mortality (NHSOF, PHOF)

1-3 years

Current national KPI KPI Source KPI Ref. Project Ambitions Population Outcomes

Health Visiting

2-2 ½ year review
Percentage of children that receive a developmental review by the age of 2 ½ years, based on the month in which the child reached 2.5 years. National HV Dashboard
Health improvement, improving the wider determinants of health (NHSOF, PHOF)

Children's Centre

Early Education assessment, 2 years - disadvantaged families
The number of available early education places being accessed within the centres reach area. Ofsted Framework
Improving the wider determinants of health (NHSOF, PHOF)
2 year Developmental Check
The number of 2 year developmental checks completed by the children's centre for children within their reach area. Ofsted Framework
Health improvement, improving the wider determinants of health (NHSOF, PHOF)
Dental Care
Number of children and families that are known to be registered with a dentist. Local Authority Measure (Local)
Healthcare public health and preventing premature mortality (NHSOF, PHOF)

General Practice

Provision of childhood Immunisations
Population immunisation coverage. PHOF PHOF 3.3i - 3.3x
Health improvement, health protection (NHSOF, PHOF)

3-5 years

Current national KPI KPI Source KPI Ref. Project Ambitions Population Outcomes

Children’s Centre

Early Education assessment 3 and 5 years - disadvantaged families
The number of available early education places being accessed within the centres reach area. Ofsted Framework
Improving the wider determinants of health (NHSOF, PHOF)
Early Years Foundation Stage Profile
Percentage of children within the centres reach area that are achieving a total of 78 points across the EYFS. Ofsted Framework
Improving the wider determinants of health (NHSOF, PHOF)
Early Years Foundation Stage Profile (narrowing the gap)
The number of children not achieving 78 points across the EYFS and the gap between the highest achives and the lowest 20%. Ofsted Framework
Improving the wider determinants of health (NHSOF, PHOF)

General Practice

Provision of childhood Immunisations
Number of immunisations provided. PHOF - data source - Information centre
Health improvement, health protection (NHSOF, PHOF)

All Age Groups

Current national KPI KPI Source KPI Ref. Project Ambitions Population Outcomes

Health Visting

CAF Completion
Number of new CAFs completed, per WTE as a % of caseload, within a month. HV National Dashboard HVSR 12(NHS E)
Wider determinants of health, health improvement (NHSOF, PHOF)
Child & Family Meetings
Number of child & family meetings attended by HV staff, per WTE as a percentage of caseload, within a month. HV National Dashboard HVSR 13 (NHS E)
Wider determinants of health, health improvement (NHSOF, PHOF)
Safeguarding Training
Percentage of staff who have recived mandatory child protection training (commensurate with their role) in the last 36 months (rolling). HV National Dashboard HVSR 15 (NHS E)
Improving the wider determinants of health, health improvement (NHSOF, PHOF)
Safeguarding Referrals - Urgent (Random Audit of 50 cases)
Percentage of 50 urgent referrals that recived a same day or next day response to the referrer. HV National Dashboard HVSR 16 (NHS E)
Improving the wider determinants of health, health improvement (NHSOF, PHOF)
Percentage of 50 urgent referrals where contact was made with the family within two working days. HV National Dashboard HVSR 17 (NHS E)
Improving the wider determinants of health, health improvement (NHSOF, PHOF)
Patient Experience
Annual Report on patient experience feedback from families and caregivers. HV National Dashboard HVSR 16 (NHS E)
Improving the wider determinants of health, health improvement (NHSOF, PHOF)
Transfer of Care where a child moves out of the area (Random Audit of 50 cases)
Percentage of 50 transfers where health records are transferred to the HV service within the new area within 2 weeks. HV National Dashboard HVSR 16 (NHS E)
Improving the wider determinants of health, health improvement (NHSOF, PHOF)
Transfer of Care where a child moves out of the area and is on a Child Protection
Percentage of 50 transfers where health records are transferred to the HV service within the new area within 2 weeks. HV National Dashboard
Improving the wider determinants of health, health improvement (NHSOF, PHOF)
Transfer of Care/Access to service
All referrals from whatever source (including families transferring in) will receive a response to the referrer within 5 working days, with contact made with the family within 10 working. HV National Dashboard HVSR 18 (NHS E)
Improving the wider determinants of health, health improvement (NHSOF, PHOF)

Children’s Centres

Vulnerable Family access, this includes: Teenage Mothers, Workless families
Number of families categorised as being vulnerable within an individual centres reach area that are registered and accessing services at the centre (minimum 65%). Ofsted Framework
Improving the wider determinants of health, health improvement (NHSOF, PHOF)
CAF Completion
Number of CAF's being completed or currently involving staff/services from the individual children's centre. Ofsted Framework
Wider determinants of health, health improvement (NHSOF, PHOF)
CIN & CIP (Known)
The number of children on a CIN or CIP within an individual centres reach area that are known to the centre. Ofsted Framework
Wider determinants of health, health improvement (NHSOF, PHOF)
CIN & CIP (Working with)
The number of children on a CIN or CIP within an individual centres reach area that the centre are actively working with. Ofsted Framework
Wider determinants of health, health improvement (NHSOF, PHOF)
Reach area of children's centre
The number of families with children under the age of five within a centres reach area. (minimum 65%). Ofsted Framework
Wider determinants of health, health improvement (NHSOF, PHOF)
Registration with a Children's Centre
The number of families with children under the age of five, within a centres reach area that are registered with the centre. (minimum 65%). Ofsted Framework
Wider determinants of health, health improvement (NHSOF, PHOF)
Registration with a Children's Centre - Access
The number of families with children under the age of five, within a centres reach area that are registered with and access services at the centre. (minimum 65%). Ofsted Framework
Wider determinants of health, health improvement (NHSOF, PHOF)

