1

Children, young people, parents

and carers will be treated with
respect and given support and
information to enable them to
understand and cope with illness

Children and
or injury and treatment needed.
They will be encouraged to be
active partners in decisions about
their healthcare and where
possible exercise choice.

Young People OUR VISION:

To deliver services that meet the
health needs of children, young

Strategy 2
Children and young people
people, parents and carers and
provide effective and safe care,
through appropriately trained
will receive care that is

2012-2017 integrated and coordinated

around their needs and
that of their family.
and skilled staff working in a
suitable child friendly and safe
environment
Part 1
(strategy includes neonatal services)

3
Children and young people
will receive appropriate
high quality evidence based
care, developed through
clinical governance systems
and delivered by staff with
the right set of skills and
competencies.
4
Care will be delivered in an 5
appropriate location and in Children, young people,
an environment that is safe parents and carers will
and well suited to the age participate in designing
and stage of development NHS services that are readily
of the child and young accessible, respectful,
person. empowering, follow best
practice and provide effective
response to their needs.

1
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Children and Young People Strategy

We want our children to...

enjoy and
achieve
achieve
economic
wellbeing

be
healthy

make a
positive
contribution

stay
safe

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Children and Young People Strategy

What our children say...

give us things keep us safe

to do to take our
mind off being
poorly

talk to us as
well as our
parents

we want a
playground

we want to be
in a separate
children’s area

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Children and Young People Strategy

What our children want...

cared for in a
young people
friendly
environment
access to
internet and
age appropriate
information

good food and

accommodation

staff with
right training
to care for us

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Children and Young People Strategy

What our parents say, we want/need...

Enough
accommodation
so that we don’t
have to leave
Consistent our child
information
from all staff

Enough seats
to be able to sit
at the cotside
with our baby
to be actively
involved in
their care

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Children and Young People Strategy

Core Values & Strategic Themes

Quality of Care & Patient Safety Business Sustainability
Be healthy - Stay Safe Achieve Economic Well Being
l Leadership - supporting and developing leaders in children and young people services l Influence commissioning services for children and young people
l NSF & quality standards l Our vision, our health, our north east clinical partnership
l You’re welcome standards l Fundraising
l Care Quality Commission Standards l Divisional partnership working
l Patient / parent experience
e and resp l Innovation bids
l Patient safety indicators
t, valu ect l Children and young people programme board
l Mental health and psychological well being
or ea and clinical governance structure
l Transition p me n
l Board of Directors - children and young people’s
ove t in s story / annual report

up

ch
l Bereavement services
pr e l Strategic meetings and business planning - children

ff s
l Environment for parents

oth
l Young people’s unit m and young people agenda item and section

rv
within reports and business cases

Sta

er
l Privacy and dignity

ous

ice
l High dependency care Children & l CQUINS
l Quality accounts

delivery
young people

u
l Separate children’s A&E / emergency care centre l High impact actions

n
l children in need of safeguarding
l QIPP
are central to
l Workforce development
l HCA l advanced practitioners Conti everything l Family centred care
l Children and young people forums
l volunteers l nurse consultants we do l Parents forum
l nurse prescribing PGD`s l succession planning l Acute / community forums
l specialist therapy roles l Youth workers
l Practice development - CPDT l Volunteers
l Support for nurses working outside of children’s services l University
l Working groups - programme board l Children’s trusts
l Nurse led discharge l PCT’s / commissioners
l Training strategy for staff caring for children and young people l Voluntary organisations
l Medical staff training /development l Separate children’s section of the main hospital site
l Family nurse partnership l Project groups
l LSCB
Enjoy & Achieve Making a Positive Contribution
Organisational Capability Partnerships & Engagement

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Children and Young People Strategy
Strategic Objectives
Safeguarding children and young people
Ambulatory Care
Provision of an integrated
urgent care service
providing one point of
access for urgent care on
both sites
Provision of child and family
friendly care in an age
appropriate department
Provision of safe and
appropriate initial
assessment of children
Provision of safe and
effective care of the sick
child
Care provided by
appropriately trained and
competent staff
Neonatal Services
Provision of services in
line with NICE specialist
Neonatal standards
Achievement of Bliss
standards
Provision of safe and
effective care of the sick
neonate
Care provided by
appropriately trained and
competent staff
7
Prevent children suffering harm and to promote their welfare, provide them with the services they require
to address their identified needs and safeguard children who are being or who are likely to be harmed
Inpatients
Provision of child centred hospital
services that:
> consider the “whole child”, not
simply the illness being treated
> treat “children as children and
young people as young people
> are concerned with the overall
experience for the child and
family
> treat children, young people
and parents as partners in care
> integrate and coordinate
services around the child and
families particular needs
> graduate smoothly into adult
services at the right time
> work in partnership with
children, young people and
parents to plan and shape
services and to develop the
workforce
Hospital stays will be kept
to a minimum through the
coordinated delivery of care.
Effective discharge planning will
meet the needs of the child or
young person and family.
Care will be provided in a setting
which meets the individual needs
of the child or young person
Outpatients Community
Surgery Services
Children`s outpatient
Provision of south of region surgical service for services are truly Provision of paediatric
Tees Conurbation based at JCUH. Care provided designed around the community services to
in all areas in an environment which is physically
needs of children, meet the needs of children,
separated from adults and will be provided young people and their young people and their
by appropriately trained staff with adequate parents. Provision of
families
caseload to maintain skills: specialist nursing child and family friendly
specialist surgeons specialist support services. Provision of safe and
care in an appropriate effective, evidence based
environment
care in the community
Implementation of the
Healthy Child programme
Child Therapy Services
Achievement of the
Children with identified needs will have equitable national Health Visiting
access to appropriate services. High quality plan & school nursing
general and specialist services will be delivered
review recommendations
in a co-ordinated, planned and timely way,
in collaboration with children, young people Provision of child and
and their parents/carers to optimise health, family friendly community
care in an age appropriate
functioning and well being.
department
Care provided by
appropriately trained and
Medicine competent staff
(including intensive care) Hospital stays are kept to
Children and young people requiring intensive a minimum and care is
care will be cared for in line with the Paediatric transferred to a paediatric
Intensive Care: National Guidance. community team
Children and Young people requiring inpatient Achievement of family
medical care will receive care and support in nurse partnership
line with the children’s national framework programme
and other national guidance.
Achievement of Unicef
accreditation
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Children and
Young People Strategy
Part 2

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Children and Young People Strategy

NSF Framework

Strategic Objectives Target Strategy Vision No.

