Integrated Childrens Services for Asthma Patient - Case Study Example

 Integrated Children’s Services for Asthma Patient Introduction There are a variety of options available for children within the children’s services program. These options all allow for children with health or social issues to receive adequate health and social services. Integrated services can be considered for these children in order to ensure that they receive adequate health and social services. This paper shall consider how professionals/individuals from children’s services could provide an integrated service for a six year old child with asthma. It shall critically analyse the concepts of partnership and collaboration in relation to outcomes for children and young people. It shall evaluate contemporary policies and laws associated with partnership working and collaborative care of children and young people. It shall also critically appraise the roles, responsibilities and relationships between professionals within and across sectors and with children, young people, and their families. Finally, this paper shall critically debate the factors which enhance and inhibit partnership and collaborative working and the implications for children, young people, their carers, and/or their families. This paper is being carried out in order to establish a clear and thorough conceptualization of services for children with asthma and similar afflictions. More specifically, this case shall discuss the case of Elliot who is 6 years old and is in his first year at the same primary school as his brother. Elliot has severe asthma and takes inhalers every day. He has already had several hospital admissions due to his asthma. His father, James, smokes and has been encouraged by the asthma nurse to stop his habit because this would benefit Elliot immensely; however, James is finding this a difficult habit to break. Discussion Collaboration and coordination of services Collaboration in relation to securing children’s health and services can be seen in different contexts. Part of the complications associated with collaboration is that the term includes different inclusive arrangements. Five levels of collaboration can be considered in this process. First is communication, where individuals from various disciplines talk with each other; second is cooperation, where there is low key joint working on a case-by-case basis; third is coordination, where more formalized joint working without sanctions for non-compliance is applied; fourth is coalition, where joint structures merge to create new joint identity; and finally, integration, where organizations merge to create new joint identity (Horwath and Morrison, 2007). In effect, collaborative partnerships can be seen in terms of the local and formal contribution, including whole agency collaboration. Collaboration is focused primarily on delivering services for individual users; then it relates to staff working with each other in order to deliver local services; lastly it refers to whole systems collaborating in relation to planning, commissioning, and managing services (Horwath and Morrison, 2007). Governments have now recognized the need to implement an interconnected relationship between the child and the individuals performing the services. With the implementation of the policies of “Every Child Matters,” coordinated services are now being available from all departments and agencies involved in children’s services. In considering the outcomes of collaboration for Elliot who is asthmatic, the concepts of collaboration includes the cooperation and collaboration of the child’s GP, family members, health visitors (health); and teachers, classmates (school); social services for assistance in relation to financial needs and support. The cooperation of these individuals is needed because their actions can all impact on the child’s health. The lowest level of coordination is related to each individual user. For Elliot, the coordination is focused on him first and on the immediate individuals involved in his care, which may include his parents and the primary caregiver. In this case, the coordination refers to his family, especially his father who needs to coordinate with other family members to effect the process of change in his life – that of quitting smoking. The next level refers to the staff working together to deliver local services. This involves then the coordination of the staff members – in the hospital or clinic where Elliot is receiving his medical care. This would include his GP, his nurses, pharmacist, social workers, and other individuals involved in his health care. Their coordination involves the close discussion and communication with each other in the delivery and implementation of interventions for Elliot’s care. The highest degree of integration is seen when whole systems collaborate in relation to planning, commissioning, and managing services (Horwath and Morrison, 2007). For Elliot, this degree of integration and coordination now includes the participation of the community and the entire health care system in planning and managing all the services that he would need in order ensure the efficient management of his disease. Contemporary policy and legislation After the death of eight year old Victoria Climbie in 2000, actions were made in order to introduce new laws for the protection of children in England. The government came up with the ‘Keeping children safe’ report and the ‘Every Child Matters green paper’ which then became the Children Act of 2004 (NSPCC, 2010). This act was not meant to replace or amend the Children Act of 1989, but it sets forth the processes for integrating services for the children to attain five important outcomes under ‘Every Child Matters,’ which are: stay safe; enjoy and achieve; make a positive