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The National Service Framework (NSF) for children, young people, and maternity services in England has recently been published by the Department of Health. On 15 October the equivalent Welsh consultation document was launched by the Minister for Health and Social Services at the Welsh Assembly Government, Mrs Jane Hutt; the consultation document of the Welsh NSF differs from the English NSF in a number of ways.
First, the Welsh document has set standards not just for health and social care but also for the other agencies which have a strong influence on the health and wellbeing of children, such as education, housing, leisure, and transport. The document has been endorsed in a foreword signed by the First Minister, Rhodri Morgan, and all members of the Cabinet of the Welsh Assembly Government.
A second difference from the English NSF is that the Welsh document is written with 21 standards and 203 “key actions”, each of which is specific, written in the present tense, and can be measured. The third difference is that a web based self-assessment audit tool is being developed for use by all the agencies who will be involved in implementing the NSF in order to assess progress locally (in the 22 local government authorities throughout Wales). This measurement should prove invaluable in helping to determine local priorities for future service development.
As part of the process, the Welsh Assembly Government commissioned an extensive series of consultation events with children and young people, parents, and carers at a variety of venues around Wales, as well as through questionnaires sent out to schools. The final reports of these consultation exercises are available to view or download from the NSF website; the development of the key actions within the document have been driven by the results of these consultation exercises to ensure that children and their families have been placed at the heart of all service planning.
There is now a three month consultation period when we hope that all will have an opportunity to read and then comment on the draft document. The document is being made available on the website, but also has three different hard copy versions: a full version, including references (158 pages long); a shorter version containing the key actions (93 pages); and a young person’s version, which will enable young people to participate in the consultation.
We are conscious that the implementation strategy is at least as important as the setting of standards and the key actions themselves. The major challenge has been how to ensure that there is joint working across the different organisations which are involved in the services that children need. Many of the key actions within the NSF are the responsibility of several organisations, which will be required to work in partnership; the Consultation Document specifies which relevant organisations need to take responsibility for each key action.
The coordination of local services is the responsibility of Children and Young People’s Framework Partnerships which are partnerships made up of local authorities, health services, other statutory bodies such as the police, and voluntary organisations. Each partnership in Wales must involve children, young people, and families in preparing a framework plan which sets out the strategic priorities for services.
The key actions within the NSF will only be as good as our ability to implement them. We cannot know if we are being successful in our implementation unless we measure the extent to which they are being delivered, and the challenge has been to develop a methodology for measuring success that is compatible with the performance management framework already in existence. To try to meet this requirement, a web based self-assessment audit tool is being developed for publication at the same time as the final standards in the summer of 2005, which we hope will enable local measurement of progress in achieving the key actions. In addition, the standards and key actions will be subject to inspection processes by Health Inspectorate Wales (HIW) (working in conjunction with the Healthcare Commission), and we anticipate that there will be joint inspections carried out in Wales between HIW, Social Services Inspectorate Wales, Care Standards Inspectorate Wales, and the Inspectorate for Education and Training in Wales (ESTYN).
It is clear that the profile of the children’s and young people health and wellbeing is higher than it ever has been on the political and planning agenda, in both England and Wales. We can learn from each other and we, in Wales, would be grateful to receive comments from all parts of the UK on our Welsh NSF, as part of the consultation process, before the final document is published in summer 2005. Please access the website www.wales.nhs.uk/nsf and let us have your comments.
Competing interests: none declared
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