Safeguarding
Vision At a strategic level, agencies and professionals work in partnership with each other, service users 2
and members of the local community, in accordance with their agreed ACPC (or its successor, the
Local Safeguarding Children Board) annual business plan.
Agencies develop, implement and evaluate the effectiveness of policies, procedures and 2
practices for safeguarding and promoting the welfare of children and young people including
those concerned with the recruitment and management of staff
Where there are concerns about a child's welfare, an assessment is undertaken in accordance 2
with the Framework for the Assessment of Children in Need (1) and their Families and plans are
made, implemented and reviewed which result in each child achieving their optimal outcomes.
Children and families are actively involved in these processes unless this would result in harm to
the child
All staff are alert to the increased likelihood of harm being suffered by disabled children, or by 2
those children who are living in special circumstances, whose needs may not be recognised by
staff in statutory agencies and who, therefore, are 'invisible' to the system.
A broad range of integrated, evidence-based services are available to prevent children and 2
young people from being harmed, safeguarding those who are likely to suffer significant harm,
and address the needs of those children who have suffered harm, at the same time, providing
support to their parents/carers.
Agencies provide staff working with children, young people and families with supervision and 2
with support to enable them to manage the stresses inherent in this work, implement systems
which quality assure the services they provide or commission, and ensure their staff use effective
systems to record their work with children and families.

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Children and Young People Strategy

NSF Framework

Strategic Objectives Target Strategy Vision No.

Safeguarding
Staff (at all levels) understand their roles and responsibilities regarding safeguarding and 2
promoting the welfare of children and young people and are appropriately trained to
undertake these effectively.
All agencies have in place safe recruitment practices for all staff in contact or working with 2
children
Prioritising Safeguarding At the strategic level, all agencies in contact with children and young people, including health, 2
and Promoting the Welfare social services, education and housing, should work together, and with service users and
of Children and Young members of the local community, to plan comprehensive and co-ordinated children's services
People which address the needs of all children and families living in their area.
At both a strategic and individual agency level, there should be a commitment to safeguarding 2
and promoting the welfare of children which is reflected in local policies and procedures.
Local strategic partners identify children and young people's welfare as a priority and each 2
constituent agency includes safeguarding and promoting children's welfare as a key priority
area in their strategic partnership plan for children and the Children and Young People's Plan.
The processes for developing these plans should also reflect this commitment.
All agencies ensure that the Local Safeguarding Children Board (LSCB), is effective in 2
safeguarding and promoting the welfare of children and young people through the provision of
adequate financial and human resources, senior management representation and adherence to
its policies and procedures. (Working Together to Safeguard Children (4))
Agencies work in partnership within the framework of Multi-Agency Public Protection 2
Arrangements (MAPPA) to safeguard and promote the welfare of children and young people.
(Criminal Justice Act 2003 (5); The MAPPA Guidance (6).)

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Children and Young People Strategy

NSF Framework

Strategic Objectives Target Strategy Vision No.

Safeguarding
Senior management in all agencies demonstrates leadership, is informed about, and takes 2
responsibility for the actions of their staff in providing services to children, young people and
families which safeguard and promote the welfare of children. Agencies have systems in place
to safeguard and promote the welfare of children and young people in special circumstances
i.e. those children whose needs are often not recognised or addressed by services - universal,
targeted or specialist.
Promoting the welfare of All agencies promote awareness, within the community and among professionals, of children 2
children and young people's rights under the United Nations Convention on the Rights of the Child
(7) (in particular Article 19 - the right to be protected from harm) through public education
campaigns, and training and supervision for staff at all levels within the organisation. The
methods used to communicate with the public are sensitive to the cultures and languages of
local community members.
All agencies have comprehensive single and multi-agency policies and procedures to safeguard 2
and promote the welfare of children which are easily accessible by staff at all levels within each
organisation
These policies and procedures are informed by the policies and procedures of the ACPC or its 2
successor, the LSCB, which in turn, are in line with legislation, regulations and government
guidance
All agencies have in place safe recruitment practices for all staff, including agency staff, students 2
and volunteers, working with children. Where a criminal record review on employment is
mandatory, these are undertaken routinely.
All agencies have in place comprehensive policies and procedures for addressing allegations 2
against staff which take account of the recommendations from Lost in Care (13), the inquiry into
the abuse of children in care in North Wales.

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Children and Young People Strategy

NSF Framework

Strategic Objectives Target Strategy Vision No.

Safeguarding
All organisations have in place and promote robust complaints and whistle-blowing policies 2
which are extended to all commissioned services. Agencies offer a guarantee to staff and service
users that using these procedures appropriately will not prejudice their own position and
prospects.
Roles and Responsibilities 2
Each NHS Trust is required to designate a named doctor and a named nurse and named 2
midwife who takes a professional lead in the Trust on safeguarding children matters. These
named professionals have expertise in children's health and development, the nature of child
maltreatment, and local arrangements for safeguarding and promoting children's welfare.
A named professional is responsible for conducting the NHS Trust's internal case review as part 2
of a serious case review (except when she/he has had substantial personal involvement in the
case and then it is the responsibility of the designated professional for the Primary Care Trust
area).
Serious case reviews are conducted: 2
When a child dies, and abuse or neglect are known or suspected to be a factor in the death; 2
Where a child sustains a potentially life-threatening injury or serious and permanent impairment 2
of health and development, or has been subjected to serious sexual abuse, and the case gives
rise to concerns about interagency working to safeguard children.
All services ensure that their staff are competent and confident to contribute to serious case 2
reviews.
Agencies implement the findings from serious case reviews to improve services 2

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Children and Young People Strategy

NSF Framework

Strategic Objectives Target Strategy Vision No.

