Transformational Leadership in Gwent's Pathways of Accessing Support: Enhancing Services and Outcomes for Children and Young People
Aneurin Bevan University Health Board
Introduction:
In Gwent, children and young people with developmental, neurodivergence, emotional, and mental health needs can now access support through three single points of access: Integrated Support for Children with Additional Needs (ISCAN), Single Point of Access for Children’s Emotional (SPACE) Wellbeing, and the evolving Neurodiversity Early Support Hub (NESH). This transformation emerged from a need to address fragmented services, long referral delays, and poor coordination. A strategic, whole-systems approach was adopted to ensure high-quality, person-centred care in line with statutory duties and national frameworks.
Methods:
Led by Dr. Kavitha Pasunuru and Tracey Smith, a collaborative leadership approach grounded in quality improvement was implemented. Stakeholders from health, education, social care, and third sectors, including children and families, co-designed solutions. Using Plan-Do-Study-Act (PDSA) cycles, the team redesigned referral pathways, standardised processes, introduced a real-time performance dashboard, and embedded continuous improvement training. Staff were empowered through quality improvement capability building, while shared ownership and data transparency drove engagement.
Outcomes:
- Average referral processing times reduced by 40%
- 85% of families reported better communication and faster support
- Staff morale improved, with clearer roles and reduced duplication
- Cross-service collaboration strengthened, enhancing holistic care
- Real-time data enabled informed decision-making and gap identification
The initiative aligned closely with Health and Care Quality Standards, particularly in timeliness, effectiveness, and person-centredness.
Learnings:
Co-production with families surfaced insights beyond data. Strong inter-agency relationships, data transparency, and adaptive leadership were key enablers. Empowering frontline staff created a more resilient and engaged workforce. Change was understood as continuous, requiring flexibility, shared vision, and commitment to quality.
What next?
Next steps include expanding NESH, enhancing early intervention links, embedding improvement forums and leadership development, refining digital tools, and establishing advisory panels. Lessons will be shared nationally to inform wider system transformation across Wales.
