SlideShare ist ein Scribd-Unternehmen logo
1 von 23
Downloaden Sie, um offline zu lesen
Children’s missed health care appointments:
an initial scoping review
Dr Catherine Powell, Dr Jane Appleton,
Lindsey Coombes
BASPCAN Congress Presentation
April 2015
Background
This study builds on our previous work &
presentation at BASPCAN Congress 2012
 Children have a fundamental right of access to
health care (UNCRC, 1989)
 Failing to ensure a child’s access to health
care sits within statutory definitions of neglect
(e.g. HM Government, 2013)
 Missed appointments are a known feature in
the history of children who have suffered
serious child maltreatment (e.g. Brandon et
al.,2012)
Research Question
How do health care organisations
respond when children do not
attend/were not brought to their health
care appointments?
Methods
The study, which began in August 2013, involved two work packages:
1. A web-based scoping review of NHS provider policies for managing
missed appointments. The scoping review involved accessing health
care provider web-sites across England, Scotland, Wales and
Northern Ireland;
2. A case-study at one NHS Hospital Trust utilising a number of data
sources (documentary analysis, semi-structured face to
face/telephone interviews with 13 respondents, examination of the
‘systems’ in place, feasibility of case-tracking) to ascertain how a
hospital system manages children’s missed health care appointments
in practice.
Work package one:
Web-based scoping review
Findings: web-site searches
 180/185 web-sites for Trusts in England (17 policies)
 Seven Health Board web-sites in Wales (one policy & one guidance
document)
 14 regional Health Boards web-sites in Scotland (national guidance)
 Five ‘Health and Social Care’ web-sites in Northern Ireland (one multi-
site policy and one guidance document)
 Four Independent Provider websites (no policies)
 Google search (three additional policies)
Findings: declaration of compliance
(England)
Trusts in England are expected to have a public
‘declaration of compliance’ against safeguarding
children standards (Care Quality Commission, 2009);
144/180 declarations were found and scrutinised for a
mention of a policy for the follow-up of children’s missed
appointments;
125/144 had an overt mention of such a policy on their
websites.
Example of a declaration
Findings: Policies
Our concerns at the outset that the majority of providers
would place their policies on ‘intranets’ rather than
‘internets’ proved to be the case;
The 24 policies/guidance that were elicited were rated
against six pre-determined standards: 0 not met, 1 partially
met, 2 fully met;
Mean score was 7.2, range 3-11.
Standards for rating policies
1. The policy/procedure provides a definition of childhood that
recognises that childhood goes up to 18 years of age
2. The policy/procedure reflects the UN Convention/Children Act 1989
and the duty to meet the welfare and protection needs of CYP,
including access to health care
3. The policy/procedure provides a statutory definition of neglect that
includes the failure to ensure access to health care
4. The policy/procedure makes reference to the importance of following
up children who miss health care appointments (rationale - evidence
– research - SCRs)
5. The policy/procedure provides clear guidance on the action that
should be taken to follow up children who miss health care
appointments (action staff expected to take)
6. The policy/procedure provides an auditable quality standard in
relation to following up children who miss health care appointments.
(ref to audit in practice)
Children's missed health care appointments: an initial scoping review
Findings: additional material
 Additional material relating to cost-pressures and strategies to
reduce ‘DNA’ rates more generally was found through the web-
based searches (e.g. Board minutes) and reflect the efficiency
pressures on the NHS at the current time;
 However, the emphasis in many cases appeared to be primarily
about managing 'the system' and introducing penalties for those
who do not attend their appointments as scheduled;
 There appeared to be an element of disconnect between the
compliance statements on the one hand and the strategies and
policies to address 'DNA's on the other.
Work package two: Case Study Findings
 NHS professionals and staff continue to use and favour the term
'Did not Attend' (DNA) rather than ‘WNB’;
 Sympathy for the parent can prevent the professionals from 'seeing the child' and serving their best interests
 Sympathy for the parent can prevent the professionals from 'seeing
the child' and serving their best interests;
 Older children should also be involved in decisions about their care
and this would include actions that may be taken if they fail to
attend for health care;
 The degree to which a busy General Practice is able to provide the
monitoring, assessment and referral (back into the 'system'), or
take a lead in taking forward a missed appointment (or series of
missed appointments) is of concern.
.
Findings
The importance of considering the consequences for the child of
missed appointments was raised by a number of respondents,
including:
 What are the consequences of these missed appointments for the
child/young person?
 What is known already about [the family]?
 Why has there been missed appointments?
 Has the clinician spoken directly to the parent about what’s
happening?
 Does the parent understand the need to get the child to these
appointments?
Child-focussed?
'That’s a family with fluctuating circumstances whose mother
essentially is well intentioned and does understand the issues and
sometimes life is a bit much for her, but she will always come back
in the end. I suppose that’s an advantage of having known her for
about 14/15 years now'
'And the first couple of appointments they attended very well, I think I
engaged with mum very well and she was clear that she wanted to
do some work on changing his weight and obviously Social Care
were pressing me to ensure she attended all appointments.
Recommendations: UK Health Care Provider
Organisations
1. Review the title of local policies on children not attending health
care appointments to clearly reflect a focus on ‘Did Not Attend’
(DNA) or ‘Children’s Missed Health Care Appointments’;
2. At the front-line, there should be simplified communication
pathways to access guidance electronically on children’s missed
health care appointments and a simple, one-sheet flow-chart
outlining a clear pathway for decision making;
3. Children’s ‘Missed Health Care Appointments’ policies should be
subject to audit and evaluation;
4. NHS provider policies on children’s missed appointments could
include reference to ‘Did not Wait’ for those children/young people
accessing the emergency department/A&E;
Recommendations: UK Health Care Provider
Organisations
5. Risk assessments should include a review of whether there is a
pattern of missed appointments;
6. NHS provider policies on missed appointments include a
requirement to inform families that information on missed
appointments may be shared with other health professionals and
children's social care (CSC) and that when a decision to refer to CSC
is made this is discussed with the family in line with best practice and
statutory guidance;
7. That policies on missed health care appointments also reflect the
importance of considering the implication of parents (and parents to
be) not attending their own health care appointments and the
meaning of this for their parenting role (e.g. antenatal appointments,
appointments with substance misuse services);
8. NHS providers to review at what time point a cancelled appointment
is counted as a Did Not Attend (DNA);
Recommendations: NSPCC
9. To put pressure on regulatory bodies to seek assurance
from Executive Safeguarding Leads in Provider
Organisations that their policies for managing DNA are
congruent with their policies on follow up of children's
missed health care appointments;
10. To seek assurance that Equality and Diversity leads in
NHS organisations are inclusive of, and responsive to,
the needs of children and young people.
Recommendations: further research
11. There remain some gaps in knowledge of 'what is
happening' in terms of responding to children's missed
health care appointments that can only be addressed
through a more extensive study that involves children,
young people and their families as key participants. A
further study is required to understand missed
appointments from the perspective of children, young
people and their families and to explore what they
perceive as relevant interventions;
12. A tracking study is undertaken to follow a cohort of
children who DNA, through their health care pathway with
particular attention given to the interface and
communications between primary and secondary care;
Recommendations: further research
13.The degree to which a busy General Practice is able to provide the
monitoring, assessment and referral (back into the 'system') or take
a lead in taking forward a missed appointment (or series of missed
appointments) as a safeguarding concern is an area for further
exploration. There needs to be an understanding of the degree to
which GPs are aware of the importance of children's missed health
care appointments, or indeed, whether or not they have been
involved, alerted or consulted on policies that directly involve them.
14. That further work is commissioned on the experiences of 16 and
17 year olds who are receiving their health care from adult services.
Further details of the study:
This study has been made possible by a small grant from the NSPCC
We would like to express our sincere appreciation to all the pilot study
participants who contributed their valuable insights and perspectives to
this study.
We would also like to thank the hospital Trust who supported the study
and Tom Rahilly, NSPCC for his support.
ACKNOWLEDGEMENTS
For further information please contact:
•Jane Appleton - jvappleton@brookes.ac.uk
•Catherine Powell – catherine.powell@soton.ac.uk
Thank you for listening

Weitere ähnliche Inhalte

Was ist angesagt?