Safeguarding
Recognising a Child or Local authorities, NHS Trusts and Primary Care Trusts ensure that where there are concerns about 2
Young Person who requires impairment to a child or young person's health or development, or where abuse or neglect is
protecting from harm known or suspected, a timely and thorough multiagency assessment is undertaken, led by social
services. (Children Act 1989 (9); Working Together to Safeguard Children (4); Framework for the
Assessment of Children in Need and their Families (1))
During the assessment, professionals ensure that the child is seen by social services and 2
communications by all professionals are conducted in a manner which is appropriate for the
child's age, developmental stage and method of communication.
This assessment brings together information from a number of sources, including from the child 2
and family, which is then analysed and a judgement made about whether the child is in need,
if he or she requires protection from harm, and what services are required to meet the child's
identified developmental needs and provide support for the family. See Standard 3
Disabled Children Professionals who come into contact or work with disabled children are aware of their increased 2
vulnerability to neglect and abuse, and respond to concerns about their safety and welfare.
(Assessing Children in Need and their
Children in Special All professionals in contact with vulnerable children and young people are aware of the need to 2
Circumstances identify and support children and young people who are not receiving the services they need,
and make particular efforts in working together to support them.
All professionals in contact with vulnerable children and young people are: 2
Able to recognise situations, and are competent to respond, when a child or young person 2
might be involved in, or be at risk of becoming involved in, prostitution in line with the
Government Guidance Safeguarding Children Involved in Prostitution.
Aware of the new offence of commercial sexual exploitation of a child. 2

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Children and Young People Strategy

NSF Framework

Strategic Objectives Target Strategy Vision No.

Safeguarding
If there are concerns that a child is being deliberately harmed through fabricating or inducing 2
illness, the Government's Guidance 'Safeguarding Children in whom Illness is Fabricated or
Induced'(26) is followed
The impact adult problems All practitioners working with children and families and with parents who are experiencing 2
can have on children’s personal problems, should ensure that the needs of their children are assessed and that
development appropriate services are delivered to these children and their families
All staff working with women and children are alert to the relationship between domestic 2
violence and the abuse and neglect of children, and that witnessing domestic violence also
constitutes harm to a child or young person. (Children Act 1989)
All practitioners are trained and equipped to include routine questions about domestic violence 2
in all assessments, including ante-natal care. See Standard 11
All staff are aware of and supported by a local multi-agency agreement on the thresholds for 2
referral to social services in cases where there is domestic violence.
Services for Children and Local authorities, NHS Trusts and Primary Care Trusts ensure that integrated services are 2
Young People who are At available to respond in a co-ordinated manner to the assessed needs of children and young
Risk of being or have been people and their families where a child has been or is at risk of being abused or neglected.
Abused or Neglected
The types of programmes offered are based on best available evidence of what interventions are 2
effective and are subject to regular audit, the findings of which inform future service provision
Recording All staff maintain an accurate, clear record of their involvement with a child and family on a 2
routine basis. The record is clear, accessible, comprehensive and contemporaneous with both
judgements made and decisions taken carefully recorded. It is dated, signed and the person's
name legibly written at the end of the record entry.

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Children and Young People Strategy

NSF Framework

Strategic Objectives Target Strategy Vision No.

Safeguarding
All decisions and disagreements about specific decisions are recorded in children and young 2
peoples' health, social care and/or education records as appropriate.
Measuring Outcomes All services routinely audit and evaluate their work. The data collected is made available, in 2
appropriate form, to practitioner, users and commissioners.
As a minimum, all services evaluate outcomes from the perspective of users (including, where 2
possible, the referred child or young person themselves as well as key family members or carers)
and providers of the service
Resources, including administrative and practitioner time and IT equipment, are available so 2
that routine evaluation of outcomes can be carried out in all services.
Quality of Care / Quality All agencies have in place robust information systems which enable them to monitor practice 2
Assurance and the management of work with children and families to ensure their welfare is being
effectively safeguarded and promoted.
All agencies have in place a programme of internal audit and review which enables them to 2
continuously improve the protection of children and young people from harm or neglect. The
information from these audits is included in the agency's report to the ACPC and its successor
body, the LSCB. Policies, procedures and practice are refined or changed in the light of this
information.
Good Supervision of staff Agencies provide appropriate supervision to staff who work directly with children and young 2
working with Children people and specifically in relation to cases where there are concerns about harm, self-harm or
and Families, including neglect of a child or young person. This includes the supervisor regularly reading the case files to
monitoring of individual review and record in the file whether the work undertaken is appropriate to the child's current
cases needs and circumstances, and is in accordance with the agency's responsibilities

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Children and Young People Strategy

NSF Framework

Strategic Objectives Target Strategy Vision No.

Safeguarding
Training and continuing All staff who work with or come into contact with children, young people and their families 2
staff development have the common core of skills and competencies outlined in Standard 3. Staff in all settings are
competent to recognise indicators that a child or young person's welfare or development may
be being impaired or she/he is, or may be at risk, of suffering harm. This is achieved through
ongoing staff training, guidance and supervision.
All staff are alert to the messages (verbal and non-verbal) children and young people are giving 2
them about their safety and welfare and know how to respond and communicate with them
to establish their wishes and feelings. This includes children who have specific communication
needs or for whom English is not their preferred language.
All settings should have staff who are competent to: 2
complete a nationally specified common assessment for a child or young person, and 2
working with social services, contribute collaboratively to a child in need assessment of the child 2
or young person's developmental needs, and the capacity of their parents to respond to the
child or young person's needs within the wider family and community in which they live.
Specialist single agency and multi-agency training is provided for designated and named 2
professionals, child protection specialists, key workers and senior managers, governors and
members with special responsibility for children and young people, to enable them to fulfil their
responsibilities for safeguarding and promoting the welfare of children.
All agencies ensure that they resource their safeguarding and promoting the welfare of children 2
responsibilities e.g. enabling staff to attend multi-agency and other specialised training.

