Internationally it is well-recognised that sharing information about children at risk of harm can save lives. The Child-At-Risk (CAR) electronic medical record alert system implemented by Northern NSW Local Health District in 2015 enables clinicians to see that their patient or client (child or at-risk pregnant woman) has been identified as having wellbeing concerns. This alert system then prompts clinicians to ensure: (a) the patient/family has been referred to services relevant to their needs (b) the clinician has considered whether the health service has information about the family that should be shared with other prescribed bodies under Chapter 16A of the Children and Young Persons (Care and Protection) Act, 1998 and (c) that missed appointments by the patient/family are assertively followed up. This might include relaxing strict 'missed appointment' rules where, once a number of missed appointments are reached, the patient is no longer followed up. The CAR Alert information sharing system has produced excellent clinical outcomes, particularly for at-risk infants in the first 1000 days of their life. Health practitioners report that the CAR alert system has allowed them to assess children through a child wellbeing lens rather than only focussing on the presenting medical issue. Interagency child protection partners have described cases where they were able to reach families quicker to offer support due to the improved communication with health services regarding families experiencing vulnerability.

The issue: Families dealing with parental substance dependence are some of the most vulnerable within society, and yet often feel alienated from mainstream health services and supports.
Why it matters: Women with a history of substance use might not access available services due to multiple barriers. Access to parenting services during pregnancy and early childhood can increase parenting confidence and capacity.
The solution: Identification of the need for a service that caters to this vulnerable group led to the establishment of the Possum Playgroup.
The playgroup brings together existing services and resources to create an innovative approach to removing barriers to quality healthcare access. By integrating a range of health, community and social services into the healthcare setting vulnerable families can access support in a way that best meets their needs.
Since commencing in May 2016, six to eight families with a history of substance use in pregnancy have attended weekly for multiple visits. Families included fathers and siblings.
Making a difference: Since the inception of the Possum Playgroup, the increased antenatal engagement between the Midwifery, Newborn Care, Drug Health and Social Work teams has provided greater continuity of care for women and their families involved with Drug Health Services. This has led to the creation of a pathway to the provision of postnatal/post-discharge support involving multi-service collaboration in partnership with Tresillian Family Care Centres. The team will continue to work in partnership with families to address social determinants of health and build parenting capacity for this group.

As our service system becomes increasingly complex, with multiple funders, service providers and practitioners; unpredictable levels of skill; varying levels of connection to community; and all within an environment of major reform, we struggle to find effective and efficient ways of coordinating, collaborating and even debating.

It’s fine therefore to talk about systems reform, but if we don’t pay attention to how that plays out at a community level, where multiple service providers are engaged with government in meeting (or not) the needs of families and children then we are unlikely to get outcomes.

From Campbelltown to Cairns, Child and Family Service Managers are sitting around tables with their NGO and Government partners, engaging in system reform or some form of collaborative planning or co-design. There seems to be a silent assumption that all that is required is to get people round the table, sometimes with a facilitator, and we can reform and redesign.

Of course we all know that to be the Autumn/Winter Collection from the Emperor himself. The challenge presented to us, which I think we have yet to grapple with at a local level, is what are the roles we need to play at that ‘table’; what skills do we need to participate in that process; and what shared principles and framework should underpin this work.

In Australia it is still legal for adults to physically punish and chastise children but when adults hit adults they can be charged with assault. Human rights demand that children have at least the same legal protection as adults – in the family and elsewhere. However any discussion on banning physical punishment of children in the home evokes polarised and vitriolic debate in this Country. Regardless of the fact that Australia is a signatory to the Convention on the Rights of the Child (CRC), we continually ignore the overwhelming body of evidence on the plethora of harmful impacts of physical/corporal punishment.

This paper will discuss the following
• Current status on what Australia is (or is not) doing to uphold children’s rights to protection from violence in the home
• Save the Children’s global work in advocating for the prohibition of physical and humiliating punishment in all settings,
• Positive Parenting strategies which do not involve any physical punishment of children
• Advocacy plans to influence Australia to meet obligations and recognition of children as human beings and rights holders to enhance children’s position in society