Background

The NHS in Derby works with schools, social services, and healthcare professionals to deliver School Nursing Support to Derby City’s 50,000 children annually between the ages of five to nineteen. After being historically focussed more on safeguarding they began a transformation during March 2020 to provide a more rounded, needs based support for the children and young people of Derby City.

Derby City Public Health Commissioners recognised that early intervention was of critical importance and wanted the Derby City School Nursing Team (the team) to move away from providing mainly safeguarding support into delivering a public health service.

To achieve this the team needed support to become more structured and proactive rather than reactive. Whilst talking to consultancies it became apparent that The Lancaster Model (TLM) offered a package of both service transformation and a digital solution.

“The support that Kath and the team provide has been very helpful -Kath has supported every step of the way through this journey”‍

Susanna (Susie) Scales manager: Clinical Lead – School Nursing

Challenge

Prior to TLM, the team used a paper, questionnaire for parents of children only in reception and years six. This questionnaire followed a more medicalised approach, with completion by parents only and lacked the voice of the child and did not include older young people’s health review. The work that came from these questionnaires was reactive and not following the true public health brief where early intervention work can be put in place.

The team were spending a significant proportion of their time doing reactive safeguarding work, with most of their time completing hundreds of care plans, reports or attending
safeguarding meeting.

The Solution

In 2022, they moved to The Lancaster Model (TLM) and Aire Innovate to fundamentally change how they were working.

With Kath Lancaster’s (CEO of TLM and Registered Nurse & Specialist Community Public Health Nurse) expert input the nursing team now benefits from a structured way of working, and the approach has given them a route back to now being Public Health Nurses.

The digital solution is centred around universal Health Needs Assessments delivering on many government drivers including The Healthy Child Programme. Assessments are completed online by children, young people, and their families. Responses to the health and wellbeing questionnaires are instantly available for review by the case holders via an online portal.

The portal receives all assessments and alerts are immediately sent to case holders when ‘flags’ are detected, and fast action is required. A RAG status is used to prioritise actions and monitor progression, ensuring no child is lost and there is a complete audit trail.  Local processes and pathways have been adapted to support staff with the change in working and enable best use of the solution.

The solution’s aggregated reporting data is a huge hit with the local commissioners and schools alike.  Commissioners benefit from the fact that they have instant access to aggregated public health data as soon as an assessment is complete and schools love that they can see how they rank and perform compared to a national average (of other TLM users) - something they didn’t have before the TLM digitisation.

Using this data, they are identifying trends and priority areas for improvement, which has led to more tailored services and targeted health promotion and support, improving health and wellbeing for children.

“The solution has given children of Derby greater input through their own voice than they had before”

Susanna (Susie) Scales manager: Clinical Lead – School Nursing

Benefits

“Big changes have happened since the implementation of TLM”, said Susie. The solution has enabled the team to fundamentally change the services they provide across Derby City, improving the safety of children and young people.

Any child with a “Risk & Protective” (Safeguarding) alert is immediately flagged and actions will be taken the same day - this was simply not possible prior before they had TLM, as they had no visibility of these children, who often sat under the radar.

Free text boxes on the digital assessments are enabling children to freely express how they are thinking and feeling, meaning the nurses have access to insights that they and the schools have never had before.

In one example the team shared, a child’s home circumstance wasn’t known to the school, but through comments made on the assessment about how the child was feeling, it became clear that there was an issue, and a plan and intervention was put in place immediately.

The solution has improved the safety of over 14,000 children who have been assessed earlier enabling the appropriate intervention and preventative support, which may otherwise have been missed.

To find out more about Aire Innovate and the Lancaster Model, Get in touch today.