Fostering a Culture of Teamwork to Improve Outcomes for Care-Experienced Children

Cardiff and Vale University Health Board

Introduction:

Enfys was established to transform the support provided to children in care across Cardiff and the Vale. The service aimed to move away from diagnosis-led models toward a whole-system, needs-led approach - enabling children and families to receive the right support at the right time, without being passed between services.

Methods:

A multidisciplinary team, including psychology and occupational therapy (OT), developed strong links with local authority, health, education, and third sector colleagues. Weekly panels, monthly best practice meetings, and nearly 1,000 yearly consultations helped upskill the adults around each child. OT was embedded in response to the developmental impact of trauma, and adoptive families were brought into scope to reflect the long-term needs of care-experienced children. The team used annual PDSA cycles to test, adapt, and evaluate their service delivery.

Outcomes:

Enfys has shifted the culture from siloed services to cohesive multi-agency working. The team offers tailored, timely support to children and families, with a reduction in inappropriate diagnoses and medication. Consultation has led to an 80% drop in therapy requests since 2018, indicating improved upstream support. Innovative workstreams such as a new FASD panel and a collaborative OT-psychology group are improving both understanding and care. Enfys now trains over 200 professionals a year and has become a local model of trauma-informed, whole-system care.

Learnings:

The team learned the importance of stakeholder co-design, capturing feedback creatively, and the value of a small but passionate workforce. Reflective evaluation has helped refine approaches and inform service development. Future improvements include earlier stakeholder involvement and stronger research partnerships.

What next?

With short-term funding ending in 2027, a strategic steering group has been formed to secure sustainability, enhance therapeutic capacity, and expand the model regionally. Enfys is contributing to national research and influencing best practice, aligned with the NEST framework and No Wrong Door model.