Big interview: Framework for good health - Sheila Shribman, national clinical director for children's services

By Dipika Ghose

| 04 January 2006

As one of the five outcomes in Every Child Matters, health plays an important role in youth work and the wider field of children's services.

This was emphasised when the previous national clinical director for children's services, Al Aynsley-Green, moved from the health sector to take on a wider remit as children's commissioner. His replacement, Sheila Shribman, who took up the post on 1 December, is well aware that health is a key part of wider youth policy.

"Youth Matters is very relevant to both child and adolescent mental health services and the transitions agenda," she says. "My role will take account of the Choosing Health white paper and Youth Matters."

One of the more innovative health-related ideas flagged up in the youth green paper was the "personal health MOT", a screening scheme to be carried out prior to the transition to secondary school. But this is still at the drawing board stage, says Shribman.

The paper also introduced three youth-friendly health centre pilots, which go live in Bolton, Hackney and Portsmouth from next summer. "We need to think about how young people want health care delivered," explains Shribman. "There are opportunities for drop-in centres, peer work and discussions with older young people. It's not just about a young person on a committee."

Shribman has an impressive background in youth health issues. She was a consultant paediatrician for more than 20 years in Northampton, and has also worked as a registrar at the Royal College of Paediatrics and Child Health and director at an acute health trust. Every Friday she works with young outpatients in Northampton. "It's important to keep in touch with the reality of delivering services," she says.

Shribman's main purpose is to "provide leadership" for delivering the "fantastic" National Service Framework for Children, Young People and Maternity Services. The framework, a 10-year strategy that outlines 10 standards to meet on children's health care and one on maternity services in England, was released last year. Shribman's initial focus will be on Standard 8, which aims to improve services for disabled children and young people with complex health needs.

Her appointment has coincided with two "exciting" developments. One is the launch of the Office for Disability Issues, followed by a conference run by the Council for Disabled Children in Birmingham, from which a programme of work is due to be released. The second was the release by the Department of Health of an "exemplar" that outlined a child's journey through the health service, and how the National Service Framework standards would make a difference.

Shribman says one of the main challenges is to provide consistent services across the whole age range, from maternity right through to adolescents and the transition to adulthood. She says: "I'm meeting a range of leaders in the field of transitions and we hope to hold a conference in March with professionals."

Taking account of the age range of young people is one issue the revised Working Together to Safeguard Children document is designed to tackle.

The document is being led by the Department for Education and Skills and is expected to include measures for sharing information on young people's sexual activity, as outlined in protocols released by area child-protection committees in London and Sheffield.

Shribman says: "Professionals need to consider individual circumstances and the maturity of the young person. We need to achieve a balance between helping young people and not discouraging them from using services."

FYI

- Sheila Shribman has three children, aged 18, 21 and 24

- She worked as a registrar at the Royal College of Paediatrics and Child Health for three years and was the medical director at Northampton General NHS Trust

- The standards in the National Service Framework cover health and wellbeing and early intervention; supporting parenting; child, young person and family-centred services; growing up into adulthood; safeguarding and promoting welfare; young people who are ill; young people in hospital; disabled young people and those with complex needs; mental health; medicines and maternity.

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