Archived decisions
Appendix One
Key questions to be addressed
Each of the points outlined above have been developed below to provide a checklist of questions that may need to be considered. This is not meant to be exhaustive and may not be relevant to all proposals for changing services.
The assessment process suggested requires that the health body responsible for taking the proposal forward co-ordinates consultation and involvement activities with key stakeholders such as service users and carers, the relevant Patient and Public Involvement Forums and other service providers affected by the proposal. The relevant OSCs also need to be alerted at the formative stages of development of the proposal. The questions posed by the framework will assist the NHS and OSCs in determining if a proposal is substantial, identify any additional action to be taken to support the case of need and agree the consultation process.
Name of Responsible (lead) NHS Body: Portsmouth City t PCT Brief Description of the Proposal: Best evidence and the recently published Children's National Service Framework (NSF) highlight the need to re-focus Speech & Language Therapy (SLT) Service provision in this area. These indicate the need to develop early intervention and a preventative approach with pre-school children. Evidence shows that this results in fewer children entering school with significant speech and language difficulties. Additionally, where there are difficulties they will have been identified and targeted prior to Junior School. It will also ensure that SLT resources with junior and secondary aged children are targeted towards developing the communication environment within the school Description of Population Affected: Children with speech & language difficulties in: _ Fareham & Gosport _ Portsmouth City _ East Hampshire Confirmation of Health Overview and Scrutiny Committees Contacted: Name of Key stakeholders supporting the Proposal: Professional Executive Committee for Portsmouth City t PCT Portsmouth City t PCT Margaret Meikle, Professional Adviser/Manager Speech & Language Therapy Teresa Boden, Speech & Language Therapy Manager (Paediatrics) Date: 22 September 2005 |
Criteria for Assessment |
Yes/No/NA |
Comments/Supporting Evidence |
Case for Change 1 Is there clarity about the need for change, eg key drivers, changing policy, workforce considerations, gaps in service, service improvement 2 Has the impact of the change on service users, their carers and the public been assessed 3 Are supporting local health need assessments or health equity audits available 4 Do these include: (a) Demographic considerations (b) Changes in morbidity or incidence of a particular condition (c) Health equality considerations |
yes yes, informally yes yes n/a yes |
NSF focus on Early Intervention and preventative work. Research evidence highlighting the importance of this A detailed consultation plan will be forwarded as soon as this is available Areas of deprivation identified by SureStart and Early Years Projects Resources have been distributed according to clinical need These changes incorporate preparation for mainstreaming SureStart initiatives. The service also covers a number of special schools and specialist resourced provisions and the impact on these has been considered as part of the proposal |
Criteria for Assessment |
Yes/No/NA |
Comments/Supporting Evidence |
| (d) Potential reductions in care needs, eg falling birth rates (e) Comparative performance 5 Has the evidence base supporting the change proposed been defined. This should cover both with national service improvement programmes, eg NSFs, modernisation agenda and the development of clinical best practice to enhance service quality or the patient experience 6 Have the clinicians affected contributed to the development of the proposal 7 Is any aspect of the proposal contested by the clinicians affected |
n/a yes yes yes no |
There is a comparative increase in care needs due to more children with special needs surviving early difficulties National Benchmarking Reference list attached. Evidence has shown that children's needs are not effectively met through current practice. Children's NSF encourages early involvement. Children will be supported throughout the school day as part of a whole school approach to enhancing communication skills Consultation and development of these ideas since November 2003 via whole staff meetings and a small working group to tackle specific development tasks for the project The proposal is staff led |
Criteria for Assessment |
Yes/No/NA |
Comments/Supporting Evidence |
Impact on Service Users 8 Will there be changes in access to services as a result of the changes proposed 9 Can these be defined in terms of: (a) Waiting times (b) Transport (public & private) (c) Travel time (d) Other (please define) 10 Has the impact on vulnerable people using these services, now and in the future, been assessed (as a minimum this should include an impact assessment in line with the Race (Amendment) Act 2000 11 Does the proposal extend the choice available to the population affected |
yes yes n/a n/a n/a n/a yes |
_ Increased access for pre-school children _ A different type of access for new referrals of junior and secondary age children _ Clear access criteria are available Possibly shorter for children up to end of infant school age (6-7 years). For older children there will be no waiting list as many will be supported by colleagues in Education No change in service delivery venues (See also 4(c)) There will be an increased range of options for families of younger children |
Criteria for Assessment |
Yes/No/NA |
Comments/Supporting Evidence |
12 Does the proposal improve the quality of care provided to service users Engagement & Involvement 13 Were key stakeholders involved in the development of the proposal 14 Is there information regarding the involvement of: (a) Service users, their carers or families (b) Other service providers in the area affected (c) The relevant Patient & Public Involvement Forums (d) Staff affected (e) Other interested parties (please define) |
yes yes yes yes yes yes yes |
It will ensure intervention occurs at most effective and beneficial stage of child's life In anticipation of the NSF, Education colleagues were involved in informal discussions. Informal parental feedback has been received during individual meetings with parents and this has contributed to the strategy Plan of action is being developed and will be available shortly The SLT Service provides for East Hampshire, Portsmouth City and Fareham & Gosport. Further formal comments will be invited from both Portsmouth City Council and Hampshire County Council Education Departments A detailed consultation plan will be forwarded as soon as this is available Staff have been fully involved in the development of this proposal Shared with other therapy colleagues in Occupational Therapy & Physiotherapy. Plan to share with wider Community Paediatric Team |
Criteria for Assessment |
Yes/No/Na |
Comments/Supporting Evidence |
15 Is the proposal supported by the key stakeholders 16 Is there any aspect of the proposal that is contested by the stakeholders. If so, what action has been taken to resolve this Options for Change 17 Were a range of options identified to deliver the intended change 18 Were the risks and benefits of the options assessed when developing the proposal 19 Have changes in technology, including new drugs, been taken into account 20 Has the impact of the proposal on other service providers been evaluated |
yes n/a yes yes n/a yes |
_ Professional Executive Committee for Portsmouth City t PCT _ Portsmouth City t PCT _ East Hampshire PCT _ Fareham & Gosport PCT _ Local Educational Authorities _ Some informal discussion with parents Parents and Education staff will be further consulted in the autumn This proposal reflects the most up-to-date evidence of good practice available This is the most effective use of available resources to meet children's needs as identified by best evidence and the Children's NSF For example in the course of joint planning of Individual Education Plans It has been considered. However, further evaluation will be made following more detailed consultation and discussions with Education |
Criteria for Assessment |
Yes/No/Na |
Comments/Supporting Evidence |
21 Will the proposal impact on the wider community affected be evaluated, eg transport, housing, environment 22 Have the workforce implications associated with the proposal been assessed 23 Have the financial implications of the change been assessed in terms of: (a) capital (b) revenue (c) affordability (d) risks 24 Will the change contribute to the delivery of national/local targets
|
n/a yes n/a yes yes yes yes |
More effective use of existing workforce and may encourage staff retention This proposal does not release revenue but does improve accessibility for younger age group There will be no change A possible perception that in some areas the Service has been reduced when, in fact, older children should be receiving greater benefits as their daily communication environment in the classroom should improve _ Children's NSF _ Every Child Matters |