Myanmar Strategic Purchasing 5: Continuous Learning and Problem Solving
Myanmar Strategic Purchasing 5: Continuous Learning and Problem SolvingMyanmar Strategic Purchasing 5: Continuous Learning and Problem Solving
Myanmar Strategic Purchasing 5: Continuous Learning and Problem SolvingHFG Project
 
Prevention and Early Intervention Programme
Prevention and Early Intervention Programme  Prevention and Early Intervention Programme
Prevention and Early Intervention Programme Dave Mckenna
 
2015 ihi international forum shadowing poster
2015 ihi international forum shadowing poster2015 ihi international forum shadowing poster
2015 ihi international forum shadowing posterEngagingPatients
 
iHV regional conf: Sally Kendall - Building evaluation into your practice
iHV regional conf: Sally Kendall - Building evaluation into your practiceiHV regional conf: Sally Kendall - Building evaluation into your practice
iHV regional conf: Sally Kendall - Building evaluation into your practiceJulie Cooper
 
Can we solve the adult primary care shortage without more physicians?
Can we solve the adult primary care shortage without more physicians? Can we solve the adult primary care shortage without more physicians?
Can we solve the adult primary care shortage without more physicians? CHC Connecticut
 
FINAL NHSIQ_Winterbourne_Medicines
FINAL NHSIQ_Winterbourne_MedicinesFINAL NHSIQ_Winterbourne_Medicines
FINAL NHSIQ_Winterbourne_MedicinesZoe Lord
 
Cynthia's Resume Health Communication Specialist
Cynthia's Resume  Health Communication SpecialistCynthia's Resume  Health Communication Specialist
Cynthia's Resume Health Communication SpecialistCynthia Strong
 
Health information infrastructure in supported accommodation: Reducing risks,...
Health information infrastructure in supported accommodation: Reducing risks,...Health information infrastructure in supported accommodation: Reducing risks,...
Health information infrastructure in supported accommodation: Reducing risks,...Bronwyn Hemsley
 
Patient_Engagement_Whitepaper
Patient_Engagement_WhitepaperPatient_Engagement_Whitepaper
Patient_Engagement_WhitepaperTony Fanelli
 
Webinar on Quality Improvement Strategies in a Team-Based Care Environment
Webinar on Quality Improvement Strategies in a Team-Based Care Environment Webinar on Quality Improvement Strategies in a Team-Based Care Environment
Webinar on Quality Improvement Strategies in a Team-Based Care Environment CHC Connecticut
 
Healthcare -- putting prevention into practice
Healthcare -- putting prevention into practiceHealthcare -- putting prevention into practice
Healthcare -- putting prevention into practiceZafar Hasan
 
Professor Peter Fonagy - CYP IAPT National Clinical Lead
Professor Peter Fonagy - CYP IAPT National Clinical LeadProfessor Peter Fonagy - CYP IAPT National Clinical Lead
Professor Peter Fonagy - CYP IAPT National Clinical LeadCYP MH
 
Behavioral Health Staff in Integrated Care Settings
Behavioral Health Staff in Integrated Care SettingsBehavioral Health Staff in Integrated Care Settings
Behavioral Health Staff in Integrated Care SettingsCHC Connecticut
 
Learning from the best: A webinar with the Patient Safety Champion Awards Fin...
Learning from the best: A webinar with the Patient Safety Champion Awards Fin...Learning from the best: A webinar with the Patient Safety Champion Awards Fin...
Learning from the best: A webinar with the Patient Safety Champion Awards Fin...Canadian Patient Safety Institute
 
Kings Road Medical Centre rated Outstanding by Care Quality Commission
Kings Road Medical Centre rated Outstanding by Care Quality CommissionKings Road Medical Centre rated Outstanding by Care Quality Commission
Kings Road Medical Centre rated Outstanding by Care Quality Commissionatmedics
 

Was ist angesagt? (20)

Myanmar Strategic Purchasing 5: Continuous Learning and Problem Solving
Myanmar Strategic Purchasing 5: Continuous Learning and Problem SolvingMyanmar Strategic Purchasing 5: Continuous Learning and Problem Solving
Myanmar Strategic Purchasing 5: Continuous Learning and Problem Solving
 
Prevention and Early Intervention Programme
Prevention and Early Intervention Programme  Prevention and Early Intervention Programme
Prevention and Early Intervention Programme
 
2015 ihi international forum shadowing poster
2015 ihi international forum shadowing poster2015 ihi international forum shadowing poster
2015 ihi international forum shadowing poster
 
iHV regional conf: Sally Kendall - Building evaluation into your practice
iHV regional conf: Sally Kendall - Building evaluation into your practiceiHV regional conf: Sally Kendall - Building evaluation into your practice
iHV regional conf: Sally Kendall - Building evaluation into your practice
 
Can we solve the adult primary care shortage without more physicians?
Can we solve the adult primary care shortage without more physicians? Can we solve the adult primary care shortage without more physicians?
Can we solve the adult primary care shortage without more physicians?
 
FINAL NHSIQ_Winterbourne_Medicines
FINAL NHSIQ_Winterbourne_MedicinesFINAL NHSIQ_Winterbourne_Medicines
FINAL NHSIQ_Winterbourne_Medicines
 
Cynthia's Resume Health Communication Specialist
Cynthia's Resume  Health Communication SpecialistCynthia's Resume  Health Communication Specialist
Cynthia's Resume Health Communication Specialist
 
It’s not WHAT you do; it’s HOW you do it!
It’s not WHAT you do; it’s HOW you do it!It’s not WHAT you do; it’s HOW you do it!
It’s not WHAT you do; it’s HOW you do it!
 
Health information infrastructure in supported accommodation: Reducing risks,...
Health information infrastructure in supported accommodation: Reducing risks,...Health information infrastructure in supported accommodation: Reducing risks,...
Health information infrastructure in supported accommodation: Reducing risks,...
 
