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FIONA CASSIE talks to nursing leader and Children's Team member Sonia Rapana about her role in the Children's Team initiative to help children not only survive but also thrive.

The wraparound support that can be offered by Children's Teams and lead professionals epitomises what holistic nursing is all about, says Sonia Rapana.

Rapana, a nurse and clinical manager for Tipu Ora (a Rotorua provider of primary health and social services), is a member of the country's first Children's Team, which was launched in Rotorua in July last year.

Children's Teams aim to step in and offer intensive child-centred family support to vulnerable children so they don't progress down the path to needing Child, Youth and Family child protection or being abused, or worse, becoming a statistic.

The team is made up of professionals from across health, education, social, and other sectors who have the skills, resources, and networks to help children and their families. The team also provides oversight and advice to the lead professionals (often social workers or nurses) who coordinate an individual child's care plan.

Rapana says nurses often aim to work holistically to try and help a client's housing or school issue but soon come across systemic or time barriers to finding out the information or seeking the support they need.

“As a lead professional, you've got at your immediate disposal people in the Children's Team from those sectors that you can go to for that information.”

In August –just over a year after being launched as the country's first demonstration site – he Rotorua Children's Team and its 10 lead professionals were supporting 57 children and their families/whānau.

Rapana is one of seven members of the Rotorua Children's Team, which includes a senior social worker (working in liaison role between Child, Youth and Family and the Lakes District Health Board), a paediatrician, another registered nurse representing Whānau Ora, a third registered nurse with a mental health background, a police representative, and it is chaired by regional children's director Mahalia Paewai, who has a background in education and psychology.

The team meets weekly to consider referrals for Children's Team interventions, with referrals coming in from the organisations and agencies like the DHB, CYF, Family Start, Ministry of Education, and Police. If the referral meets the criteria, the child/children and their family are assigned a lead professional who works with them to draw up a shared care plan and to coordinate all the agencies and professionals needed to bring the plan to fruition – be it housing, health, school, or finding their whakapapa (lineage).

“Making sure everybody is on the same waka,” Rapana says.

Rapana says a family will not be accepted if the team considers the family situation is too complex and the risk too high that CYF intervention is needed instead. Tragic abuse victim Nia Glassie would have been unlikely to come under the team.

The team may also decline a referral if it believes the needs of the family can be met by existing services and agencies. An example is Family Start, which works with children from 0–3 years old.

“It was very obvious that some health and other professionals didn't really know that programmes like Family Start existed, so we were referring children to the Children's Team,” said Rapana. “It has highlighted that some services need to be more visible.”

Tipu Ora has provided one lead professional (LP) to the team, a social worker working full-time as an LP, but other LPs, which include nurses, are working part-time for the team and part-time for their regular employer.

Rapana says as a demonstration site the Children's Team process is still evolving, but she says the big point of difference from before and now is having all sectors sitting around the same table and feeding into a shared plan for a child in need.

“It's how we should all be working.”