Our journey begins by firstly providing an overview of what led to the development of the commitment to developing the Keyworking Function and then looks at the progress across the Humber and North Yorkshire so far.
A review by Dame Christine Lenehan, Director, Council for Disabled Children, was commissioned by the Department of Health, and published in 2017. This was triggered by a small number of individual cases that had focussed public and government attention on the care, support and treatment provided to the group of children and young people described as having complex needs involving mental health problems and learning disabilities, autism or both. The review These Are Our Children called for every child at risk or in an inpatient setting (due to their mental health, autism and/or a learning disability) to be assigned a “Keyworker” by health or local authority services.
Although Keyworking is not a new concept, this recommendation outlined how this function would provide a liaison point for young people and their families, to help them navigate the system to ensure continuity of care and ensuring the voices of children, young people and their families are heard.
The government recognised the need placing the commitment within the NHS Long-Term Plan that this would be implemented by 2023/24 by providing dedicated funding to the new evolving Integrated Care Systems. To achieve this ambition Integrated Care Systems were able to provide an Expression of Interest to receive funding to pilot and test different models of Keyworking. The commitment to Keyworking is one of several other commitments that focus on reducing the reliance on inpatient care in mental health hospitals for children and young people with a learning disability, autism or both by building the right support in the community.
This model of Keyworking is not a clinical role or a replication of statutory duty, it is however a function of the Dynamic Support Register, where the purpose is to identify, review and monitor children, young people and adults with a learning disability, autism or both who are at risk of admission to a mental health hospital to ensure that they receive the right support the right time.
Progress Across the Humber and North Yorkshire so far….
Stakeholders and people with lived experience from across the six areas of Humber and North Yorkshire came together to form a Project Group which focused on developing the model for the Keyworker Service. A Hub and Spoke Model was developed as an integrated model across the whole area. The Expression of Interest to be an early implementer site from Humber and North Yorkshire Health and Care Partnership was successful in March 2021.
Following the successful bid, the Humber and North Yorkshire Project Group continued to meet to support the mobilisation of the service. The service has dedicated time to: developing a role that enables the voice of the child, young person and their family to be heard when situations and relationships may be fraught or fragmented, promoting our service with other agencies, and recruiting a team with the right qualities and values identified by people with lived experience during the development of the Expression of Interest.
Since the service launched in March 2022, there are now several children, young people, their families and carers who are being supported through an allocated Keyworker. Whilst it is recognised that work still needs to be done, there are a number of highlights over the past year including: Keyworkers supporting children/young people who have not been admitted to a mental health hospital following Care, Education and Treatment Reviews, examples of person centred approaches to building relationships with children young people and their families, alongside Keyworkers developing strong links with partners across Humber and North Yorkshire.
Our Keyworkers bring a wealth of experience, including personal lived experience and experience in educational, advocacy, health, social care and learning disability nursing roles. The Keyworker Service has been developed over several phases initially focusing on those under 18 and transitioning to adulthood. In the next gradual and planned phases of development the service will start to look at supporting those aged 18 to 25, to ensure that the best quality of support to the children, young people and families is received.
An innovative and exciting development is our Community of Experience, which we are working with KIDS to develop and will wrap around the Keyworker Service. It will be available to and created by children, young people with a learning disability, autism or both up to the age of 25, their families and carers. The Community of Experience will offer peer support, information and signposting and add value to our service. More information will follow.
Finally, I would also like to give a big thank you to all the people with experience of autism, learning disability or both who have contributed to co-producing our service, supported meetings and recruitment. I am delighted that Hull Parent Carer Forum produced a brilliant video for us about our service which can be viewed here. People with lived experience are at the centre of everything that we do.