The 0-19 Integrated Family Health Service introduced GBOs in October 2016. This was in response to our Commissioner’s becoming increasingly interested in receiving evidence that the service they commission is effective, and value for money. We had also identified that as a service we weren’t so good at monitoring and evaluating what we offered. The introduction of the GBO’s supported us with this and we have since been able to evidence the excellent service and the positive difference that we are making to the children, young people and families within the City.
Using goals in one-off/ drop-in contacts
In terms of measuring short term goals, we have adapted the GBO tool to capture the positive difference we make to children and families in one-off / drop in contacts. This allows us to capture the impact of the information we deliver to families such as breastfeeding information, behaviour support, healthy eating, sleep advice etc. We have also utilised these outcome tools in one off school health drop in sessions which have been effective if evaluating our methods of service delivery and again evidencing impact to our Commissioners.
As a service we hope continue the use of the GBOs and outcome tools as we recognise the importance of them and the significant positive outcomes for the children and young people in the city.
The staff within the service have embraced this way of working. Here are some case examples where the GBO and other tools have been effective.
A referral from school was received into our Central Point of Access in March 2018 requesting support with behaviour for a young person. The behaviour was uncontrollable, he had assaulted a Teacher and other Pupils, it was having a detrimental impact on his learning, and the young person was on the verge of permanent exclusion. All previous interventions the school had implemented had not been effective. A referral to a Safe Speak Service had been made but there was a lengthy waiting list.
The young person’s Mum was fully engaged with Professionals and there was a Team Around the Family (TAF) in place. It was highlighted at a Professional’s meeting that the Young Person’s Father was suffering with post-traumatic stress disorder, he also had high anxiety levels. The young person’s parents had separated, and there was a history of domestic abuse in the relationship.
The young person was seen By the School Health Team. An RCADS was completed which evidenced a high level of anxiety and depression. An Outcome Star (My Star) was completed. The Young Person engaged well with the completion of the tool and was able to communicate his feelings well. It was evident that he was pleased he was being listened to.
Weekly contacts followed to explore the young person’s emotional responses, his coping mechanisms, exploring mindfulness activities and relaxation techniques with him. He was able to discuss how major events in his life had affected his relationships and friendships with peers. Once he had been able to reach this point and see how things had affected him, he felt it was a “turning point” and was able to work with the School Health Practitioner and work towards actions and goals to move him forward.
The young person has now shared that he feels happier and calmer. His relationships in and out of school are improving and he is able to engage better with his learning in school. He is also looking forward to starting secondary school in September.
Through the use of the GBO and outcome tools the young person was able to be at the centre of his journey, he was able to visually see his achievements and how the interventions implemented had made a positive impact upon his emotional wellbeing.
Another case a 16 year old that was self-harming highlighted that she needed support with her emotional health. Through initial assessment there was no indication that the young person was drinking alcohol. The School Health Nurse then introduced an outcome tool. By implementing this way of working, the young person was herself able to share that she was drinking significant amounts of alcohol, and that it was having a detrimental impact upon her life. The School Nurse felt that this would have not been highlighted as early, or at all, without the use of the tool.
The young person was then supported to the relevant service to address her drinking.
Leanne Millard, is the Locality Manager (area 1 & 5) for Derby Integrated Family Health Service, Derbyshire Healthcare NHS Foundation Trust
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