Patient_Engagement_Whitepaper
Patient_Engagement_WhitepaperPatient_Engagement_Whitepaper
Patient_Engagement_Whitepaper
 
Webinar on Quality Improvement Strategies in a Team-Based Care Environment
Webinar on Quality Improvement Strategies in a Team-Based Care Environment Webinar on Quality Improvement Strategies in a Team-Based Care Environment
Webinar on Quality Improvement Strategies in a Team-Based Care Environment
 
Healthcare -- putting prevention into practice
Healthcare -- putting prevention into practiceHealthcare -- putting prevention into practice
Healthcare -- putting prevention into practice
 
HCSO
HCSOHCSO
HCSO
 
vbhc
vbhcvbhc
vbhc
 
Finalcapstone
FinalcapstoneFinalcapstone
Finalcapstone
 
Professor Peter Fonagy - CYP IAPT National Clinical Lead
Professor Peter Fonagy - CYP IAPT National Clinical LeadProfessor Peter Fonagy - CYP IAPT National Clinical Lead
Professor Peter Fonagy - CYP IAPT National Clinical Lead
 
Behavioral Health Staff in Integrated Care Settings
Behavioral Health Staff in Integrated Care SettingsBehavioral Health Staff in Integrated Care Settings
Behavioral Health Staff in Integrated Care Settings
 
Learning from the best: A webinar with the Patient Safety Champion Awards Fin...
Learning from the best: A webinar with the Patient Safety Champion Awards Fin...Learning from the best: A webinar with the Patient Safety Champion Awards Fin...
Learning from the best: A webinar with the Patient Safety Champion Awards Fin...
 
Kings Road Medical Centre rated Outstanding by Care Quality Commission
Kings Road Medical Centre rated Outstanding by Care Quality CommissionKings Road Medical Centre rated Outstanding by Care Quality Commission
Kings Road Medical Centre rated Outstanding by Care Quality Commission
 
Behavioral Health Integration
Behavioral Health IntegrationBehavioral Health Integration
Behavioral Health Integration
 

Andere mochten auch

PURUSHOTHAMAN.M - RESUME.
PURUSHOTHAMAN.M - RESUME.PURUSHOTHAMAN.M - RESUME.
PURUSHOTHAMAN.M - RESUME.Purushoth M
 
A Study on Fingerprint (biometrics) Recognition
A Study on Fingerprint (biometrics) RecognitionA Study on Fingerprint (biometrics) Recognition
A Study on Fingerprint (biometrics) Recognitioneditor1knowledgecuddle
 
Những vấn đề về sức khỏe mà đàn ông cần lưu ý
Những vấn đề về sức khỏe mà đàn ông cần lưu ýNhững vấn đề về sức khỏe mà đàn ông cần lưu ý
Những vấn đề về sức khỏe mà đàn ông cần lưu ýtandy421
 
Cross Cultural Statistics, Trends, and Definitions
Cross Cultural Statistics, Trends, and DefinitionsCross Cultural Statistics, Trends, and Definitions
Cross Cultural Statistics, Trends, and DefinitionsIntercultureLife
 
Desparacitantes externos
Desparacitantes externosDesparacitantes externos
Desparacitantes externosAllan Guzman
 
Ung Dung CNTT
Ung Dung CNTTUng Dung CNTT
Ung Dung CNTTDung Le
 
Eduserv Impact Report
Eduserv Impact ReportEduserv Impact Report
Eduserv Impact ReportJen Page
 
An Overview of security issues in Mobile Ad hoc Networks
An Overview of security issues in Mobile Ad hoc NetworksAn Overview of security issues in Mobile Ad hoc Networks
An Overview of security issues in Mobile Ad hoc Networkseditor1knowledgecuddle
 

Andere mochten auch (13)

IBDL outline
IBDL outlineIBDL outline
IBDL outline
 
PURUSHOTHAMAN.M - RESUME.
PURUSHOTHAMAN.M - RESUME.PURUSHOTHAMAN.M - RESUME.
PURUSHOTHAMAN.M - RESUME.
 
A Study on Fingerprint (biometrics) Recognition
A Study on Fingerprint (biometrics) RecognitionA Study on Fingerprint (biometrics) Recognition
A Study on Fingerprint (biometrics) Recognition
 
Những vấn đề về sức khỏe mà đàn ông cần lưu ý
Những vấn đề về sức khỏe mà đàn ông cần lưu ýNhững vấn đề về sức khỏe mà đàn ông cần lưu ý
Những vấn đề về sức khỏe mà đàn ông cần lưu ý
 
Cross Cultural Statistics, Trends, and Definitions
Cross Cultural Statistics, Trends, and DefinitionsCross Cultural Statistics, Trends, and Definitions
Cross Cultural Statistics, Trends, and Definitions
 
Desparacitantes externos
Desparacitantes externosDesparacitantes externos
Desparacitantes externos
 
Ung Dung CNTT
Ung Dung CNTTUng Dung CNTT
Ung Dung CNTT
 
Yourprezi
YourpreziYourprezi
Yourprezi
 
ciobanu_catalina_flickr
ciobanu_catalina_flickrciobanu_catalina_flickr
ciobanu_catalina_flickr
 
CV
CVCV
CV
 
Eduserv Impact Report
Eduserv Impact ReportEduserv Impact Report
Eduserv Impact Report
 
An Overview of security issues in Mobile Ad hoc Networks
An Overview of security issues in Mobile Ad hoc NetworksAn Overview of security issues in Mobile Ad hoc Networks
An Overview of security issues in Mobile Ad hoc Networks
 
Question 3
Question 3Question 3
Question 3
 

Ähnlich wie Children's missed health care appointments: an initial scoping review

Child Sexual Exploitation
Child Sexual ExploitationChild Sexual Exploitation
Child Sexual ExploitationBASPCAN
 
Day 1: Challenges and opportunities for better detection, diagnosis and clini...
Day 1: Challenges and opportunities for better detection, diagnosis and clini...Day 1: Challenges and opportunities for better detection, diagnosis and clini...
Day 1: Challenges and opportunities for better detection, diagnosis and clini...KTN
 
1Rough Draft Quantitative Research Critique And Ethical Consider.docx
1Rough Draft Quantitative Research Critique And Ethical Consider.docx1Rough Draft Quantitative Research Critique And Ethical Consider.docx
1Rough Draft Quantitative Research Critique And Ethical Consider.docxaulasnilda
 
Technical brief decision making factors around fp use in luweero, uganda- a r...
Technical brief decision making factors around fp use in luweero, uganda- a r...Technical brief decision making factors around fp use in luweero, uganda- a r...
Technical brief decision making factors around fp use in luweero, uganda- a r...Jane Alaii
 
A3. Current Practice Not EvidentApproaching CompetenceCompet.docx
A3. Current Practice Not EvidentApproaching CompetenceCompet.docxA3. Current Practice Not EvidentApproaching CompetenceCompet.docx
A3. Current Practice Not EvidentApproaching CompetenceCompet.docxbartholomeocoombs
 
trends.pptx
trends.pptxtrends.pptx
trends.pptxDDSID
 
Strategic IT Planning Your 3-Step ProcessIntroductionStrateg.docx
Strategic IT Planning  Your 3-Step ProcessIntroductionStrateg.docxStrategic IT Planning  Your 3-Step ProcessIntroductionStrateg.docx
Strategic IT Planning Your 3-Step ProcessIntroductionStrateg.docxrjoseph5
 
Maximizing System-Level Data to Address Health and Social Complexity in Children
Maximizing System-Level Data to Address Health and Social Complexity in ChildrenMaximizing System-Level Data to Address Health and Social Complexity in Children
Maximizing System-Level Data to Address Health and Social Complexity in ChildrenLucilePackardFoundation
 
