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Craig Russo outlines the Core Needs School Pilot, a needs-led, school-based early intervention model for young people with neurodevelopmental needs. He describes how embedding clinicians in schools enables rapid, functional assessment and support without waiting for diagnosis, improving outcomes while significantly reducing costs and demand on specialist services. It demonstrates impact and support expansion, highlighting strong value for money, improved access and alignment with national SEND reform principles. The Core Needs provides a clear, practical example of how a needs‑led model can be operationalised at scale within mainstream education, moving beyond theory into delivery. It demonstrates how embedding clinical expertise directly into schools transforms access, shifting support closer to children and young people and enabling real-time assessment, observation and intervention in their everyday environment. This approach not only improves timeliness but strengthens relationships between health, education and families, creating a more joined-up system that is easier to navigate. A key learning point is the power of intervening early with functional, strengths-based support rather than relying on diagnostic thresholds. The model shows that many young people can be effectively supported through a single, well-structured intervention, supported by a period of watchful waiting and clear step-up pathways when required. This has important implications for demand management, demonstrating a credible route to reducing pressure on specialist services while maintaining safe and appropriate escalation. The pilot also highlights the importance of building capability within schools. By working alongside SENCOs and staff, clinicians are not only supporting individual children but leaving a lasting legacy of increased confidence, skills and consistency within the wider workforce. This creates a multiplier effect, where impact extends beyond the initial intervention and contributes to longer-term system resilience. From an operational perspective, the pilot identifies critical enablers of success, including strong multi-agency partnership working, clear referral processes, dedicated workforce capacity and a structured delivery model. It also makes clear the risks of not investing, particularly around increasing demand, widening inequity of access and continued reliance on costly statutory pathways. For decision-makers, the key action is to consider how this model can be embedded as part of the core local offer, rather than as a time-limited pilot. The evidence presented supports scaling through a phased approach, ensuring quality and consistency are maintained while expanding reach. It also prompts a wider reflection on how services can redesign pathways to prioritise early intervention, improve flow and ensure that resources are directed where they have the greatest impact. Overall, this pilot offers a compelling, evidence-informed case for system change, showing not just what should be done differently, but how it can be delivered in practice in a way that is sustainable, equitable and centred on the needs of children and young people. More blogs on the hub from Craig Russo: Partnership working between A&E, the police and custody healthcare

With general practice in crisis due to workforce shortages, an increasingly complex workload, rising public expectations, and further pressures caused by the Covid-19 pandemic, The King's Fund are providing the time and space for you to reflect, think differently, share and learn. Join peers and experts from The King’s Fund to explore: what the future of general practice looks like how the experience for patients and staff can be improved how to ensure those actions are building blocks towards the future. This event is for GPs, commissioners, nurses, practice managers, allied health professionals, Additional Roles Reimbursement Scheme (ARRS)-funded roles, and other professionals working in multidisciplinary general practice teams and those responsible for general practice at place or neighbourhood level. Register

