Actions speak louder: A second review of healthcare in ... - HMCPSI

ACTIONS SPEAK LOUDER
FINDINGS
An absence of health workers also clearly affects the degree of training and ongoing
support necessary for YOT caseworkers to understand, assess and refer health
needs satisfactorily. The lack of resources in general health nursing, which was
found in 30% of YOTs in this review, has meant that appropriate interventions have
not been delivered to meet the physical health needs of children and young people,
including many elements that would promote a healthy lifestyle.
Where there are gaps in direct provision, it becomes even more important for
universal services to provide a sufficient bridge, and for a possible fast-tracking
system to be in place in order to ensure that identified needs are met. Where there
have been issues with thresholds and the extent of universal provision, particularly
in mental health, needs that are potentially linked to crime remained unmet in this
vulnerable group.
Monitoring and evaluation
The extent of evaluation of healthcare within YOTs was also problematic, since many
YOTs have no clear idea of the impact of their health provision. There was, indeed,
little evidence of the systematic evaluation of either the effectiveness of health
services on offending behaviour, or their link to the overall performance of the YOT.
Targeted monitoring and outcome measures, including service users’ feedback,
need to improve and become more reliable and consistent so that health services
can understand, and learn from, achievements or shortcomings in their work
with YOTs.
Where monitoring and evaluation has been carried out effectively, often directly
related to the standard key performance indicators, good use has been made of
the potential to influence performance improvement. When Asset is accurately
completed, for example, this electronically based assessment system can offer a
range of ‘wizards’ (individually designed reports), which identify the most common
and high-scoring needs. This can influence resource allocation and then ascertain
changes or trends over time.
Good practice from inspection reports
“Data was used to improve service outcomes for children and young
people in a range of ways. The psychologist in the YOT also undertook
an audit of mental health needs within the YOT, which was used
to inform the decision to secure the continued specialist input to
the team.”
“The head of youth offending service held monthly meetings with the
local PCT and CAMHS, where monthly performance information was
discussed.”
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