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Children and Young People Strategy
NSF Framework
Strategic Objectives
Ambulatory Care
An integrated urgent care
system
Child and family friendly
care in an age appropriate
environment
Safe and appropriate initial
assessment of children
17
Target Strategy Vision No.
All front line staff delivering urgent care to children are competent in the basic skills required 3
for safe practice
Working with commissioners we will ensure safe urgent care provision for children in the local 3
geographical area
Notification of the child`s attendance at any urgent care setting should be made in a timely way 2
to the primary care team
Staff will prevent unnecessary hospital admissions by being aware of alternative options and 3
developing care pathways for community and paediatric colleagues
Children and young people will be cared for in an environment which is appropriate to their age 4
and development which is separate from adults
As well as audio visual separation from adults, consideration will be given to security issues, 4
availability of food and drink, and breast feeding areas, and hygienic, safe play facilities
Achievement of You`re Welcome standards 2
Play specialists will provide appropriate support and care at peak times of attendance 4
Comments will be sought from children to improve services and facilities 5
Provision of facilities to meet parent’s needs 5
All children will be visibly assessed within minutes of arrival, to identify an unresponsive or 2
critically ill child
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Children and Young People Strategy
NSF Framework
Strategic Objectives
Ambulatory Care
Safe and appropriate initial
assessment of children
Safe and effective care of
the sick child
18
Target Strategy Vision No.
A brief clinical assessment will occur within 15 mins of arrival 2
A system of prioritisation for full assessment will be in place if the waiting time exceeds 15 mins 2
Initial assessment must include a pain score 2
Registration details must include specific additional information (e.g.: health visitor, school 2
nurses, school attended, accompanying adult)
Staff caring for children and young people will have access to an appropriate range of drugs and 3
equipment with the support of the children’s pharmacist
All staff caring for children and young people will be trained in basic life support. Nurses 3
working in emergency departments will be PILS / PLS or equivalent trained. Consultants in
emergency medicine, nurse practitioners and if possible senior trainees dealing with acutely
unwell children will be APLS / EPLS trained
Support is available for advanced airway management 3
Paediatric anaesthesia is carried out by competent staff 3
The facilities and staff required to establish high dependency care and intensive level care for 4
airway and respiratory support are available
Systems are in place to ensure safe discharge of children, including advice to families on when 2
and where to access further care if necessary
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Children and Young People Strategy

NSF Framework

Strategic Objectives Target Strategy Vision No.

Ambulatory Care
Appropriately trained and Nursing staff will have as a minimum basic competence in both emergency nursing skills and in 3
competent staff care of children
There will be at least one RN (child) or RSCN per shift to care for children and young people 3
Additional training in paediatric skills will be facilitated for all staff in the ambulatory care 3
setting and there will be a long term strategy for recruitment and retention of paediatric-skilled
nurses
Safeguarding of children Achievement of National Safeguarding Standards under the leadership of the children and 3
and young people young people safeguarding governance group
Major Incidents involving Specific care of children and young people are included in the Trust`s major incident plan 2
children
Bereavement support The recommendations of the Kennedy Report are adopted 2
Parents witnessing resuscitation are supported by a member of staff 2
Following the death of a child early information is shared with the lead paediatrician for child 2
death
Following the death of a child the family will receive an effective bereavement support service 2
which meets their needs
Recommendations from CDOP panels will be implemented within the organisation 2

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Children and Young People Strategy

NSF Framework

Strategic Objectives Target Strategy Vision No.

Ambulatory Care
Networking, Information Subscription to the Trauma Audit and Research Network (TARN) takes place 3
system and data analysis
Staff will participate in and plan audit and research projects specifically in relation to care of 3
children and young people
Staff will link with regional and national working parties in relation to care of children and 3
young people in the urgent care setting
Patient experience Deliver year on year improvement in patient and carer experience 2
Service development Partnership working to ensure children and young people and their parents / carers are involved 5
in service developments
Workforce Recruitment and training of nursing staff to provide paediatric nurse practitioner role over 7s 3
day per week
Severely injured child Appropriate separate audio visually separate facilities are available to receive severely injured 4
children
Ambulatory Children’s area The ambulatory children’s area will have appropriate facilities to ensure children and adults are 4
separated for diagnostic procedures

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Children and Young People Strategy
NSF Framework
Strategic Objectives
Inpatients
Service provision
Nutrition
Transition to adult services
Participation and
Partnerships / User
Consultation and
Involvement
21
Target Strategy Vision No.
Services are well coordinated, particularly for those with complex conditions who may benefit 2
from having someone available who can act as a key worker
A nutritional diet is provided with choices that are appropriate to age, cultural needs and health 2
needs and meet children`s individual preferences and development needs
Transisiton of children with long term conditions to adult services will be appropriate to age, 4
cultural needs and health needs and meet individual children`s needs
A Trust wide lead for Transition is appointed to lead this programme of work 3
For children with long term conditions transition to adult services will be at the 18th birthday 2
There is a focus on working together, negotiation and information sharing with children, young 1
people and their families to plan deliver and evaluate care.
Year on year improvement for patient and carer experience is achieved through an agreed 1
strategy specifically for children young people and parents which will be measured and monitored
annually
Children and young people are encouraged to be active partners in decisions about their health 1
and care and where possible to exercise choice
Children, young people and families are routinely involved In the planning and improvement 5
of services. Methods of seeking children and young people`s views are consistent with the DOH
You`re Welcome standards
Children and young people will be used during the recruitment process 5
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Children and Young People Strategy

NSF Framework

Strategic Objectives Target Strategy Vision No.

Inpatients
Participation and Children and young people will be able to make choices about the care they receive, providing 1
Partnerships / User they are of an appropriate age and have the competence to understand.
Consultation and
Involvement
Young people of 16 years and over will be offered a choice of where they are cared for. 4
Children and young people`s needs are specifically addressed as part of the Patient Advice and 1
Liaison Service, ensuring that children and young people have access to an advocate, and can
make a compliant if they should wish
Clinical Governance Children and young people receive appropriate high quality evidence based hospital care, 3
Systems developed through clinical governance and delivered by staff that have the right set of skills
Staff caring for children have up to date training and knowledge to meet the specific needs of 3
children and young people
Each service providing care to children and young people ensures that care of children is integral 3
to the plans of each service and are reflected in governance arrangements. This will focus on
child protection training, resuscitation / life support, pain assessment and management and
communication.
Environment Achievement of patient safety thermometer specific to paediatric services. 3
Care is provided in an appropriate location and in an environment that is safe and well suited to 4
the age and stage of development of the child or young person. Babies and children up to and
including 16 years of age are admitted to children`s wards.
Parents are able to sleep and rest near their child 2
All wards should provide appropriate facilities for resident parents 2

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Children and Young People Strategy

NSF Framework

Strategic Objectives Target Strategy Vision No.

