A question of equity; Partnering across Government agencies to improve health outcomes for vulnerable children and young people – Navigate your Health

Abstract

Introduction: In Australia, the Queensland Child Protection Commission of Inquiry¹\xa0 highlighted that children and young people entering ‘Out-of-home care’ (OOHC) are under-immunised, experience higher prevalence of developmental delays, poor oral health, higher rates of mental health problems and substance misuse compared to those not in care. In an Australian context OOHC is ‘the care of children aged 0 –17 yearswho are unable to live with their primary caregivers. It involves the placement of a child with alternate caregivers on a short- or long-term basis’². Short description of practice change implemented: As Queensland’s largest city, with a population of approximately 2.4 million, metropolitan Brisbane has an estimated 925 children and young people (0 -17yrs) who at any one time live in OOHC. Improving health outcomes for these children and young people was identified as a priority by the Queensland Department of Child Safety Youth and Women (DCSY&W). Children’s Health Queensland Hospital and Health Service (CHQ) has partnered with the DCSY&W – Brisbane Region, and the Brisbane Aboriginal and Torres Strait Islander Community Health Service (ATSICHS) to co-design and implement an integrated interagency approach to improving the health and wellbeing outcomes of this vulnerable population. Aim and theory of change: The Navigate your Health (NYH) initiative is a ‘health navigator’ model designed to provide this population with improved access to health and developmental assessments, primary, secondary and tertiary health care and other social services to address and/or support identified health and social care needs. Through a process of co-design, the program is leading sustainable system-wide change by developing and implementing processes and pathways that mitigate the risks associated with single person or single agency solutions. Targeted population and stakeholders: The targeted population are all children and young people who enter OOHC during the two-year pilot period, and a proportion of children and young people already in OOHC. The major stakeholders are the DCSY&W, and the Brisbane ATSICHS, GPs, other health providers within the Brisbane region catchment. Timeline: The pilot program is running over a two-year period from January 2018 – January 2020. Highlights (innovation, Impact and outcomes): As of August 2018, over 250 children and young people have been referred to the program with 32% of referrals for Aboriginal and Torres Strait Islander children. Intensive case management has been required for 36% of referrals. Comprehensive health and development profiles have been completed for 75% of referrals. Sustainability: This project is a proof of concept for a replicable and sustainable model of service delivery that can be scaled to meet the unique local needs of other jurisdictions across Queensland. Transferability: Navigate your Health can be adapted to other jurisdictions. Conclusions, discussion and lessons learned: Early impact evaluation has indicated a number of significant improvements in both individual health outcomes in addition to system reform through enhanced service integration and collaboration. References: 1- State of Queensland, Queensland Child Protection Commission of Inquiry 2013. 2- Australian Government, Department of Human Services, 2007.