contribution; and achieve economic well being (NSPCC, 2010). This act also highlights the important responsibility of local authorities in appointing a director for children’s services and a lead member who is elected to manage the children’s services and who can be held responsible for the delivery of services. This act has also placed a duty on local authorities and the police, health service providers, and the juvenile justice system to work with each other in safeguarding the wellbeing of children and to help safeguard and promote the welfare of children (Barker, 2009). This act has also placed the Local Safeguarding Children Boards on the same legal footing; also giving them responsibilities of investigating and reviewing child cases of illness or deaths in their areas. This act revises the laws on physical punishment and punishing the act of hitting a child if such act causes mental harm or if it leaves a lasting mark on the child’s skin (NSPCC, 2010). It repeals the parent’s defence of ‘reasonable chastisement’ in the reprimand of their children. After the Children Act of 2004, the Children and Young Persons Act of 2008 set forth various recommendations for high quality care and services for children in care (NSPCC, 2010). These laws and policies help provide a firm basis for authorities and service providers involved in the Elliot’s care. The coordination needed from the different agencies is supported by the Children Act of 2004 because it directs the agencies and the service providers to coordinate with each other and promote the welfare of children. Their failure to cooperate and coordinate with each other is under threat of legal sanctions as it also mandates police authorities to carry out their tasks in monitoring service providers and other people involved in the child’s care. The asthmatic Elliot is entitled to legal protection under these mandates because he needs more than the usual amount or standard of care. He has been hospitalized more than once due to his asthma. The different individuals and agencies involved in his care are legally mandated to coordinate their activities with each other and ensure that these activities are in line with the goals of ‘Every Child Matters’ which are to: stay safe; enjoy and achieve; make a positive contribution; and achieve economic well being (NSPCC, 2010). Appraisal of roles, responsibilities, and relationships between professionals There are various individuals involved in the care of an asthmatic child. The medical profession alone would involve the patient’s paediatrician, nurse, and in some instances a respiratory paediatrician; a social worker would also be involved, as well as the child’s family members, and the local police authorities. The medical team involves the child’s paediatrician, nurse, and in some cases, a respiratory therapist (Cave, 2008). The child’s paediatrician would be involved in the child’s medical care; in monitoring the child’s health; and in prescribing the appropriate medications for the child’s care. He would also be recommending the appropriate medical care which the nurse and other members of the medical team can implement (Cave, 2008). This paediatrician would have to coordinate his activities and recommendations to the nurse and the other members of the medical team. The nurse is there to deliver care; to offer emotional support for the patient and his family; to implement the doctor’s orders; to implement constant and continuous monitoring for the patient. Her role is to coordinate the medical services needed by the patient – across departments and medical units (Barron, 2009). Since she spends the most time with the patient, her role is also to provide health education to the patient and his family; and to teach them about Elliot’s disease – the proper interventions he needs, and the remedies they can implement in order to assist Elliot in managing the symptoms of his disease (Barron, 2009). The respiratory therapist can assist in the management of Elliot’s disease because he can recommend efficient measures which would ensure that Elliot’s breathing and oxygen saturation would be adequate (Schroeder, 2004). In some instances, the pharmacist is also an essential part of the medical team. Her role is to help ensure that Elliot is receiving his medications, in the proper dosage, the proper route, and under the proper combinations with other medications. The medical team must coordinate these services and these functions in order to ensure that Elliot’s welfare is properly secured. The community sector includes individuals who have an involvement in every child’s and his family’s care. They have their own expertise in child care, especially in covering a wider community, identifying the unmet needs, involving users in the delivery of services, and in developing innovative practice (Department for Education, 2003). The government’s role is to remove the barriers to increased participation in service planning and delivery. The schools also have important roles to play in order to help the child realize their full potential. The role of schools is to improve standards by personalising the learning process in order to fit individual student goals, circumstances, and talents (Department for Education, 2003). In other words, the goal of the program is to “ensure all children have the opportunity to fulfil their potential and those with complex needs receive responsive services, quickly and accessibly on a graduated basis” (Department for Education, 2003, p. 38). In effect, schools and communities are encouraged to work with communities and specialist services in the care of each child. In the case of Elliot, his school needs to be involved in his care in order to ensure that his learning process would fit his individual needs and circumstances, despite