Inpatients
Environment All services will comply with environmental standards required to meet the needs of the child 4
with disabilities
Aspirational vision: 4
All young people under age of 18 will be admitted to a young people’s unit and will be followed
up by the paediatric team in outpatients department.
Until then children without long term conditions above the age of 16 will be admitted to adult
areas and referred to adult practitioners as outpatient attendees.
Play and education There is access to age appropriate play and recreational equipment 4
All children staying in hospital have daily access to staff skilled in delivery of play services 3
Play and recreational facilities are available for children and young people, staying in and / or 4
visiting the hospital sites
The ongoing educational needs of children and young people staying in hospital are met 2
Where admission to hospital is planned, children are prepared through pre admission and 1
information. A visit to the ward / department is always offered
Training Staff caring for children and young people as a core element of their role (all neonatal areas, 3
children`s wards and departments, accident and emergency units and anaesthetics and surgery)
undertake specific training (at a level appropriate to their roles) in the following areas:
Safeguarding children, Pain assessment and management, Paediatric life support, Communication
Nursing staff will develop skills in nurse prescribing to meet the needs of children and young 3
people. Use of Patient Group Directives will increase thought paediatric care areas

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Children and Young People Strategy

NSF Framework

Strategic Objectives Target Strategy Vision No.

Inpatients
Named paediatrician When children and young people are admitted to hospital under the care of a consultant, other 3
than a paediatrician, there is always a consultant paediatrician available for advice throughout
the 24 hour period
Pain management, symptom Children`s needs in relation to pain relief and management are met 2
relief and sedation
Safeguarding of children Achievement of National Safeguarding Standards under the leadership of the children and young 3
and young people people safeguarding governance group
Discharge and transition Effective discharge planning meets the needs of children young people and their families. The 2
arrangements needs of children and young people are properly catered for and there is a seamless transition to
adult services
Shared records and Accurate and timely information is provided to meet the needs of all children and young people. 1
information A single documentation record for each patient is used across the Trust for all staff involved in the
care of each individual child or young person. Copies of child’s attendance to A&E will be included
in notes for all children admitted to inpatient areas

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Children and Young People Strategy

NSF Framework

Strategic Objectives Target Strategy Vision No.

Surgery
Pain, symptom relief and A Trust wide agreed pain assessment tool is used for children and young people and staff have 3
sedation attended training in relation to this tool.
Where procedures are planned a pain assessment is completed using the approved Trust wide pain 3
assessment tool
Staff have received training in paediatric pain assessment and administration 3
Nursing staff within the paediatric surgical ward will be able to prescribe paediatric pain relief 3
Staff have access to paediatric pain management guidelines 3
Staff have access to sedation protocols 3
Where procedures are planned and pain can be predicted the opportunity should be taken to 2
prepare the child through play and education and pain relief is given through the procedure
Service providers ensure that staff receive the appropriate training to develop relevant 3
competencies in dosage calculation, prescribing, dispensing and administration of medicines for
children
Safe and child friendly All children / young people are cared for requiring daycare within a separate paediatric day case 4
environment facility with paediatric trained staff
Children planned to come into hospital are prepared through a pre admission visit and 1
information
All children / young people are cared for within a separate paediatric recovery area with paediatric 3
trained staff

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Children and Young People Strategy

NSF Framework

Strategic Objectives Target Strategy Vision No.

Surgery
Safe and child friendly All staff are familiar with the concept of “competence” in gaining consent 3
environment
All staff have access to a Trust wide consent policy which makes particular reference to consent in 3
children and young people
Patients and their parents are given informed choices over aspects of treatment and care e.g.: 1
where to be admitted, treatment options
Children, young people and parents are given valid, relevant, accurate and up to date easily accessible 1
information that is appropriate to their level of understanding before they can decide whether to consent
to or refuse treatment
Adolescents are cared for in a specific adolescent area, ideally in an adolescent unit by staff trained 4
to meet their specific needs
A fully integrated system of safe standards of cleaning, decontamination and sterilization of 3
equipment with all staff engaged in risk assessment, investigation of events, audit and updating
knowledge to minimise the risk of untoward events
Children and young people identified with chronic pain problems are referred to the paediatric 2
chronic pain service
The use of play techniques is used across the multi disciplinary team caring for children, with 4
appropriate numbers of play specialists taking a lead in techniques that other staff can adopt,
including preparation of children for surgery
Children undergoing surgery will be fasted in line with agreed guidelines to maintain their safety 2
Achievement of You`re Welcome in all areas 2

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Children and Young People Strategy
NSF Framework
Strategic Objectives
Surgery
Safe and child friendly
environment
Safeguarding of children
and young people
Paediatric specific training
Communication
Children and parents are
partners in care – including
choice and consent
Child focused clinical
governance
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Target Strategy Vision No.
Development of an admissions area within ward 22 4
Achievement of National Safeguarding Standards under the leadership of the children and young 3
people safeguarding governance group
All children are recovered by children`s trained staff (preferably with specific theatre recovery 3
competencies)
All staff who work with children and families, and those who have access to children’s records, 3
receive child protection awareness training and appropriate CRB checks
Staff working with children and young people should have training in the necessary 3
communication skills to enable them to work effectively with children, young people and parents
At every level in the organisation where children access services, staff are trained to provide 3
paediatric basic life support
Consent policy available for all staff 3
Procedure specific and age specific information is available for parents, children and young people 1
All equipment used for children is safe and effective and appropriate for use in children 3
Equipment is of the correct size for the child and is tailored to the needs of children of different 3
ages and stages of development
Staff using equipment with children and young people are trained to do so 3
together we do the amazing
Children and Young People Strategy

NSF Framework

Strategic Objectives Target Strategy Vision No.

Surgery
OPD and elective surgery There is a dedicated children`s theatre list within a children`s theatre 2
child only lists
Children planned to come into hospital are pre assessed prior to admission 1
All parents are allowed in the recovery room as soon as it is deemed safe and provided there is no 2
other emergency in the recovery area
All parents stay until induction of anaesthesia and are supported after leaving the anaesthetic 2
room
Workforce Clear workforce planning will take place to ensure future service provision for children 3
Recruitment of a paediatric orthopaedic surgeon within 1st year 3
Increase in nurse prescribers and use of PGD`s 3
Workforce Junior doctor role established in paediatric surgery ward 2
Commissioning / marketing Joint work with commissioners to ensure provision of high quality sub regional paediatric surgery 5
for Tees Conurbation based at JCUH
Patient experience Deliver year on year improvement in patient and carer experience 2
Service development Partnership working to ensure children and young people and their parents / carers are involved in 5
service developments

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Children and Young People Strategy

NSF Framework

Strategic Objectives Target Strategy Vision No.

