When my colleague Hannah Stace and I were appointed to establish the Gateway Programme Team in August 2022, we were excited to be part of this clinican led, co-produced, Complex Needs Escalation Support Framework.
Designed for multi-agency utility across all 9 Places in Cheshire and Merseyside, to promote timely action to address complex, unmet needs of children and young people, the model represented an excellent opportunity for evidence-based integration across a range of professions and employing organisations. We were delighted that stakeholders involved in Gateway's design had clearly stated their commitment to hold children, young people and their carers at the heart of the model from the earliest point in appreciative enquiry.
Aligned to strategic objectives reflecting the aims of the Transformation Programme for Children and Young People and NHS Long Term Plan, the Gateway Programme's key principles and underpinning values ensured implementation corresponded with other national publications, including The Marmot Review, which particularly resonated given post-pandemic system challenges experienced in the UK by health and care during 2022/23.
As this 18 month period of support for the Gateway Programme draws to a conclusion and we reflect upon what we have learned, I am reminded of the strength of ownership at Place for this model. Whilst consistency is undoubtedly crucial for system working, to ensure information and learning may be shared appropriately for equity of service, ownership at Place is also essential, so professionals closest to the young person and their carers may advance appropriate action in a timely manner.
Professionals acting as Gateway Chairs since August 2022 have been fundamental to implementation at Place, developing visibility of the model across employing organisations and promoting membership representing health and care, whilst avoiding unwarranted variation by leading co-production of Terms of Reference. 11 colleagues have acted as Gateway Chair during this period and we have been grateful to them for leadership and support provided for Gateway Members, as captured in the role descriptions developed in 2023.
As a result, we have enjoyed a superb level of engagement with professionals via Gateway Community of Practice. Online and in-person events have been supported by colleagues strongly committed to care for children, young people and carers, with a passion for sharing information, experience and best practice across the network. The atmosphere generated by the Community of Practice has been so postive and energetic, it would be impossible to leave events without feeling inspired.
Perhaps the greatest privilege of the period was working with Level Up Experts by Experience, who generously shared their time, knowledge and extensive skills to support implementation of Gateway. The resources they developed, including recorded material, in partnership with the Programme Team to support professionals engaged in Gateway are invaluable and we were delighted to see it featured in their award winning application to the Patient Experience Network Annual Awards in 2023 (PENNA).
Gateway is an example of what is possible when policy and research aligns with practice: Implementation of a new model across the diverse professions and organisations caring for children and young people across 9 Places requires detailed planning, in addition to an energetic and caring workforce, which recognises the importance of developing effective professional relationships.
Whilst the professional training, range of employing organisations, team and individual experiences Gateway Members bring will be rich in diversity (and this is most welcome, if we are to appropriately serve our communities at Place well) we must recognise that, without compassionate management and leadership, there will be a risk efforts to generate integration lead to misunderstanding, inadvertantly resulting in unhelpful barriers to timely action. By acknowledging difference and engaging in the development opportunity Gateway implementation has presented, Gateway Chairs and Members in Cheshire and Merseyside have been alert to the possibility of potentially unhelpful barriers, focussing on professional standards in common to develop multi-agency solutions, with a shared language developing around the model, which continues to be amplified. This emerging system identity evolving alongside Gateway development at Place is welcome.
The formal evaluation of Gateway, conducted by Liverpool John Moores University, will report later in 2024. The Gateway Programme Team would like to thank professionals and Experts by Experience from Cheshire and Merseyside supporting implementation of the Gateway Programme between August 2022 and March 2024. We are especially grateful to Dr Fiona Pender for her vision and leadership, who has guided us with kindness and compassion.