Development of KPIs

Pre-conception Care

Rationale for development of a KPI Potential KPIs (for further development) Project Ambitions

Pre-conception Care

Seek to meet the challenges of reducing health inequalities through improving maternal health ensuring the best start in life / best possible outcome. Supports early engagement with maternity and specilaist services if required. Pre-conception: Percentage of women that have had pre-conceptual advice to be recorded at birth.

Antenatal

Rationale for development of a KPI Potential KPIs (for further development) Project Ambitions

Maternal Mental Health Assessment

To identify the most vulnerable and highlight the level of need and to deliver the most appropriate service. Number of Maternal Mental Health assessments completed at 28 weeks antenatally as a % of total 28 week antenatal contacts.

Delivery of appropriate support to parents

To ensure delivery of public health messages and advice whilst preparing mothers and fathers for parenthood. Availability and uptake of preperation for parenting programmes as:
  • Number of programmes available
  • % parents accessing programme
To ensure delivery of public health messages and advice whilst preparing mothers and fathers for parenthood. Pregnancy Birth & Beyond - availability and uptake of jointly delivered programmes as:
  • Number of programmes available
  • % parents accessing programme

Notification of 􏰀r􏰁􏰂nac􏰃 an􏰄 birth between professionals

Ensure robust processes exist to provide effective communication between professionals. Notification of pregnancy and birth - (exception reporting) number of incidents and % of total notifications, where notification was not recived by HV service for both pregnancy and birth.

Post-natal 0 - 6 weeks

Rationale for development of a KPI Potential KPIs (for further development) Project Ambitions

Birth Weight

There is a greater risk of mortality and morbity in pre term babies. The identification of trends within the local health system is an impotant driver in the design, delivery and targetting of services. Number of pre term babies (less than 37 weeks) delivered per month as a % of total births.

Maternal Mental Health Assessment

To identify the most vulnerable and highlight the level of need and to deliver the most appropriate service. Number of Maternal Mental Health assessments completed at 10-14 days post natally as a percentage of total new birth visits completed.

6 weeks - 6 months

Rationale for development of a KPI Potential KPIs (for further development) Project Ambitions

Maternal Mental Health Assessment

To identify the most vulnerable and highlight the level of need and to deliver the most appropriate service. Number of Maternal Mental Health Assessments completed as a % of total of 3-4 month HV contacts.

1-3 years

Rationale for development of a KPI Potential KPIs (for further development) Project Ambitions

Delivery of appropriate support to parents

To monitor the level of appropriate support being provided to parents across the health and care system. Number of packages of care being delivered for specific programmes/support e.g. potty training, sleep.

Developmental Review

Integrated reviews provide a more effective and robust assesment of need and enhance communication and joint working. The number of joint 2-21⁄2 year reviews completed as a % of the total number of reviews.

All Age Groups

Rationale for development of a KPI Potential KPIs (for further development) Project Ambitions

Care of the new born

There is a greater risk of mortality in pre term and low weight babies. The identification of trends within the local health system is an impotant driver. Mortality rates for low birth weight and pre term babies as a % (in each category) and of total births.

Support to Parents

Monitor the availability and provision of specialist programmes to vulnerable groups. Availability and uptake of CONI programmes as:
  • Number of programmes available
  • Percentage parents accessing programmes

Appropriate support to parents and child

Monitor the availability and provision of specialist services for children with long term health and care needs. Children with Disability:
  • availability and access to childrens community nurses
  • referrals to CDU”

Effective information sharing

Effective information sharing is an essential component of integrated service delivery. All Service can demonstrate that they have an agreed HCP specific information sharing protocol.

Provision of a skilled workforce

Clear research exists to demonstrate that regular and appropriate supervision is effective in maintaining and identifying training and support. Supervision - all services record the uptake of supervision for staff involved in the delivery of the HCP.

Care of the child

Identification of vulnerable children. A&E attendances caused by unintentional and deliberate injury (under 5s), rate per 100,000 population (to be developed).

Monitoring of Need

Monitoring and identification of need within the local population.
  • Total number and proportion of families in UPP.
  • Total number and proportion of families in UP.
  • % of families on each UP and UPP pathway.

System-wide Measures

Rationale for development of a KPI Potential KPIs (for further development) Project Ambitions

Are effective mechanisms in place for multi-agency oversight of the Healthy Child

Multi-agency oversight is essential to ensure services are working effectively together to collectively support local children and familes. Is a multi-agency oversight in place? Does the group have links to the Health and Wellbeing Board as well as the Local Safeguarding Children Board and the Child Death Overview Panel?.

All Services can demonstrate that they have an agreed HCP

Effective and consistent information sharing is essential to the safe delivery of multi-agency care. Is an agreed HCP specific information sharing protocol in place in each service.

All Services can demonstrate that they have an agreed HCP

Annual audit will provide service with a clear indication if pathwyas are being delivered consistently and to the quality required. Is an annual audit pathway programme in place?