Abbie experienced a high-risk pregnancy with her twin girls. They were born at 27 weeks gestation and weighed in at just 677g and 500g. After 150 nights in Neonatal Intensive Care Unit (NICU), both of Abbie’s daughters came safely home.  In this blog, Abbie highlights the importance of building a trauma-informed, clinical network around women whose babies have spent time in NICU. Drawing on her own experience and insights, she offers suggestions for how midwives, GPs and health visitors can support their mental health postnatally.  The post-partum period is important. A mother recovers and heals physically from birth, but it also is a strong influencing factor on the long term physical and emotional wellbeing of both mother and baby. I want to consider a quote I saw recently, ‘Remember to hold the mother, not just her baby.’ Whilst I welcome society recognising that women shouldn’t be forgotten once their baby has been born, my immediate thought was - but what if the mother isn’t even holding her baby? What if the baby hasn’t left the hospital yet? Who holds the mother then, and ensures she feels safe, heard and supported? We know that parents who have experienced time on a NICU Unit are 80% more likely to experience psychological distress, than parents who haven’t. Care for a woman during and after, needs to be trauma-informed, supportive and personalised; their mental health must be prioritised. As the data demonstrates, the contacts during the postnatal period, affect the weeks, months and even years that follow. Frequent, open communication asking how she is throughout, will ultimately support her wellbeing safety. Here’s are some of my thoughts on how midwives, GPs and health visitors can help support women who have had babies in NICU… Community midwives It is important that women whose babies remain in NICU, feel considered and counted too. We once were the patient too. Never let women fall down a gap in accessing their postnatal care, because their baby was not discharged to home, when they themselves were discharged. These appointments provide important opportunities to talk postnatally about maternal mental health. Women may be feeling frightened and scared about their baby in NICU. They may also be feeling guilt about their baby being early or sick. Acknowledge that these feelings are all entirely normal for the circumstances they are in. Acknowledge that it is hard and difficult. Acknowledge that the separation between mum and baby, rather than both home together, is not how it should be. Ask what she needs. These early days can often feel fast, and our minds have not caught up yet. Be prepared to sit with silence as she starts to process what is happening. Hold that space open to listen. Take early opportunity to refer or signpost for support where appropriate. Early identification can often avoid crisis. General practitioners Ensure that postnatal follow up is completed at 6-8 weeks post birth. It is not exclusive to those whose babies are home and able to also attend this appointment. Access to this must be equitable for all women. It may be an initial telephone appointment, or have to be considerate of time that the woman wishes to spend on the NICU. A degree of flexibility is needed here to achieve access, as the surrounding circumstances are different to the regular postnatal check up alongside baby. Continue the dialogue about postnatal mental health. Be considerate of language here too. I know I personally found phrases such as, ‘still in NICU’, or ‘at least they’re in the right place,’ difficult. Support us by knowing NICU can feel like a marathon and all we want too, is for our baby to come safely home with us. Normalise talking about postnatal maternal mental health in primary care, from the beginning. Trusting relationships are built this way, and women will feel safer reaching our to their GP if they are struggling. Whether that’s in the first few weeks, or even a year down the line, GPs can empower women postnatally and equip them with choice regarding support. It is important to know support exists and that other mothers have needed this too. Health visitors Often it is after the much yearned for hospital discharge, there is more time to reflect and consider what happened in the immediate postnatal period. This can be when women start to really feel the effects of spending time in NICU. Balancing this processing of events, with the demands of raising your baby, and adding in more sleep deprivation on top, can often lead to the perfect storm. Babies who have spent time in NICU usually leave with an array of outpatient appointments and there can be a theme, that they remain the patient and centre of support beyond. Developmental assessments, ‘milestones’ and even birthdays, can all evoke the feelings we had in NICU right at the start. Often our feelings of fear, guilt, and even a grief regarding the path we thought antenatally, we would follow, re-emerge. Anxiety regarding baby’s development and their continued health can be at the forefront of our mind because of the experiences we have had. The health visitor is such a valuable continued contact here in these following months for mother and baby. Rather than viewing their NICU experience as simply in the past, let mothers know there is space to talk about it postnatally. Demonstrate an understanding that a mother’s experience of NICU, is not simply left at the NICU doors when discharged. Listen and validate the feelings that come up, do not dismiss them. Tell them about the support choices available. Approaching appointments or contacts like this will really help mothers feel able to speak openly and ask for support if and when they need it. Final thoughts Spending time in NICU with your baby is traumatic. Whether your baby was there for a day, a few weeks or even months. Building trusting, listening relationships that validate how women are feeling postnatally, can empower them with choice and information about support they can access, at the right time for them. It recognises that whilst the trauma cannot be erased, care can go a long way to mitigate the experiences postnatally. Related reading Women who experience high-risk pregnancies are too often forgotten when their babies are born My Black Motherhood: Mental Health, Stigma, Racism and the System (by Sandra Igwe) Racial disparities in postnatal mental health: An interview with Sandra Igwe the Founder of The Motherhood Group Patient safety and maternal mental health during covid Neonatal herpes: Why healthcare staff with cold sores should not be working with new babies Leading for safety: A conversation with Jane Plumb, Founder of Group B Strep Support

This is part of our series of Patient Safety Spotlight interviews, where we talk to people working for patient safety about their role and what motivates them. Bill talks to us about how patient safety and transparency have been key priorities throughout his career as an Operating Department Practitioner (ODP) and then a leader in the NHS. He highlights the need for a longer-term approach to workforce planning and talks about how leaders can set a culture that engages with and prioritises patients.