Early Intervention: Improving Access to Mental Health by 2020 [Presentations]
Early Intervention: Improving Access to Mental Health by 2020 [Presentations]Early Intervention: Improving Access to Mental Health by 2020 [Presentations]
Early Intervention: Improving Access to Mental Health by 2020 [Presentations]Sarah Amani
 
Engaging Fathers in Children's Social Care
Engaging Fathers in Children's Social CareEngaging Fathers in Children's Social Care
Engaging Fathers in Children's Social CareSuzanne Triggs
 
Organising Health Information in an eHealth Environment - Principles & Concepts
Organising Health Information in an eHealth Environment - Principles & ConceptsOrganising Health Information in an eHealth Environment - Principles & Concepts
Organising Health Information in an eHealth Environment - Principles & ConceptsHealth Informatics New Zealand
 
Lessons Learned for Strengthening Early Infant Diagnosis of HIV Programs
Lessons Learned for Strengthening Early Infant Diagnosis of HIV ProgramsLessons Learned for Strengthening Early Infant Diagnosis of HIV Programs
Lessons Learned for Strengthening Early Infant Diagnosis of HIV ProgramsHFG Project
 
Promoting The Health And Well Being Of Londons Looked After Children Presenta...
Promoting The Health And Well Being Of Londons Looked After Children Presenta...Promoting The Health And Well Being Of Londons Looked After Children Presenta...
Promoting The Health And Well Being Of Londons Looked After Children Presenta...Shirley Ayres
 

Ähnlich wie Children's missed health care appointments: an initial scoping review (20)

Health supervision
Health supervisionHealth supervision
Health supervision
 
What will the parents say
What will the parents sayWhat will the parents say
What will the parents say
 
Child Sexual Exploitation
Child Sexual ExploitationChild Sexual Exploitation
Child Sexual Exploitation
 
Day 1: Challenges and opportunities for better detection, diagnosis and clini...
Day 1: Challenges and opportunities for better detection, diagnosis and clini...Day 1: Challenges and opportunities for better detection, diagnosis and clini...
Day 1: Challenges and opportunities for better detection, diagnosis and clini...
 
1Rough Draft Quantitative Research Critique And Ethical Consider.docx
1Rough Draft Quantitative Research Critique And Ethical Consider.docx1Rough Draft Quantitative Research Critique And Ethical Consider.docx
1Rough Draft Quantitative Research Critique And Ethical Consider.docx
 
Technical brief decision making factors around fp use in luweero, uganda- a r...
Technical brief decision making factors around fp use in luweero, uganda- a r...Technical brief decision making factors around fp use in luweero, uganda- a r...
Technical brief decision making factors around fp use in luweero, uganda- a r...
 
A3. Current Practice Not EvidentApproaching CompetenceCompet.docx
A3. Current Practice Not EvidentApproaching CompetenceCompet.docxA3. Current Practice Not EvidentApproaching CompetenceCompet.docx
A3. Current Practice Not EvidentApproaching CompetenceCompet.docx
 
trends.pptx
trends.pptxtrends.pptx
trends.pptx
 
trends.pptx
trends.pptxtrends.pptx
trends.pptx
 
Strategic IT Planning Your 3-Step ProcessIntroductionStrateg.docx
Strategic IT Planning  Your 3-Step ProcessIntroductionStrateg.docxStrategic IT Planning  Your 3-Step ProcessIntroductionStrateg.docx
Strategic IT Planning Your 3-Step ProcessIntroductionStrateg.docx
 
The Future of Child Public Health: A Director of Public Health View
The Future of Child Public Health:  A Director of Public Health ViewThe Future of Child Public Health:  A Director of Public Health View
The Future of Child Public Health: A Director of Public Health View
 
Maximizing System-Level Data to Address Health and Social Complexity in Children
Maximizing System-Level Data to Address Health and Social Complexity in ChildrenMaximizing System-Level Data to Address Health and Social Complexity in Children
Maximizing System-Level Data to Address Health and Social Complexity in Children
 
Early Intervention: Improving Access to Mental Health by 2020 [Presentations]
Early Intervention: Improving Access to Mental Health by 2020 [Presentations]Early Intervention: Improving Access to Mental Health by 2020 [Presentations]
Early Intervention: Improving Access to Mental Health by 2020 [Presentations]
 
Engaging Fathers in Children's Social Care
Engaging Fathers in Children's Social CareEngaging Fathers in Children's Social Care
Engaging Fathers in Children's Social Care
 
Organising Health Information in an eHealth Environment - Principles & Concepts
Organising Health Information in an eHealth Environment - Principles & ConceptsOrganising Health Information in an eHealth Environment - Principles & Concepts
Organising Health Information in an eHealth Environment - Principles & Concepts
 
Lessons Learned for Strengthening Early Infant Diagnosis of HIV Programs
Lessons Learned for Strengthening Early Infant Diagnosis of HIV ProgramsLessons Learned for Strengthening Early Infant Diagnosis of HIV Programs
Lessons Learned for Strengthening Early Infant Diagnosis of HIV Programs
 
Adolescent Medical Home Policy Brief July 2016. Tebb, K.P., Pica, G., Peake, ...
Adolescent Medical Home Policy Brief July 2016. Tebb, K.P., Pica, G., Peake, ...Adolescent Medical Home Policy Brief July 2016. Tebb, K.P., Pica, G., Peake, ...
Adolescent Medical Home Policy Brief July 2016. Tebb, K.P., Pica, G., Peake, ...
 
Promoting The Health And Well Being Of Londons Looked After Children Presenta...
Promoting The Health And Well Being Of Londons Looked After Children Presenta...Promoting The Health And Well Being Of Londons Looked After Children Presenta...
Promoting The Health And Well Being Of Londons Looked After Children Presenta...
 
Primary Health Care Strategy
Primary Health Care StrategyPrimary Health Care Strategy
Primary Health Care Strategy
 
Primary Health Care Strategy
Primary Health Care StrategyPrimary Health Care Strategy
Primary Health Care Strategy
 

Mehr von BASPCAN

Using Coronial Records to Understand Deaths of Infants Through Co-sleeping
Using Coronial Records to Understand Deaths of Infants Through Co-sleepingUsing Coronial Records to Understand Deaths of Infants Through Co-sleeping
Using Coronial Records to Understand Deaths of Infants Through Co-sleepingBASPCAN
 
'Letting the Future In' an intervention for child sexual abuse: from practice...
'Letting the Future In' an intervention for child sexual abuse: from practice...'Letting the Future In' an intervention for child sexual abuse: from practice...
'Letting the Future In' an intervention for child sexual abuse: from practice...BASPCAN
 
Evaluation of an Abuse and Trauma Recovery Service: A Multi-Agency Collaboration
Evaluation of an Abuse and Trauma Recovery Service: A Multi-Agency CollaborationEvaluation of an Abuse and Trauma Recovery Service: A Multi-Agency Collaboration
Evaluation of an Abuse and Trauma Recovery Service: A Multi-Agency CollaborationBASPCAN
 
A family approach to protecting children whose parents misuse drug/alcohol: E...
A family approach to protecting children whose parents misuse drug/alcohol: E...A family approach to protecting children whose parents misuse drug/alcohol: E...
A family approach to protecting children whose parents misuse drug/alcohol: E...BASPCAN
 