Specialist Care
Environment Care provided for children and young people whose care is delivered across the AHP pathway will 4
be provided in a child friendly age appropriate environment
Review of current footprint of space for paediatric service delivery to take into account the 4
environmental needs for therapies to deliver their services effectively
Equipment All equipment used for children and young people is accessible, safe and effective and appropriate 3
for their use
Care planning All members of the AHP team are involved in comprehensive care planning for individual children 2
and young people across the pathway of care
Appointments Appointment system which is flexible and takes account of the needs of children and their families 2
is offered
Discharge Effective admission/discharge planning commences on admission and is negotiated to meet the 2
needs of the child and family, which are continually assessed. Effective discharge planning takes
place for children with complex needs to ensure that a safe and quality discharge is achieved with
appropriate liaison between acute and community services.
Transition Every lead health professional has adequate arrangements for transfer of young people to adult 3
services, preferably via specific transition clinics involving staff from both paediatric and adult
services
Information Age appropriate information is available about specific conditions, medicines, procedures, services 1
and support groups in a variety of formats and media
Hospital pharmacy provide information that is easily understandable about medicines being used 1
to treat children

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Children and Young People Strategy

NSF Framework

Strategic Objectives Target Strategy Vision No.

Specialist Care
Safeguarding of children Achievement of National Safeguarding Standards under the leadership of the children and young 3
and young people people safeguarding governance group
Service developments Increase in psychology services for children and young people accessing hospital and specialist services 2
to ensure that their psychological needs are met
Implementation of the recommendations from the recent review of paediatric therapy services, co- 3
ordinating this with the ongoing process of integration into Clinical Support Services
Integration of speech and language service with inpatient settings to meet needs of inpatient 2
paediatric and neonatal patients
All future service developments will identify the impact of the development on AHP services and their 3
needs will be reflected within any new developments
Model of Integrated working for children with complex needs 3
Networking / Experienced AHP staff are members of relevant peer, clinical interest, development groups 3
benchmarking
The Trust is compliant with the NSF medicines management standard 3
Workforce Clear workforce plans will be developed to ensure safe and effective ongoing provision of care to 3
children, young people and their parents
Training Therapy staff working with children are trained to provide general and specialist interventions and 3
receive supervision appropriate to their role

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Children and Young People Strategy

NSF Framework

Strategic Objectives Target Strategy Vision No.

Specialist Care
Training All trust staff are trained, updated and supported in safeguarding children and attend level 1 3
safeguarding children training
All staff working regularly with children are trained, updated and supported in safeguarding 3
children and attend level 2 safeguarding children training
Training and supervision opportunities are available 3
Patient experience Year on year patient experience will be measured and feedback given to children and young 2
people in relation to changes as a result of feedback via the You Said We Did method

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Children and Young People Strategy

NSF Framework

Strategic Objectives Target Strategy Vision No.

Medicine (including
intensive care)
Pain, symptom relief and A Trust wide agreed pain assessment tool is used for children and young people and staff have 3
sedation attended training in relation to this tool.
Where procedures are planned a pain assessment is completed using the approved Trust wide pain 3
assessment tool
Staff have received training in paediatric pain assessment and administration 3
There is one nurse per shift in all areas trained to prescribe paediatric pain relief 3
Staff have access to paediatric pain management guidelines 3
Staff have access to sedation protocols 3
Where procedures are planned and pain can be predicted the opportunity should be taken to 2
prepare the child through play and education and pain relief is given through the procedure
Service providers ensure that staff receive the appropriate training to develop relevant 3
competencies in dosage calculation, prescribing, dispensing and administration of medicines for
children
Safeguarding of children Achievement of National Safeguarding Standards under the leadership of the children and young 3
and young people people safeguarding governance group
Safe and child friendly Areas are accessible for all children with facilities for wheelchairs and buggies, accessible car 4
environment parking, clear sign posting
Provision of Intensive Care for children and Young people in line with National Guidance 3
Framework

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Children and Young People Strategy

NSF Framework

Strategic Objectives Target Strategy Vision No.

Medicine (including
intensive care)
Safe and child friendly Areas are appropriately equipped, baby and child friendly treatment rooms, have suitable play 4
environment and recreational equipment
Mothers have access to breast feeding facilities and also baby changing facilities 4
Health promotion messages are promoted in the departments; Reduce smoking, health eating, 1
prevention of accidents, promoting breast feeding, alcohol reduction
All settings that deliver services to children and young people have drinking water readily 2
available in an appropriate place and at no charge
All staff are familiar with the concept of “competence” in gaining consent 3
All staff have access to a Trust wide consent policy which makes particular reference to consent in 3
children and young people
Patients and their parents are given informed choices over aspects of treatment and care e.g.: 1
where to be admitted, treatment options
Children, young people and parents are given valid, relevant, accurate and up to date easily 1
accessible information that is appropriate to their level of understanding before they can decide
whether to consent to or refuse treatment
Adolescents are cared for in a specific adolescent unit by staff trained to meet their specific needs 4
The use of play techniques is used across the multi disciplinary team caring for children, with 2
appropriate numbers of play specialists taking a lead in techniques that other staff can adopt,
including preparation of children for surgery
All children have access to a play therapist 3

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Children and Young People Strategy

NSF Framework

Strategic Objectives Target Strategy Vision No.

Medicine (including
intensive care)
Safe and child friendly Children are weighed and heighted on admission and measurements are plotted in growth charts 3
environment
Nutritional screening assessment is performed and a feeding plan is written, implemented and 3
evaluated if required.
Scales are approved and calibrated annually 3
The environment / equipment is conducive to eating 4
There is a breast feeding policy that is disseminated to all staff, is universally implemented and is 3
evaluated. Mothers are supported with breastfeeding and have private facilities to do so
Food meets the standards set out in the “better Hospital Food Catering Services for Children and 2
Young Adults”
Food is presented to patients in a way that takes into account what appeals to them 2
Patients have sufficient information to enable them to access food 1
Patients have set meal times but are offered a replacement if they miss a meal and can access 2
snacks at any time
Menus are appropriate to religious, cultural and ethnic background 2
Protected mealtimes are in place 2

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Children and Young People Strategy

NSF Framework

Strategic Objectives Target Strategy Vision No.

