Welcome to the RCSLT’s webinar: Introduction to clinical business skills: Children's services 8 th December 2014 #ClinicalBusiness
Chair of webinar: Kamini Gadhok MBE CEO, RCSLT Presenters: Maria Luscombe David Amos Chair RCSLT Workforce Planning and RCSLT’s Board of Trustees Development Adviser
Welcome Kamini Gadhok MBE CEO RCSLT
Maria Luscombe Chair RCSLT’s Board of Trustees
Data is one of the keys to influencing and building your case!
Understanding needs of children and young people with SLCN “Assessing and understanding the needs of individuals as well as of the population as a whole is integral to helping them achieve good outcomes” Bercow 2008
Share the knowledge ! Develop a shared understanding of the needs of children and young people with SLCN Engage and influence local decision makers within and external to your own organisation
Population and demographic data - know your local area! Local demographics Population trends Ethnicity / language profiles Deprivation indices – children in poverty Health inequalities – infant mortality Educational outcomes JSNA and commissioning priorities
Local Trends - Children and young people with complex difficulties at birth with ASD with behavioural difficulties excluded from school accessing youth offending teams Survival rates of pre-mature /low birth babies Foundation stage results for communication , language and literacy Attainment of students with SEN SEN and school census data sets
Link to - ‘At risk factors’ SLCN Gender -Boys over represented relative to girls 2.5:1 for SLCN and 6:1 for ASD. Birth season strong indicator for SLCN in school Socio-economic disadvantage Poor sensory or linguistic environment Family history Survival rates of pre-term / low birth weight babies Co-morbidities (ASD, learning difficulties, physical and sensory difficulties, hearing loss )
Link the impact of having a SLCN with outcomes – often have difficulties forming friendships are at risk of poor attainment academically. commonly have difficulties with reading and writing and accessing the curriculum. often have poor behaviour - may find it hard to socialise with their peers. more likely to be bullied than other children. more likely to be excluded A high proportion of young offenders have SLCN. Communication is crucial and at the core of all social interaction .’ (Bercow 2008) 11
Prevalence and incidence SLCN 1% of five year olds entering school in England - have the most severe and complex SLCN. 7% of children at school entry will have significant speech, language or communication needs which will not improve without specialist interventions as part of the team working with the child, including the parents Up to 50% of CYP in some socio-economically disadvantaged populations have speech and language skills that are significantly lower than their peers. 10% of all children with SLCN which may be complex and long-term.
Prevalence of SLCN – The balanced System ( M Gascoigne 2012) ? of all CYP in your Local 1% most severe and pervasive at Authority school entry ? of those entering reception Specialist each year in your school 7% of school entry age have been found to have significant SLCN ? of all CYP in your Local Authority ? of those entering reception each year in your school Targeted Figure unknown but Up to 50% of there will be significant children entering variability correlated to school in most the demographic socio-economically Universal variation. deprived areas will have impoverished This can be estimated. language skills In areas of high deprivation may be as high as 50+%
Impact on commissioning and service provision Support for children and young people and their families Communication and language friendly environments Need for early and appropriate interventions Workforce with appropriate knowledge and skills A system wide approach Continuum of universal, targeted and specialist services should be commissioned for children’s speech, language and communication. Speech and Language Therapy
SLT service data sets Referral rates and trends Links with areas of social deprivation, schools Hard to reach groups Age, gender, ethnicity, language Waiting times referral to treatment Activity data Non attendance rates Gaps in service provision Service and user feedback Speech and Language Therapy
SLT Staffing - Number What are SLT’s delivering? What is being commissioned Clinical hours available Skill mix, competencies required Clinical leadership Management Administrative support, IT systems
Sources Health profiles in England, Scotland, Wales and Northern Ireland 1. (links on RCSLT – support for services web page) Public health England datagateway@phe.org.uk 2. Local authority and Department for education websites 3. Better Communication Research Programme ( BCRP) 4. http://www2.warwick.ac.uk/fac/soc/cedar/better/ The Communication Trust web site 5. https://www.the communicationtrust .org.uk What Works . The Communication Trust working with BCRP to develop the What Works database. Commissioning support tools Implementation of SEND reforms conference report Feb 14 .
RCSLT on line resources and tools Commissioning support tools Matrix reports Support for services Leadership series SEND reforms and guidelines
David Amos RCSLT Workforce Planning and Development Adviser
Understand, influence and control 1. To have a far greater understanding of the principal drivers and nature of change facing SLT services. 2. To be capable and confident enough to be able to influence action plans for achieving greater influence and control. 3. To build personal and team resilience during times of continuous change.
Clinical business skills development The challenges ahead Dealing with change Making the clinical business case Building personal and team resilience
Public sector spend trend and forecast
NHS Funding profile: Nuffield Trust 1. Funding pressure on the NHS 2. Increase in allocation in line with NHS long-term average 3. Increase in allocation in line with GDP 4. Real-terms freeze in allocation
NHS productivity: 1995-2010 [ONS survey]
England NHS
Understanding a changing world • Less revenue to run existing services • Lack of clarity about how services will be commissioned • Potential increase in the use of personal budgets • Increase in privately funded SLT • Changes affecting the SLT team themselves and the rest of the organisation within which it fits • Growing demand for services driven by demographic change and new ways of meeting patient and client need • Merger at either employer or department level • Dramatic changes at the top of the employer facing insolvency • Opportunity to introduce new patient/client pathways and ways of working which are more efficient and better for those in need • New professional developmen t requirements and limited time to undertake
What could my organisation be planning? 1. Making cost improvement and efficiency savings each year 2. Merging with another provider organisation 3. Merging the clinical service with another one 4. Placing the SLT service under the leadership of another profession 5. Introducing a service level agreement 6. Undertaking a job evaluation exercise 7. Implementing advanced job planning 8. Being involved in a procurement exercise
Dealing with change: how employees react “Not me!” “What will this do to my job security?” Anger Gossip “Who’s in charge here?” Panic! “I quit!” “This is a challenge!” Enthusiasm “Maybe I could adjust to this change . . . .” Positive Vision Peter Barron Stark 2010 “Common Manifestations of Employees’ Anticipation of the Unknown”
How employers react to change • Often feel that something is being done to them by the system • Consult early without details or later with details • Spend time checking that a major change (eg financial challenge) is as great as originally quantified • Consider first all options which do not affect the staff • Try and take advantage of the need for change to achieve the best for patients – why waste a crisis?
Clinical business language dictionary Acquisition Budgetary management Consultation Co-production Cost avoidance Cost reduction Efficiency Heads of terms Merger Procurement Productivity Privatisation Public-private joint venture Redeployment Service level agreement Tendering
Creating extra workforce capacity and capability Capacity used to Capacity used to reduce spend generate additional revenue elsewhere Capacity used to Capacity removed as enhance service redundant elsewhere
Workforce cost reduction productivity improvement opportunities : reducing backfill costs : training and deploying lower levels of staff : commercial solutions and working in partnership with other organisations : diverse, effective teams, well-led and rewarding careers : using advanced technology and new working environments and arrangements
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