Asking for, and getting help for child neglect:children, young people and par...
Asking for, and getting help for child neglect:children, young people and par...Asking for, and getting help for child neglect:children, young people and par...
Asking for, and getting help for child neglect:children, young people and par...BASPCAN
 
Young People's Perspectives on Recognising and Telling about Abuse and Neglect
Young People's Perspectives on Recognising and Telling about Abuse and NeglectYoung People's Perspectives on Recognising and Telling about Abuse and Neglect
Young People's Perspectives on Recognising and Telling about Abuse and NeglectBASPCAN
 
WE MUST BE DOING SOMETHING RIGHT: CHILD SEXUAL ABUSE DISCLOSURE ACROSS THE DE...
WE MUST BE DOING SOMETHING RIGHT: CHILD SEXUAL ABUSE DISCLOSURE ACROSS THE DE...WE MUST BE DOING SOMETHING RIGHT: CHILD SEXUAL ABUSE DISCLOSURE ACROSS THE DE...
WE MUST BE DOING SOMETHING RIGHT: CHILD SEXUAL ABUSE DISCLOSURE ACROSS THE DE...BASPCAN
 
No One Noticed, No One Heard
No One Noticed, No One HeardNo One Noticed, No One Heard
No One Noticed, No One HeardBASPCAN
 
The Parents Under Pressure (PuP) Program
The Parents Under Pressure (PuP) ProgramThe Parents Under Pressure (PuP) Program
The Parents Under Pressure (PuP) ProgramBASPCAN
 
Improving Decision-Making in Pre-birth Assessment: The OxPUP Project
Improving Decision-Making in Pre-birth Assessment: The OxPUP ProjectImproving Decision-Making in Pre-birth Assessment: The OxPUP Project
Improving Decision-Making in Pre-birth Assessment: The OxPUP ProjectBASPCAN
 
A Pilot Study on the Feasibility and Efficacy of the Parents Under Pressure (...
A Pilot Study on the Feasibility and Efficacy of the Parents Under Pressure (...A Pilot Study on the Feasibility and Efficacy of the Parents Under Pressure (...
A Pilot Study on the Feasibility and Efficacy of the Parents Under Pressure (...BASPCAN
 
Engaging young advisors in creating strategies for increasing safety at the i...
Engaging young advisors in creating strategies for increasing safety at the i...Engaging young advisors in creating strategies for increasing safety at the i...
Engaging young advisors in creating strategies for increasing safety at the i...BASPCAN
 
Young People's Perspective on Online and Offline Experiences of Interpersonal...
Young People's Perspective on Online and Offline Experiences of Interpersonal...Young People's Perspective on Online and Offline Experiences of Interpersonal...
Young People's Perspective on Online and Offline Experiences of Interpersonal...BASPCAN
 
Incidence, nature and impact of online and offline forms of intimate partner ...
Incidence, nature and impact of online and offline forms of intimate partner ...Incidence, nature and impact of online and offline forms of intimate partner ...
Incidence, nature and impact of online and offline forms of intimate partner ...BASPCAN
 
Teenage Intimate Partner Violence Online/Offline - Findings from Expert Consu...
Teenage Intimate Partner Violence Online/Offline - Findings from Expert Consu...Teenage Intimate Partner Violence Online/Offline - Findings from Expert Consu...
Teenage Intimate Partner Violence Online/Offline - Findings from Expert Consu...BASPCAN
 
Perceived adult support and disclosure of maltreatment among Swedish adolesce...
Perceived adult support and disclosure of maltreatment among Swedish adolesce...Perceived adult support and disclosure of maltreatment among Swedish adolesce...
Perceived adult support and disclosure of maltreatment among Swedish adolesce...BASPCAN
 
Babies on Top of the World: Early Intervention in the Indian Himalayas Part 3
Babies on Top of the World: Early Intervention in the Indian Himalayas Part 3Babies on Top of the World: Early Intervention in the Indian Himalayas Part 3
Babies on Top of the World: Early Intervention in the Indian Himalayas Part 3BASPCAN
 
Babies on Top of the World: Early Intervention in the Indian Himalayas Part 2
Babies on Top of the World: Early Intervention in the Indian Himalayas Part 2Babies on Top of the World: Early Intervention in the Indian Himalayas Part 2
Babies on Top of the World: Early Intervention in the Indian Himalayas Part 2BASPCAN
 
Babies on Top of the World: Early Intervention in the Indian Himalayas
Babies on Top of the World: Early Intervention in the Indian HimalayasBabies on Top of the World: Early Intervention in the Indian Himalayas
Babies on Top of the World: Early Intervention in the Indian HimalayasBASPCAN
 
An Inclusive and Families Strengths Based Approach in Child Protection
An Inclusive and Families Strengths Based Approach in Child ProtectionAn Inclusive and Families Strengths Based Approach in Child Protection
An Inclusive and Families Strengths Based Approach in Child ProtectionBASPCAN
 

Mehr von BASPCAN (20)

Using Coronial Records to Understand Deaths of Infants Through Co-sleeping
Using Coronial Records to Understand Deaths of Infants Through Co-sleepingUsing Coronial Records to Understand Deaths of Infants Through Co-sleeping
Using Coronial Records to Understand Deaths of Infants Through Co-sleeping
 
'Letting the Future In' an intervention for child sexual abuse: from practice...
'Letting the Future In' an intervention for child sexual abuse: from practice...'Letting the Future In' an intervention for child sexual abuse: from practice...
'Letting the Future In' an intervention for child sexual abuse: from practice...
 
Evaluation of an Abuse and Trauma Recovery Service: A Multi-Agency Collaboration
Evaluation of an Abuse and Trauma Recovery Service: A Multi-Agency CollaborationEvaluation of an Abuse and Trauma Recovery Service: A Multi-Agency Collaboration
Evaluation of an Abuse and Trauma Recovery Service: A Multi-Agency Collaboration
 
A family approach to protecting children whose parents misuse drug/alcohol: E...
A family approach to protecting children whose parents misuse drug/alcohol: E...A family approach to protecting children whose parents misuse drug/alcohol: E...
A family approach to protecting children whose parents misuse drug/alcohol: E...
 
Asking for, and getting help for child neglect:children, young people and par...
Asking for, and getting help for child neglect:children, young people and par...Asking for, and getting help for child neglect:children, young people and par...
Asking for, and getting help for child neglect:children, young people and par...
 
Young People's Perspectives on Recognising and Telling about Abuse and Neglect
Young People's Perspectives on Recognising and Telling about Abuse and NeglectYoung People's Perspectives on Recognising and Telling about Abuse and Neglect
Young People's Perspectives on Recognising and Telling about Abuse and Neglect
 
WE MUST BE DOING SOMETHING RIGHT: CHILD SEXUAL ABUSE DISCLOSURE ACROSS THE DE...
WE MUST BE DOING SOMETHING RIGHT: CHILD SEXUAL ABUSE DISCLOSURE ACROSS THE DE...WE MUST BE DOING SOMETHING RIGHT: CHILD SEXUAL ABUSE DISCLOSURE ACROSS THE DE...
WE MUST BE DOING SOMETHING RIGHT: CHILD SEXUAL ABUSE DISCLOSURE ACROSS THE DE...
 