his health limitations. The presence of health professionals in the school is also an important addition to each institution because it helps ensure that efficient medical care for the child would be at hand at all times. Health services and professional health care givers have a critical role to play in a child’s life. Health services are important options for children who cannot afford health care or who are living below or within the poverty line. These services seek to balance out society’s situation in relation to the rich and the poor members of the community. Coordination with the Department of Health has been set forth in order to carry out a public consultation on how to improve the nation’s health, including the health of children (Department for Education, 2003). Such consultation was carried out in order to address the roles and responsibilities of individuals and of government authorities involved in the child’s care; this consultation also helped to address issues in relation to obesity and smoking. As a government agency, the NSF has a crucial role to play in implementing much needed changes in the health and social services program. The NSF’s role is to impose standards of care and improve health outcomes for children, while supporting a wider vision for children (Department for Education, 2003). Such services are secured by encouraging Primary Care Trusts and other health bodies to coordinate with local authorities to create Children’s Trusts. These services include: maternity and child health promotion; sexual health; school health; child and adolescent mental health services; speech and language therapy; and community and acute paediatrics (Department for Health, 2003). In relation to Elliot’s care, his needs cover the services offered under Primary Care Trusts. The coordination of care for his health needs have to be coordinated with the NSF and the health bodies involved in the delivery of health care services. Factors that enhance and inhibit collaboration Factors which enhance the partnership and collaborative working relate to the common goals and mandates which have already been set forth under the Children Act of 1989, and then later by the Children Act of 2004. Setting forth the standards of collaboration and coordination into law helps redirect the activities of the health and other professionals and individuals involved in the patient’s care – towards the goals which help affirm the child’s well-being. The groundwork for coordination has already been set forth by previous laws and these laws were reaffirmed and strengthened, thereby helping in the current implementation of coordinated activities. Factors preventing the collaboration process mostly involve practical financial considerations. Implementing the mandates of the programme, ‘Every Child Matters’ is a costly and time-consuming enterprise and the authorities are aware of this fact. They consider this a barrier to the actual implementation to the promotion of children’s welfare. Nevertheless, efforts have been made by the government to allocate adequate resources for the implementation of the programme and in safeguarding children’s welfare (House of Commons, 2005). In considering the above factors, it is important to note that local authorities need to enhance and maintain the links which they already have established with other agencies and individuals involved in the child’s care. These links and networks are essential to the efficient delivery and communication between and among those involved in the child’s care. In strengthening the network, it is possible to assist not just the child, but his family as well. In Elliot’s case, his father may also be assisted in the process of quitting his smoking habit in a strong effort towards helping his son. The barriers affect the delivery of efficient health services because it forestalls the process of caring for the child’s health and welfare—not just for Elliot, but also for millions of children needing essential services. Conclusion The discussion above sets forth important points under the programme ‘Every Child Matters’ as applied to Elliot who is an asthmatic child. The importance of collaboration was highlighted in this discussion and this collaboration is essential from the members of the team involved in the child’s care – from the health care team, to the teachers, and even to the police and law enforcement authorities. The importance of this collaborative aspect of securing a child’s welfare was discussed in terms of individual functions which eventually end up being a major determinant or improved child outcomes. Works Cited Barker, R. (2009) Making Sense of every child matters, multi professional practice guidance. London: Policy Press Barron, K. (2009) Health inequalities: written evidence. London: Stationery Office Publications Cave, J. (2008) Managing the acutely ill child. Br J Gen Pract, volume 58(549): pp. 228–229 Department for Education (2003) . Every Child Matters. Retrieved 04 March 2011 from http://www.education.gov.uk/consultations/downloadableDocs/EveryChildMatters.pdf Horwath, J. & Morrison, T. (2007) Collaboration, integration and change in children’s services: Critical issues and key ingredients. Child Abuse & Neglect, volume 31; pp. 55–69 House of Commons. (2005) Every Child Matters Ninth Report of Session 2004–05. Retrieved 04 March 2011 from http://www.publications.parliament.uk/pa/cm200405/cmselect/cmeduski/40/40.pdf Schroeder, C. (2004). Introduction to medical terminology. London: Cengage Learning The National Society for the Prevention of Cruelty to Children (2010). An introduction to child protection legislation in the UK. Retrieved 04 March 2011 from http://www.nspcc.org.uk/Inform/research/questions/child_protection_legislation_in_the_uk_pdf_wdf48953.pdf Read More