Medicine (including
intensive care)
Safe and child friendly Menus are developed with children and young people and their feedback is used to inform any 5
environment changes to menu development
The Trust has an appointed LSMS (Local Security Manager Specialist) There are Trust security and 3
fire policies. Staff have security ID badges. Inpatient wards have restricted access
(Aspirational) depending if future commissioning arrangements for inpatient pediatric units - A 4
wing on the ground floor of the hospital at JCUH will be dedicated to children`s services
Improved parents facilities are provided to meet the needs of parents and carers during their 4
child`s stay in hospital
The environment meets the needs of children and young people and meet health and safety and 4
disability regulations
Environment meets the needs of siblings visiting the hospital 4
Discharge and ongoing care Written child focused information for ongoing care is available for patients and their families 1
Discharge planning commences on admission and is negotiated to meet the needs of the child and 2
family, which are continually assessed
Inpatient documentation includes discharge plan negotiated/ agreed with child and family 2
Discharge information is available for children and their families which is age appropriate and in 1
different languages
Where child protection / safeguarding concerns exist the hospital procedure for discharge in such 3
situations is followed

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Children and Young People Strategy

NSF Framework

Strategic Objectives Target Strategy Vision No.

Medicine (including
intensive care)
Hospital stays are kept to a minimum with ongoing care transferred to a paediatric community 2
team
Parents / children / carers are provided with education and training and have documented 3
competency packs completed prior to discharge for complex discharge patients
Every lead health professional has adequate arrangements for transfer of young people to adult 3
services, preferably via specific transition clinics involving staff from both paediatric and adult
services
Transitional care policies are in place and audited regularly 3
Achievement of You`re Welcome in all areas 2
Ongoing audit of transition process takes place 2
Good practice would be: All 12+ year olds are offered “air time” with doctor or nurse on their own 2
when they attend outpatient areas
Good practice would be: All competent 14+ year olds are offered copies of letters written about 2
them
Shared records and Accurate and timely information on services is provided to meet the needs of all children and 1
information young people in every section of the community. The information is written with the participation
of children, young people and their families using a variety of formats, media and languages
Service providers ensure that families receive information, explanation and support concerning 1
benefits they are entitled to, particularly when there are children with complex needs in the family

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Children and Young People Strategy

NSF Framework

Strategic Objectives Target Strategy Vision No.

Medicine (including
intensive care)
Shared records and
information
Paediatric specific Training /
workforce
Age appropriate information is available about specific conditions, medicines, procedures, services 1
and support groups in a variety of formats and media
A range of communication methods are used and information is available about specific 1
conditions, medicines, health promotion information
A single documentation record (single case notes) for each patient is used across the Trust for all 3
staff involved in the care of each individual child or young person
Any prior records are available at all times whenever and wherever children are seen and assessed 3
Clinicians letters are copied to the patient and or parents (as appropriate / competence level) 1
All care is given by paediatric trained staff 3
Provision of play therapy / recreational support meets the needs of all children and young people 2
The nurse practitioner role will be developed and implemented in the department 3
Expansion of specialist nursing services 2
Exploration and implementation of Nurse Consultant role 3
At every level in the organisation where children access services, staff are trained to provide 3
paediatric basic life support
The paediatric emergency team members are all competent to undertake any role required of 3
them in the clinical emergency situation

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Children and Young People Strategy

NSF Framework

Strategic Objectives Target Strategy Vision No.

Medicine (including
intensive care)
Paediatric specific Training /
workforce
Children and parents are
partners in care
For all emergency, day case and A&E area where children and young people access there is one 3
nurse trained to APLS level on each shift
All staff in paediatric day case and a&e areas have access to and are aware of the process of 3
contacting the PICU emergency team when required
All staff have attended training in relation specifically to handling and moving of children. Staff 3
have access to relevant moving and handling equipment
Staff working with children have some knowledge and additional training in CAMH. Specialist 3
support is available when needed e.g.: access to CAMHs teams
Exploration of model of hospital based social worker 2
Children and family are active members on the planning, delivery and evaluation of care pathways 5
and individualised care
Children and young people, receiving services from any agency, are fully involved in regular 5
reviews that allow them to express a view about how their needs are met, including the
professionals and organisations that will provide the services
Children and families are trained and assessed to be competent in caring for their child and know 3
how to access appropriate services when required
Structures and environments are in place to meet the needs of parents while resident or visiting 4
their child
In cases of emergency (e.g.: visiting children in PICU) then structures are in place to meet the needs 2
of siblings while visiting

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Children and Young People Strategy

NSF Framework

Strategic Objectives Target Strategy Vision No.

Medicine (including
intensive care)
Children and parents are A formal process of assessment occurs on admission which ensures that parents and older children are 3
partners in care competent to administer their medicines on their own whilst in hospital and this is reviewed regularly
“informed” consent is obtained prior to procedures / treatment by a competent professional able 3
to undertake them and understanding is confirmed
Consent policy available for all staff 3
Procedure specific and age specific information is available for parents, children and young people 1
Child focused clinical Appropriate equipment is available to resuscitate and stabilise a collapsed child 3
governance
All equipment used for children is safe and effective and appropriate for use in children 3
Equipment is of the correct size for the child and is tailored to the needs of children of different 3
ages and stages of development
Staff using equipment with children and young people are trained to do so 3
Service development Development of services with CAHMS to ensure support of this client group of children and young 2
people
Appointment of a hospital based social worker for children and young people and their families 2
Closer working between services providing care for children and young people within acute 2
setting and also with community services
Increase in community paediatric nursing service 3
All patients requiring transfer between hospital sites will be transferred safely 3

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Children and Young People Strategy

NSF Framework

Strategic Objectives Target Strategy Vision No.

Outpatients
Appointments Outpatient settings provide an appointment system which is flexible and takes account of the 2
needs of children and their families
Systems are in place so that children with complex conditions who require multiple appointments 2
can be seen on the same day and in the same setting.
Service Improvement Review of Children`s Outpatients – including rapid access clinics and 3
workloads (roles and responsibilities)
Establishment of age specific clinics where appropriate 4
Improved information for young people in relation to their outpatient appointment and potential 1
to attend on their own if so desired
Information Families who have to attend outpatient appointments are provided with information about 1
eligibility and arrangements for claiming travel subsistence
Age appropriate information is available about specific conditions, medicines, procedures, services 1
and support groups in a variety of formats and media
Services will identify if children and families require extra support, for example those who need 2
interpreters or advocates and children in need including disabled children
Clinicians letters are copied to the patients and / or parents (as appropriate / competence level) 1
All professionals are familiar with the concept of “competence” in giving consent 3
Children, young people and parents are given valid relevant accurate and up to date easily 1
accessible information that is appropriate to their level of understanding before they decide
whether to consent to or refuse treatment

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Children and Young People Strategy

NSF Framework

Strategic Objectives Target Strategy Vision No.

