Partners: NWL ICB, South Fulham PCN, K+W South PCN
Alignment with three shifts: Hospital to community
As a result of system-wide input and insights, there is consensus to focus innovation efforts on scaling mental health provision in Child Health Hubs (CHHs).
These Hubs have 50% coverage in NWL with the potential to address challenges across both Mission workstreams: crisis prevention and supporting ND pathways. This includes driving earlier intervention and collaborating across sectors to reduce fragmentation and treat children in a holistic way.
The CHH model enables all healthcare professionals involved in a child’s care to regularly communicate as part of an MDT, making it faster and easier to address any issues. This could include GPs, paediatric consultants, social care managers, school nurses, mental health workers, etc. Existing CHHs in NWL are well-evidenced, with outcomes including:
• 81% reduction in outpatient appointments
(42% shifted to out of hospital, 39% avoided)
• 22% reduction in A&E attendances
• 17% reduction in paediatric admissions
Our approach to selecting the Implementation Sites to trial and scale mental health provision in CHHs, was informed by data on population size, deprivation level, and A&E attendances for children. This gave priority to CHHs that serve a larger population of CYP, operate in more deprived areas where services are likely needed most, and have a higher level of A&E attendances (a large proportion of which are likely to be mental health related). This means that innovation is implemented in Hubs where it can have greatest impact.
Using this data-driven approach, we invited applications from relevant PCNs (which host CHHs) and selected two sites that aligned with the following selection criteria: Mission ambition, leadership,
and readiness.
During the last quarter of 2024/25, we’ve worked with K+W South PCN in Brent, and South Fulham PCN in Hammersmith and Fulham. Using our expertise in service design, system convening, and insights from extensive stakeholder engagement, we’ve supported co-creation of the workflow for CHH’s with mental health and ND integration. This has included:
• Mapping the local pathways, pain points and opportunities
• Conducting stakeholder mapping
• Creating a library of easy access resources
• Enabling better IT integration by linking IT teams across the ICB, borough teams, and PCNs
• Making connections between the Hubs and innovators with specific solutions that could manage pain points
• Working closely with the voluntary, community and social enterprise sector (VCSE), including Barnardos children’s charity, to facilitate discussion on CYP mental health social prescribing competencies, and the Centre for ADHD & Autism Support to enable greater understanding of their borough offers for frontline awareness
We’re now conducting an evaluation of these phase one sites. Early indicators suggest this approach has improved GP awareness of CHHs in their PCN patch, as indicated in qualitative feedback from
one hub lead. It has also improved awareness and linkage with system mental health/ND services. Outcomes of the evaluation will inform plans to scale this approach.
“I don’t think we have ever had such a complete MDT meeting… I feel the pilot is fully to thank for that.”
– Healthcare Professional, Child Health Hub