No One Noticed, No One Heard
No One Noticed, No One HeardNo One Noticed, No One Heard
No One Noticed, No One Heard
 
The Parents Under Pressure (PuP) Program
The Parents Under Pressure (PuP) ProgramThe Parents Under Pressure (PuP) Program
The Parents Under Pressure (PuP) Program
 
Improving Decision-Making in Pre-birth Assessment: The OxPUP Project
Improving Decision-Making in Pre-birth Assessment: The OxPUP ProjectImproving Decision-Making in Pre-birth Assessment: The OxPUP Project
Improving Decision-Making in Pre-birth Assessment: The OxPUP Project
 
A Pilot Study on the Feasibility and Efficacy of the Parents Under Pressure (...
A Pilot Study on the Feasibility and Efficacy of the Parents Under Pressure (...A Pilot Study on the Feasibility and Efficacy of the Parents Under Pressure (...
A Pilot Study on the Feasibility and Efficacy of the Parents Under Pressure (...
 
Engaging young advisors in creating strategies for increasing safety at the i...
Engaging young advisors in creating strategies for increasing safety at the i...Engaging young advisors in creating strategies for increasing safety at the i...
Engaging young advisors in creating strategies for increasing safety at the i...
 
Young People's Perspective on Online and Offline Experiences of Interpersonal...
Young People's Perspective on Online and Offline Experiences of Interpersonal...Young People's Perspective on Online and Offline Experiences of Interpersonal...
Young People's Perspective on Online and Offline Experiences of Interpersonal...
 
Incidence, nature and impact of online and offline forms of intimate partner ...
Incidence, nature and impact of online and offline forms of intimate partner ...Incidence, nature and impact of online and offline forms of intimate partner ...
Incidence, nature and impact of online and offline forms of intimate partner ...
 
Teenage Intimate Partner Violence Online/Offline - Findings from Expert Consu...
Teenage Intimate Partner Violence Online/Offline - Findings from Expert Consu...Teenage Intimate Partner Violence Online/Offline - Findings from Expert Consu...
Teenage Intimate Partner Violence Online/Offline - Findings from Expert Consu...
 
Perceived adult support and disclosure of maltreatment among Swedish adolesce...
Perceived adult support and disclosure of maltreatment among Swedish adolesce...Perceived adult support and disclosure of maltreatment among Swedish adolesce...
Perceived adult support and disclosure of maltreatment among Swedish adolesce...
 
Babies on Top of the World: Early Intervention in the Indian Himalayas Part 3
Babies on Top of the World: Early Intervention in the Indian Himalayas Part 3Babies on Top of the World: Early Intervention in the Indian Himalayas Part 3
Babies on Top of the World: Early Intervention in the Indian Himalayas Part 3
 
Babies on Top of the World: Early Intervention in the Indian Himalayas Part 2
Babies on Top of the World: Early Intervention in the Indian Himalayas Part 2Babies on Top of the World: Early Intervention in the Indian Himalayas Part 2
Babies on Top of the World: Early Intervention in the Indian Himalayas Part 2
 
Babies on Top of the World: Early Intervention in the Indian Himalayas
Babies on Top of the World: Early Intervention in the Indian HimalayasBabies on Top of the World: Early Intervention in the Indian Himalayas
Babies on Top of the World: Early Intervention in the Indian Himalayas
 
An Inclusive and Families Strengths Based Approach in Child Protection
An Inclusive and Families Strengths Based Approach in Child ProtectionAn Inclusive and Families Strengths Based Approach in Child Protection
An Inclusive and Families Strengths Based Approach in Child Protection
 

Kürzlich hochgeladen

OECD Webinar - ESG to deliver well-being in resource-rich regions: the role o...
OECD Webinar - ESG to deliver well-being in resource-rich regions: the role o...OECD Webinar - ESG to deliver well-being in resource-rich regions: the role o...
OECD Webinar - ESG to deliver well-being in resource-rich regions: the role o...OECDregions
 
Item # 4 - Appointment of new PW Director
Item # 4 - Appointment of new PW DirectorItem # 4 - Appointment of new PW Director
Item # 4 - Appointment of new PW Directorahcitycouncil
 
SPONSORED CONTENT - MyGovWatch - RFP Cliches Debunked: What Government Buyers...
SPONSORED CONTENT - MyGovWatch - RFP Cliches Debunked: What Government Buyers...SPONSORED CONTENT - MyGovWatch - RFP Cliches Debunked: What Government Buyers...
SPONSORED CONTENT - MyGovWatch - RFP Cliches Debunked: What Government Buyers...JSchaus & Associates
 
Yes!? We can end TB - World Tuberculosis Day 2024.
Yes!? We can end TB - World Tuberculosis Day 2024.Yes!? We can end TB - World Tuberculosis Day 2024.
Yes!? We can end TB - World Tuberculosis Day 2024.Christina Parmionova
 
The Federal Perspective on Coverage of Medications to Treat Obesity: Consider...
The Federal Perspective on Coverage of Medications to Treat Obesity: Consider...The Federal Perspective on Coverage of Medications to Treat Obesity: Consider...
The Federal Perspective on Coverage of Medications to Treat Obesity: Consider...Congressional Budget Office
 
Hub Design Inspiration Graphics for inspiration
Hub Design Inspiration Graphics for inspirationHub Design Inspiration Graphics for inspiration
Hub Design Inspiration Graphics for inspirationStephen Abram
 
2024: The FAR, Federal Acquisition Regulations - Part 17
2024: The FAR, Federal Acquisition Regulations - Part 172024: The FAR, Federal Acquisition Regulations - Part 17
2024: The FAR, Federal Acquisition Regulations - Part 17JSchaus & Associates
 
india sanitation coalition Swachata Abhiyan ​.pdf
india sanitation coalition Swachata Abhiyan ​.pdfindia sanitation coalition Swachata Abhiyan ​.pdf
india sanitation coalition Swachata Abhiyan ​.pdfcoalitionindiasanita
 
Living life to the full: How can we make our longer lives healthier, happier ...
Living life to the full: How can we make our longer lives healthier, happier ...Living life to the full: How can we make our longer lives healthier, happier ...
Living life to the full: How can we make our longer lives healthier, happier ...ResolutionFoundation
 
Water for Prosperity and peace - United Nations World Water Development Repo...
Water for Prosperity and peace -  United Nations World Water Development Repo...Water for Prosperity and peace -  United Nations World Water Development Repo...
Water for Prosperity and peace - United Nations World Water Development Repo...Christina Parmionova
 
Sensitivity Training for 2023 BSKE.pptx
Sensitivity Training for  2023 BSKE.pptxSensitivity Training for  2023 BSKE.pptx
Sensitivity Training for 2023 BSKE.pptxAllidaacLuap
 
Parents can give charity ideas for kids.
Parents can give charity ideas for kids.Parents can give charity ideas for kids.
Parents can give charity ideas for kids.SERUDS INDIA
 
Item # 5&6 - 218 Canyon Drive replat prop.
Item # 5&6 - 218 Canyon Drive replat prop.Item # 5&6 - 218 Canyon Drive replat prop.
Item # 5&6 - 218 Canyon Drive replat prop.ahcitycouncil
 
2024: The FAR, Federal Acquisition Regulations - Part 16
2024: The FAR, Federal Acquisition Regulations - Part 162024: The FAR, Federal Acquisition Regulations - Part 16
2024: The FAR, Federal Acquisition Regulations - Part 16JSchaus & Associates
 
