B8 - 10 High Impact Changes
PCT guide to applying change

C1 - CAMHS Tier 4 Review
East Midlands Review 2006

C14 - Palliative Care Commissioning Strategy
A practical guide

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   2 - Focus On Particular Groups

  • - Did you know?
  • - Guidance
  • - Regional Benefits
  • - Commissioning principles in action -

1. Data on local needs will:
  • inform LAA negotiations and CYPP priorities
  • inform commissioning decisions, service design and individual packages of care (micro commissioning)
2  Assessment of data on local groups will:
  • enable better understanding of local needs
  • cover universal as well as specialist needs eg ethnicity and diversity, sexual orientation, deprivation, housing, children in need, children in care, refugee children, anti-social behaviour. health needs.
3. Understand where children and young people live, learn and play:
  • so that services can be made as accessible as possible
  • use postcode mapping to show where needs are most prevalent across an area.
4. Review national guidance, research  and best practice:
  • to understand what services might be required and what works best for the particular groups you are focusing upon.
  • consider how broader initiatives (eg health promotion) might provide opportunities to target on prevention and intervention.
  • understand how major local and national policy issues are likely to have an impact on service direction.
5. Present findings in an easy to understand way:
  • easily understood by Children’s Trust members, professionals, community, parents, children and young people
6. Project set-up:
  • to establish a clear project and communication plan right from the start
  • to outline the key activities to be undertaken and timetable to work to
  • specify the focus of the strategy and the roles and structures to undertake and support the commissioning activities.
Identifying the ‘particular groups’Children’s Trusts develop their commissioning approach based on their analysis of the needs of different groups. Most commissioning frameworks have been developed upon a tiered model of levels of need and intervention that provides a conceptual framework for matching the level of children's need to the complexity of the interventions required to meet that need.


Nottingham's Preventative Strategy Model



In 2006 NFER’s research of 75 CYPPs identified eleven different groups identified when setting out joint commissioning strategies. The most frequent groupings were children with learning difficulties and disabilities, looked after children, substance abusers, vulnerable groups and teenage mothers. See Resource C2.


Joint Commissioning strategies in the East Midlands

Joint commissioning strategies specifically to improve outcomes for particular groups of children and young people are developed through the Children’s Trust arrangements across the East Midlands. Generally speaking these involve partnerships roughly consistent with local authority boundaries. See Resource C3.


DH & DfES guidance:


“Look within the overall picture at outcomes for specific children, young people, and parents (eg disabled, special educational needs, looked after children, sick children or those with mental health difficulties) as they require a differentiated approach to service provision or additional support. Consider the current pattern and recent trends of outcomes for children and young people in their area against national and relevant local comparators”


  • Learning from emerging regional strategies for CAMHS, Looked after children protocols, maternity, Targeted Youth Support
  • Reducing issues across geographical boundaries
  • Regional approach to low-incidence population groups
  • Sharing of regional data collected for national out of authority analysis.

Commissioning principles in action

User's needs first Strategic leadship Early intervention Partnership work People with skills Long-term view Work with providers Continuous evaluation Spend wisely Open Process
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Did you know? 

Nottinghamshire LA and their health partners are conducting a comprehensive review of ‘short breaks’ for children with disabilities to develop early prevention services and provide improved support for families.