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Pregnancy Family Conferencing Program

Sydney Local Health District
Project Added:
23 February 2016
Last updated:
8 April 2016

The Pregnancy Family Conferencing Program

Summary

The Pregnancy Family Conferencing (PFC) program provides early engagement and interagency care planning for pregnant women and families, where there are serious child protection concerns and a risk of placing the newborn in out of home care at birth.

Aim

To improve the health and wellbeing of pregnant women and families who require intervention from child protection services.

Benefits

  • Enhances collaboration and communication between families, disciplines and agencies.
  • Promotes patient-centred care and respect for the client, so their voices are heard.
  • Empowers families to understand and address the risks to their baby and make decisions about the welfare of their baby.
  • Aims to reduce the risk of out of home care placement for the baby after birth and decreases the length of stay in hospital.
  • Targets overrepresentation of Aboriginal children in the child protection system, through early intervention.
  • Improves the capacity for teams to work collaboratively, by providing a supportive structure.
  • Increases the number of coordinated care plans developed for clients, reducing the risk of crisis assumptions of care in hospital.

Background

Pregnant women who require intervention by child protection services often present with a number of complex health and social issues, with care provided by a range of disciplines and agencies. These multidisciplinary teams comprise professionals with varied roles and priorities, as well as differing views on whether the client is the baby or the mother.

Historically, collaboration between these teams was dependent on individual workers and agency practice. This resulted in a high level of crisis-driven casework and emergency foster care placements following the birth of a baby. Urgent assessments conducted in hospitals by child protection workers to determine the safety of newborn babies were reported to be traumatic for mothers, hospital staff and community services case workers. Identification of suitable foster carers also led to delays in infant discharge from hospital, placing increased pressure on the hospital system.

Implementation

  • Multidisciplinary teams are supported by highly-skilled and independent facilitators, who aim to improve collaboration and provide high-quality, patient-centred care.
  • Facilitators are recruited from child protection, mental health, social work and nursing backgrounds, bringing a wealth of knowledge and experience to the role.
  • Facilitators chair three meetings with families and multidisciplinary teams over the course of the program, to support the development of a coordinated care plan. The ‘three houses’ tool is used to guide these meetings, which was adapted from a program in Western Australia that adopted ‘Signs of Safety’ as their child protection practice framework.
  • Late referrals to the program are welcomed and consist of one meeting with very clear goals.
  • Facilitators undertake ongoing professional development to support their role, while Family and Community Services (FACS) prenatal case workers attend monthly meetings to ensure a coordinated and streamlined response to delivering care.

Project status

  • Sustained - the initiative has been implemented and is sustained in standard business.

Key dates

  • Project Start: April 2012.
  • Project Finish: July 2015.
  • Ongoing Funding: 2015-2017.

Implementation sites

  • Royal Prince Alfred Hospital
  • Canterbury Hospital

Partnerships

  • NSW Department of Family and Community Services
  • SLHD Drug health
  • SLHD Mental Health

Results

  • Since the project was implemented, the program has become embedded in the practice of social work staff in hospitals and at the Department of Family and Community Services.
  • Referrals to the program increased by 25% in 2014-15 compared to the previous year, from 16 families to 20 families.
  • Families who choose not to participate still benefit from the collaborative systems and clinical practices put in place as a result of the program.
  • Early intervention has reduced the resource requirements for hospital social workers. Prior to the project, assumption of care at an unplanned, crisis birth took 10 hours, while the average time per referral in PFC program meetings in which all relevant professionals are all present for case discussion and case planning is six hours.
  • Sharing information at structured and facilitated meetings has decreased the need for written Chapter 16A requests and multiple forms of communication, reducing the risk of miscommunication.
  • Executive support for the program has resulted in funding for a coordinator for two years from July 2015, ensuring ongoing stability and substantiality of the program. Funding is split between SLHD and FACS, with program accountability to both agencies.
  • Professionals interviewed in the program evaluation phase report that the PFC program allows them to work in genuine partnership with families. In cases where babies needed to be taken into out of home care, the process is viewed as better planned and coordinated.
  • Word of mouth referrals is strong, with one client in 2014-15 actively seeking to participate in the program after hearing about it from other clients.
  • The project is now being replicated in other local health districts throughout NSW. SLHD has assisted implementation in these districts, with program briefings, consultations and up-skilling of facilitators through knowledge sharing and skills-based training.
  • The program continues to evolve to meet the inevitable challenges associated with child protection work, where no two families are the same.

Awards

  • 2015 SLHD Quality Awards Entrant - Collaborative Team.

Lessons learnt

As with most complex interagency work in the child protection sector, the PFC program continually challenges practitioners to work more efficiently and collaboratively.  We learn something new from each conference we do – for example, how to engage fathers better in the process, how to manage differences of opinion in conferences and how to maintain a group of skilled and motivated facilitators.

Further reading

  • Turnell A. Adoption of the Signs of Safety and the Department for Children’s Protection child protection practice framework: background paper. Perth, WA: Department for Child Protection; 2008.

Contact

Michelle Maiese
Director Child Protection
Sydney Local Health District
Phone: 02 9378 1333
Email: michelle.maiese@sswahs.nsw.gov.au

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