Outpatients
Information Informed choices over aspects of treatment or care are offered to the child or young person e.g.: 1
where to be admitted, different treatment options
Health promotion messages are promoted in all departments e.g.: reducing smoking, healthy 1
eating, prevention of accidents, breast feeding, the risks of alcohol / alcohol reduction
Safeguarding of children Achievement of National Safeguarding Standards under the leadership of the children and young 3
and young people people safeguarding governance group
Play therapy All children have access to a play specialist 2
All children planned to come into hospital are prepared though pre admission visits and 1
information
Pain management Where procedures are planned and pain can be predicted the opportunity is taken to prepare the 2
child through play and education and pain relief is given through the procedure
Where procedures are planned a pain assessment is completed using the approved Trust wide pain 3
assessment tool
Environment Children and young people are reviewed in departments that are accessible, safe, suitable and 4
baby, child and family friendly
Outpatient and all day case facilities are child friendly and appropriate and accessible for all 4
children with facilities for wheelchairs and buggies
All departments are appropriately equipped, baby and child friendly treatment rooms with 4
suitable play and recreational equipment
Mothers will have access to facilities to breastfeed as well as baby changing facilities 4

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Children and Young People Strategy

NSF Framework

Strategic Objectives Target Strategy Vision No.

Outpatients
Environment (Aspirational) Larger footprint for housing paediatric outpatient department to increase potential 4
of hosting additional clinics (currently held in adult clinics) for children and young people in a
child friendly environment
Where children young people are seen in a joint child / adult clinic there is physical separation 4
within the department
Review of service provision on Friarage site 3
All services will comply with environmental standards required to meet the needs of the child with 4
disabilities
Workforce Establishment of phlebotomy staff with paediatric phlebotomy skills 3
Development of more specialist nursing roles within community child health team 3
Patient experience Deliver year on year improvement in patient and carer experience 2
Service development Partnership working to ensure children and young people and their parents / carers are involved in 5
service developments
Compliance with the DNA policy in all areas where children and young people access services 3
Development of more integrated working to meet the needs of children with complex needs 2
Development and implementation of a Neurodisability Pathway 2

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Children and Young People Strategy

NSF Framework

Strategic Objectives Target Strategy Vision No.

Community Services
Environment Services delivered within a child friendly and safe environment 4
Achievement of You`re Welcome standards 2
Better use of community facilities for service provision 4
Information Greater integration and information sharing with family services 1
Proactive promotion of attachment and the prevention of behavioural problems 2
A greater focus on parenting support, as well as on surveillance and health promotion 2
Better integration and information sharing between maternity services and HV team 2
Better integration and information sharing between Health Visiting, School Health and adolescent 2
services, including acute and mental health services
Regular supervision, and monitoring of quality and outcomes of teams and individual practitioners 3
Safeguarding of children Achievement of National Safeguarding Standards under the leadership of the children and young 3
and young people people safeguarding governance group
Workforce Multi-skilled team working across boundaries to make use of common processes such as the com- 2
mon assessment framework
An agreed and defined lead role for the health visitor – implementation of the family nurse part- 3
nership model
Implementation of the recommendations of the review of school nursing role 3
Implementation of family nurse partnership programme 3

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Children and Young People Strategy

NSF Framework

Strategic Objectives Target Strategy Vision No.

Community Services
Workforce A team with up to date knowledge and skills 3
A team with the competencies to work with children and parents, to deliver the core elements of 3
the Healthy Child Programme and to work effectively across service boundaries
National priorities Deliver of the Implementation of the Healthy Child Programme 3
An increase in the percentage of infants being breastfed at six to eight weeks 1
A reduction in the under-18 conception rate per 1,000 females aged 15-17 1
A reduction in obesity among primary school children 1
A reduction in smoking prevalence among young people aged 16 or over 1
Service development Implementations of recommendations from children`s therapy services review 3
Promotion of earlier safe discharge with support of paediatric community teams 2
Provision of streamlined pathways of care to meet the needs of children, young people and their 2
families
Achievement of Unicef accreditation 3

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Children and Young People Strategy

NSF Framework

Strategic Objectives Target Strategy Vision No.

Neonatal Services
Neonatal Standards Provision of neonatal special high dependency, intensive care following perinatal network 3
guidelines and care pathways that are integrated with other maternity and newborn network
guidelines and pathways
Sufficient skilled and competent multidisciplinary workforce 3

Provision of a neonatal transport service which provides babies and their parents with safe and 3
efficient transfers across the region to and from specialist neonatal care
Parents of babies receiving specialist neonatal care are encouraged and supported to be involved 1
in planning and providing care for their baby, and regular communication with clinical staff occurs
throughout the care pathway
Provision of Sufficient parents accommodation on both sites and sufficient transport between 4
JCUH and FHN for parents who move between our services.
Mothers of babies receiving specialist neonatal care are supported to start and continue 1
breastfeeding, including being supported to express milk.
Babies receiving specialist neonatal care have their health and social care plans coordinated to 2
help ensure a safe and effective transition from hospital to community care
Providers of specialist neonatal services maintain accurate and complete data, and actively partici- 3
pate in national clinical audits and applicable research programmes
Babies receiving specialist neonatal care have their health outcomes monitored 2

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Children and Young People Strategy

NSF Framework

Strategic Objectives Target Strategy Vision No.

Neonatal Services
Safeguarding of children Achievement of National Safeguarding Standards under the leadership of the children and young 3
and young people people safeguarding governance group
Workforce Development of health care assistant role within low dependency care 3
Increase in Advanced neonatal nurse practitioner workforce 3

Workforce with competence and skills to deliver safe and effective care to babies who require 3
neonatal care
Service development Provision of appropriate facilities for parents of babies requiring neonatal care 4
Bliss standards Achievement of Bliss Standards 2
Achievement of the Maternity NSF 3

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Children and Young People Strategy

Children and Young People Strategy Implementation Team

Programme Board
Chair
Vice Chair

Young
Safeguarding
People / Child
Ambulatory Inpatient Community Children Professional
Neonatal Surgery Transition Outpatient
Care Paediatric Therapy and
Services Services Services Forum
Medicine Services Young
You’re
People
Welcome

Key elements running through each of the separate strategy project groups:

• Safeguarding
• NSF
• Communication
• Information
• Workforce
• Children with disabilities
• Patient Experience

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