Meet the team
Continuous Improvement Manager
Sheffield Children's NHS Foundation Trust
- England - Yorkshire and Humber
Improvement Project Manager
Sheffield Children's NHS FT
- England - Yorkshire and Humber
- Edd Crawley
- Karen Arnold
- Laura Freeman
What is the challenge your project is going to address and how does it connect to your chosen theme?
Roma/Slovak children do not regularly access healthcare in Sheffield. These families are predominately based in the North of Sheffield and access to the Children’s Hospital is via two buses and can be expensive. The Was Not Brought rate for Roma children during 2018/19 was approximately 30% compared to the average of 11.7%. Health literacy is low and therefore engagement with families on health issues can be challenging. These families and their children have well-documented genetic health conditions, including ophthalmic and audiological issues, which result in late diagnosis and long-term follow up, leading to significant challenges for the health providers in Sheffield. The aim of this project is to reduce some of these barriers, delivering services that these families are more likely to access for their children and therefore improve health outcomes. It will also give clinicians experience of working with other professions eg. GPs and learn from their approach.
What does your project aim to achieve?
There is currently a health drop in facility at one of the local schools which is run by Health Visitors. This has proved very successful, with many Roma/Slovak families accessing the support and advice at times to suit them via the drop in arrangement. We would therefore like to build on this approach and develop the offering to include paediatric input to these families on the same drop in basis. This provides an opportunistic approach which could potentially identify health issues that might not be prioritised by these families as requiring further investigation. The aim, therefore, is to increase attendance of children at clinics, deliver care to children in a familiar environment ie. their local school, improve the health outcomes for children from the Roma/Slovak community and work alongside vGPs and other professionals to improve children’s services in these deprived areas.
How will the project be delivered?
The project will be delivered by a multi-disciplinary team which will include Consultant Paediatricians and will have a dedicated Improvement Project Manager. The governance of the project will be overseen by Sheffield Children’s Transformation Programme Board which has workstreams for Modernising Outpatients and Partnership working. It will be managed through an evidenced based Project Management methodology with clear lines of responsibility and escalation. We will also use quality improvement tools such as a Microsystems approach, to ensure that those involved have a clear understanding of the project aim and are supported to implement Plan Do Study Act (PDSA) cycles.
We have strong working relationships with other partners across the City including the Children & Young People’s Health and Wellbeing Board and the Sheffield Accountable Care Partnership and there are other existing forums within the voluntary sector eg. Young Healthwatch where this project will report into.
What and how is your project going to share learning throughout?
We anticipate that the learning from this project will be around strategies to engage with Roma communities to improve health literacy, particularly in areas of high deprivation and poverty. In addition, we expect to learn what best practice exists and how it can be deployed in alternative ways, e.g. in schools, community centres and patient homes and how we work with our partners to deliver this.
We have a citywide Childrens Health and Wellbeing Board. This board is made up of many public sector bodies in Sheffield, and the learning from this project will be shared through this forum. In addition, this board is part of a research project, led by the University of Sheffield looking at how children’s services are developed in Sheffield using a systems-based approach. The findings of this research will be shared widely across the country and beyond to help other health organisations to develop more cohesive links and how best to deliver joint services.
How you can contribute
- Any examples of similar ideas, and what they have learned
- Any examples of working with Roma communities, and how they've worked with these families
- Any examples of working with communities in areas of high deprivation, and what they've learned
- Provide challenge on the idea to help improve it
- Act as a champion to encourage others to consider whether similar ideas may work in their own areas
- Generate potential solutions and suggestions for further exploration
|29 Feb 2020||Scoping, recruitment, and SLAs in place|
|31 Mar 2020||Mobilisation complete, and Marketing commenced|
|1 Apr 2020||First Health Drop In Session|
|30 Jun 2020||3 Month Review to commence|
|31 Jan 2021||Evaluation to commence|
|28 Feb 2021||Decision of whether to continue drop in to be made.|
|31 Mar 2021||Evaluation Complete, Pilot of Q Funded drop in to cease.|
20 May 2020
The project has established a health drop in café at a local school every Thursday morning during and after the school’s breakfast club (8.15am to 12 noon depending on demand). The café is run by Health Visitors and is aimed specifically at Roma/Slovak families to enable them to easily access support and advice at times to suit them via the drop in arrangement. In addition there is consultant paediatric input to these families on the same drop in basis every other week. This provides an opportunistic approach which could potentially identify health issues that might not be prioritised by these families as requiring further investigation and deliver care to children in a familiar environment ie. their local school.
What have we learned so far, either from the successes we have had or from where things haven’t gone to plan?
Due to the situation with the Coronavirus pandemic, the health café is not running at the current time. We ran the one and only session at Owler Brook Primary School in Fir Vale, Sheffield, on Thursday 12 March before the country went into lockdown. The photograph below shows Cath, one of the Health Visitors, setting up for the first session, which was attended by 6 parents (all mums) mainly from Pakistani backgrounds, there were no Roma/Slovak families there that day. There was also an interpreter at the session who interacted with the mums. At the time, there were a few questions regarding Coronavirus and the impact on children, but mainly general conversation about what the health café could offer in the forthcoming weeks.
It was a great start and following a de-brief at the end of the session, we recognised the need for us to reflect and consider how we could engage more Roma families in attending. We also needed to be clear about how and what data would be collected at each session to ensure that there was sufficient information to undertake the evaluation at the end of the project. We were also aware that the Consultant Paediatrician could not be released from her current clinic on a Thursday morning until the end of April, which meant that the café would run without medical input for the next 6 weeks or so. This was not felt to be detrimental to the project as the health visitors could start to develop the sessions and get to know the families better.
What could others learn from our experience of working with a range of stakeholders and collaborating across boundaries (geographical, professional, sector) – what is working well and any challenges we have faced?
The main stakeholders involved so far are the school headteacher and the school’s head of early year’s foundation stage. Both have been eager to help set up the café as they recognise the challenges that this community face. The health visitors have already enjoyed a good relationship with the school and therefore had a foundation on which to build further conversations regarding the set up of the project. Whilst the focus is on Roma/Slovak families, the health café is open to all families attending the school and this was an essential part of the agreement to use the school. Some mornings up to 60 families attend the breakfast club, where free breakfast is provided to the child attending the school, their siblings and their parents. It was therefore an ideal opportunity to use the breakfast club as it was already well established and valued by the community.
We have also received an enquiry from a local GP surgery who we had been in contact with about the project, asking if they could work alongside us to help to build a resilient resource for the Roma Slovak community. We were in the process of inviting them along to attend the meetings as they know the community very well and could help us to raise awareness of the café. Once we are back up and running, we will make contact with the GP surgery to continue these discussions and find out what we could do to work together.
All in all, it was a great start to the project and we will be having discussions over the next few weeks to agree a recovery plan for when the café can start up again. My guess is that this will not be before the Autumn term begins in September.