Quality statement 3: Improving access to services

Quality statement

Children and young people with a conduct disorder who have been referred for treatment and support have a key worker to oversee their care and facilitate engagement with services.

Rationale

Children and young people with a conduct disorder and their families who have been referred for treatment and support have high treatment dropout rates and can sometimes find it difficult to access and engage with services. The identification of a key worker from one of the services in contact with the child or young person and their family is intended to support coordination of services and facilitate engagement.

Quality measures

Structure

Evidence of local arrangements to ensure that children and young people with a conduct disorder who have been referred for treatment and support have a key worker to oversee their care and facilitate engagement with services.

Data source: Local data collection.

Process

Proportion of children and young people with a conduct disorder referred for treatment and support who have a key worker.

Numerator – the number of children and young people in the denominator who have a key worker.

Denominator – the number of children and young people with a conduct disorder who have been referred for treatment and support.

Data source: Local data collection.

Outcome

a) Treatment uptake rates.

b) Treatment completion rates.

c) 'Did not attend' rates for children and young people with conduct disorders and their families.

Data source: Local data collection.

What the quality statement means for service providers, health and social care practitioners, and commissioners

Service providers ensure that they have sufficient resources in place and agreements with local partner agencies for children and young people with a conduct disorder who have been referred for treatment and support to have a key worker who will oversee their care and facilitate engagement with services.

Health and social care practitioners ensure that children and young people with a conduct disorder who have been referred for treatment and support have a key worker identified to oversee their care and facilitate engagement with services.

Commissioners ensure that they commission services that can provide children and young people with a conduct disorder who have been referred for treatment and support with a key worker identified to oversee their care and facilitate engagement with services.

What the quality statement means for patients, service users and carers

Children and young people with a conduct disorder who have been referred for treatment and support have a member of staff from one of the services they are in contact with to help coordinate their care and support them to access services.

Source guidance

Definitions of terms used in this quality statement

Key worker

This can include a member of staff from Child and Adolescent Mental Health Services (CAMHS), or a member of staff from a relevant social care, education or healthcare setting. The decision about who is the most appropriate professional will depend on what service is best placed to meet the needs of the child or young person – based on the severity and nature of the disorder. [Adapted from Antisocial behaviour and conduct disorders in children and young people (NICE clinical guideline 158), recommendation 1.7.6]

Oversee care and facilitate engagement

This includes working with children, young people and their families or carers to support engagement (for example, through following up with people if they do not attend initial appointments) and access to services by facilitating:

  • assessment and interventions outside normal working hours

  • assessment and interventions in the person's home or other residential settings

  • specialist assessment and interventions in accessible community-based settings (for example, community centres, schools and colleges and social centres) and if appropriate, in conjunction with staff from those settings

  • both generalist and specialist assessment and intervention services in primary care settings

  • access to services that support engagement (for example, crèche facilities, assistance with travel, interpreters and advocacy services). [Adapted from Antisocial behaviour and conduct disorders in children and young people (NICE clinical guideline 158), recommendations 1.7.7 and 1.7.8]

Equality and diversity considerations

Practitioners should support access to services and the uptake of interventions by children and young people, and their parents and carers, by being flexible in relation to settings and offering a range of support services. Recommendations 1.7.7 and 1.7.8 provide examples of settings and support services.

The workforce across agencies should, as far as possible, reflect the local community. Practitioners should have training to ensure that they have a good understanding of the culture of families with whom they are working. Interpreters should be provided if no practitioner is available who speaks a language in which the family members can converse fluently. Consideration should be given to the specific needs of:

  • girls and young women with conduct disorders

  • looked-after and adopted children and young people.