For World Water Day 2024, we promote the vital link between water and peace.
For World Water Day 2024, we promote the vital link between water and peace.For World Water Day 2024, we promote the vital link between water and peace.
For World Water Day 2024, we promote the vital link between water and peace.Christina Parmionova
 
DB9_BTR_Webinar_Slidedeck_20230320 (1).pptx
DB9_BTR_Webinar_Slidedeck_20230320 (1).pptxDB9_BTR_Webinar_Slidedeck_20230320 (1).pptx
DB9_BTR_Webinar_Slidedeck_20230320 (1).pptxNAP Global Network
 
What Teenagers Have to Say about the Grandparents
What Teenagers Have to Say about the GrandparentsWhat Teenagers Have to Say about the Grandparents
What Teenagers Have to Say about the GrandparentsSERUDS INDIA
 
CBO’s Work on Health Care and a Call for New Research
CBO’s Work on Health Care and a Call for New ResearchCBO’s Work on Health Care and a Call for New Research
CBO’s Work on Health Care and a Call for New ResearchCongressional Budget Office
 
National Women's Month Celebration for PENRO Quezon
National Women's Month Celebration for PENRO QuezonNational Women's Month Celebration for PENRO Quezon
National Women's Month Celebration for PENRO QuezonAryaCapale
 
War in Ukraine and problematics of the Ukrainian refugees in USA
War in Ukraine and problematics of the Ukrainian refugees in USAWar in Ukraine and problematics of the Ukrainian refugees in USA
War in Ukraine and problematics of the Ukrainian refugees in USAival6
 

Kürzlich hochgeladen (20)

OECD Webinar - ESG to deliver well-being in resource-rich regions: the role o...
OECD Webinar - ESG to deliver well-being in resource-rich regions: the role o...OECD Webinar - ESG to deliver well-being in resource-rich regions: the role o...
OECD Webinar - ESG to deliver well-being in resource-rich regions: the role o...
 
Item # 4 - Appointment of new PW Director
Item # 4 - Appointment of new PW DirectorItem # 4 - Appointment of new PW Director
Item # 4 - Appointment of new PW Director
 
SPONSORED CONTENT - MyGovWatch - RFP Cliches Debunked: What Government Buyers...
SPONSORED CONTENT - MyGovWatch - RFP Cliches Debunked: What Government Buyers...SPONSORED CONTENT - MyGovWatch - RFP Cliches Debunked: What Government Buyers...
SPONSORED CONTENT - MyGovWatch - RFP Cliches Debunked: What Government Buyers...
 
Yes!? We can end TB - World Tuberculosis Day 2024.
Yes!? We can end TB - World Tuberculosis Day 2024.Yes!? We can end TB - World Tuberculosis Day 2024.
Yes!? We can end TB - World Tuberculosis Day 2024.
 
The Federal Perspective on Coverage of Medications to Treat Obesity: Consider...
The Federal Perspective on Coverage of Medications to Treat Obesity: Consider...The Federal Perspective on Coverage of Medications to Treat Obesity: Consider...
The Federal Perspective on Coverage of Medications to Treat Obesity: Consider...
 
Hub Design Inspiration Graphics for inspiration
Hub Design Inspiration Graphics for inspirationHub Design Inspiration Graphics for inspiration
Hub Design Inspiration Graphics for inspiration
 
2024: The FAR, Federal Acquisition Regulations - Part 17
2024: The FAR, Federal Acquisition Regulations - Part 172024: The FAR, Federal Acquisition Regulations - Part 17
2024: The FAR, Federal Acquisition Regulations - Part 17
 
india sanitation coalition Swachata Abhiyan ​.pdf
india sanitation coalition Swachata Abhiyan ​.pdfindia sanitation coalition Swachata Abhiyan ​.pdf
india sanitation coalition Swachata Abhiyan ​.pdf
 
Living life to the full: How can we make our longer lives healthier, happier ...
Living life to the full: How can we make our longer lives healthier, happier ...Living life to the full: How can we make our longer lives healthier, happier ...
Living life to the full: How can we make our longer lives healthier, happier ...
 
Water for Prosperity and peace - United Nations World Water Development Repo...
Water for Prosperity and peace -  United Nations World Water Development Repo...Water for Prosperity and peace -  United Nations World Water Development Repo...
Water for Prosperity and peace - United Nations World Water Development Repo...
 
Sensitivity Training for 2023 BSKE.pptx
Sensitivity Training for  2023 BSKE.pptxSensitivity Training for  2023 BSKE.pptx
Sensitivity Training for 2023 BSKE.pptx
 
Parents can give charity ideas for kids.
Parents can give charity ideas for kids.Parents can give charity ideas for kids.
Parents can give charity ideas for kids.
 
Item # 5&6 - 218 Canyon Drive replat prop.
Item # 5&6 - 218 Canyon Drive replat prop.Item # 5&6 - 218 Canyon Drive replat prop.
Item # 5&6 - 218 Canyon Drive replat prop.
 
2024: The FAR, Federal Acquisition Regulations - Part 16
2024: The FAR, Federal Acquisition Regulations - Part 162024: The FAR, Federal Acquisition Regulations - Part 16
2024: The FAR, Federal Acquisition Regulations - Part 16
 
For World Water Day 2024, we promote the vital link between water and peace.
For World Water Day 2024, we promote the vital link between water and peace.For World Water Day 2024, we promote the vital link between water and peace.
For World Water Day 2024, we promote the vital link between water and peace.
 
DB9_BTR_Webinar_Slidedeck_20230320 (1).pptx
DB9_BTR_Webinar_Slidedeck_20230320 (1).pptxDB9_BTR_Webinar_Slidedeck_20230320 (1).pptx
DB9_BTR_Webinar_Slidedeck_20230320 (1).pptx
 
What Teenagers Have to Say about the Grandparents
What Teenagers Have to Say about the GrandparentsWhat Teenagers Have to Say about the Grandparents
What Teenagers Have to Say about the Grandparents
 
CBO’s Work on Health Care and a Call for New Research
CBO’s Work on Health Care and a Call for New ResearchCBO’s Work on Health Care and a Call for New Research
CBO’s Work on Health Care and a Call for New Research
 
National Women's Month Celebration for PENRO Quezon
National Women's Month Celebration for PENRO QuezonNational Women's Month Celebration for PENRO Quezon
National Women's Month Celebration for PENRO Quezon
 
War in Ukraine and problematics of the Ukrainian refugees in USA
War in Ukraine and problematics of the Ukrainian refugees in USAWar in Ukraine and problematics of the Ukrainian refugees in USA
War in Ukraine and problematics of the Ukrainian refugees in USA
 

Children's missed health care appointments: an initial scoping review

  • 1. Children’s missed health care appointments: an initial scoping review Dr Catherine Powell, Dr Jane Appleton, Lindsey Coombes BASPCAN Congress Presentation April 2015
  • 2. Background This study builds on our previous work & presentation at BASPCAN Congress 2012  Children have a fundamental right of access to health care (UNCRC, 1989)  Failing to ensure a child’s access to health care sits within statutory definitions of neglect (e.g. HM Government, 2013)  Missed appointments are a known feature in the history of children who have suffered serious child maltreatment (e.g. Brandon et al.,2012)
  • 3. Research Question How do health care organisations respond when children do not attend/were not brought to their health care appointments?
  • 4. Methods The study, which began in August 2013, involved two work packages: 1. A web-based scoping review of NHS provider policies for managing missed appointments. The scoping review involved accessing health care provider web-sites across England, Scotland, Wales and Northern Ireland; 2. A case-study at one NHS Hospital Trust utilising a number of data sources (documentary analysis, semi-structured face to face/telephone interviews with 13 respondents, examination of the ‘systems’ in place, feasibility of case-tracking) to ascertain how a hospital system manages children’s missed health care appointments in practice.
  • 6. Findings: web-site searches  180/185 web-sites for Trusts in England (17 policies)  Seven Health Board web-sites in Wales (one policy & one guidance document)  14 regional Health Boards web-sites in Scotland (national guidance)  Five ‘Health and Social Care’ web-sites in Northern Ireland (one multi- site policy and one guidance document)  Four Independent Provider websites (no policies)  Google search (three additional policies)
  • 7. Findings: declaration of compliance (England) Trusts in England are expected to have a public ‘declaration of compliance’ against safeguarding children standards (Care Quality Commission, 2009); 144/180 declarations were found and scrutinised for a mention of a policy for the follow-up of children’s missed appointments; 125/144 had an overt mention of such a policy on their websites.
  • 8. Example of a declaration
  • 9. Findings: Policies Our concerns at the outset that the majority of providers would place their policies on ‘intranets’ rather than ‘internets’ proved to be the case; The 24 policies/guidance that were elicited were rated against six pre-determined standards: 0 not met, 1 partially met, 2 fully met; Mean score was 7.2, range 3-11.
  • 10. Standards for rating policies 1. The policy/procedure provides a definition of childhood that recognises that childhood goes up to 18 years of age 2. The policy/procedure reflects the UN Convention/Children Act 1989 and the duty to meet the welfare and protection needs of CYP, including access to health care 3. The policy/procedure provides a statutory definition of neglect that includes the failure to ensure access to health care 4. The policy/procedure makes reference to the importance of following up children who miss health care appointments (rationale - evidence – research - SCRs) 5. The policy/procedure provides clear guidance on the action that should be taken to follow up children who miss health care appointments (action staff expected to take) 6. The policy/procedure provides an auditable quality standard in relation to following up children who miss health care appointments. (ref to audit in practice)
  • 12. Findings: additional material  Additional material relating to cost-pressures and strategies to reduce ‘DNA’ rates more generally was found through the web- based searches (e.g. Board minutes) and reflect the efficiency pressures on the NHS at the current time;  However, the emphasis in many cases appeared to be primarily about managing 'the system' and introducing penalties for those who do not attend their appointments as scheduled;  There appeared to be an element of disconnect between the compliance statements on the one hand and the strategies and policies to address 'DNA's on the other.
  • 13. Work package two: Case Study Findings  NHS professionals and staff continue to use and favour the term 'Did not Attend' (DNA) rather than ‘WNB’;  Sympathy for the parent can prevent the professionals from 'seeing the child' and serving their best interests  Sympathy for the parent can prevent the professionals from 'seeing the child' and serving their best interests;  Older children should also be involved in decisions about their care and this would include actions that may be taken if they fail to attend for health care;  The degree to which a busy General Practice is able to provide the monitoring, assessment and referral (back into the 'system'), or take a lead in taking forward a missed appointment (or series of missed appointments) is of concern. .
  • 14. Findings The importance of considering the consequences for the child of missed appointments was raised by a number of respondents, including:  What are the consequences of these missed appointments for the child/young person?  What is known already about [the family]?  Why has there been missed appointments?  Has the clinician spoken directly to the parent about what’s happening?  Does the parent understand the need to get the child to these appointments?
  • 15. Child-focussed? 'That’s a family with fluctuating circumstances whose mother essentially is well intentioned and does understand the issues and sometimes life is a bit much for her, but she will always come back in the end. I suppose that’s an advantage of having known her for about 14/15 years now' 'And the first couple of appointments they attended very well, I think I engaged with mum very well and she was clear that she wanted to do some work on changing his weight and obviously Social Care were pressing me to ensure she attended all appointments.
  • 16. Recommendations: UK Health Care Provider Organisations 1. Review the title of local policies on children not attending health care appointments to clearly reflect a focus on ‘Did Not Attend’ (DNA) or ‘Children’s Missed Health Care Appointments’; 2. At the front-line, there should be simplified communication pathways to access guidance electronically on children’s missed health care appointments and a simple, one-sheet flow-chart outlining a clear pathway for decision making; 3. Children’s ‘Missed Health Care Appointments’ policies should be subject to audit and evaluation; 4. NHS provider policies on children’s missed appointments could include reference to ‘Did not Wait’ for those children/young people accessing the emergency department/A&E;
  • 17. Recommendations: UK Health Care Provider Organisations 5. Risk assessments should include a review of whether there is a pattern of missed appointments; 6. NHS provider policies on missed appointments include a requirement to inform families that information on missed appointments may be shared with other health professionals and children's social care (CSC) and that when a decision to refer to CSC is made this is discussed with the family in line with best practice and statutory guidance; 7. That policies on missed health care appointments also reflect the importance of considering the implication of parents (and parents to be) not attending their own health care appointments and the meaning of this for their parenting role (e.g. antenatal appointments, appointments with substance misuse services); 8. NHS providers to review at what time point a cancelled appointment is counted as a Did Not Attend (DNA);
  • 18. Recommendations: NSPCC 9. To put pressure on regulatory bodies to seek assurance from Executive Safeguarding Leads in Provider Organisations that their policies for managing DNA are congruent with their policies on follow up of children's missed health care appointments; 10. To seek assurance that Equality and Diversity leads in NHS organisations are inclusive of, and responsive to, the needs of children and young people.
  • 19. Recommendations: further research 11. There remain some gaps in knowledge of 'what is happening' in terms of responding to children's missed health care appointments that can only be addressed through a more extensive study that involves children, young people and their families as key participants. A further study is required to understand missed appointments from the perspective of children, young people and their families and to explore what they perceive as relevant interventions; 12. A tracking study is undertaken to follow a cohort of children who DNA, through their health care pathway with particular attention given to the interface and communications between primary and secondary care;
  • 20. Recommendations: further research 13.The degree to which a busy General Practice is able to provide the monitoring, assessment and referral (back into the 'system') or take a lead in taking forward a missed appointment (or series of missed appointments) as a safeguarding concern is an area for further exploration. There needs to be an understanding of the degree to which GPs are aware of the importance of children's missed health care appointments, or indeed, whether or not they have been involved, alerted or consulted on policies that directly involve them. 14. That further work is commissioned on the experiences of 16 and 17 year olds who are receiving their health care from adult services.
  • 21. Further details of the study:
  • 22. This study has been made possible by a small grant from the NSPCC We would like to express our sincere appreciation to all the pilot study participants who contributed their valuable insights and perspectives to this study. We would also like to thank the hospital Trust who supported the study and Tom Rahilly, NSPCC for his support. ACKNOWLEDGEMENTS
  • 23. For further information please contact: •Jane Appleton - jvappleton@brookes.ac.uk •Catherine Powell – catherine.powell@soton.ac.uk Thank you for listening