Strategic partner updates for February 2014

Mon,3 February 2014
News Health & Social Care

Health and Social Care update from our work as Strategic Partner to the Department of Health, NHS England and Public Health England

Looking for participants - Summit on the Commissioning of Wheelchair Services with David Nicholson, London, end of February

NHS England are hosting a summit, chaired by Sir David Nicholson, on the commissioning of wheelchair services and they look for up to 20 users of wheelchair services.It will be held on Tuesday 25th February, 12:00-3:30 in London, venue to be confirmed.

This will be an excellent opportunity for us to bring forwards a range of perspectives. Please get in touch with Bernd.Sass@disabilityrightsuk.org    (subject: wheelchair services summit) , mob 07906 521536.  

Health and Social Care update from our work as Strategic Partner (SP) to the Department of Health, NHS England and Public Health England

This month’s update includes reflections on Disability Rights UK’s events and workplan (lead on commissioning), and on how this will support local user-led organisations and finally news and insights on Winterbourne View, CQC and better public redress for example.

http://disabilityrightsuk.org/policy-campaigns/health-and-social-care-reforms 

The Strategic Partners last met on 14 January.   

Disability Rights UK led a workshop on commissioning. SPs saw the Joint Strategic Needs Assessment (JSNA) as continuous, comprehensive and inclusive information front end to any commissioning process. Both soft qualitative case study type information and quantitative data should be respected means for evidence. Local circumstances can mean that good practice cannot easily replicated elsewhere. 

Success in commissioning would demonstrate better outcomes and systematic use of resources to target 'unmet need' : health, service quality but also independent living of disabled people for example. There was consensus that the voluntary sector should focus on making constructive responses rather than trying to revamp the commissioning system which increasingly moves from an activity-based to an outcomes-based approach.

There are three building blocks the SPs will focus on as a journey to success:

  1. Strengthening the capacity of the local Voluntary and Community Sector (VCS) by providing infrastructure support on things like information on the health and social care reforms and levers, mandate and process of involving people and making the (business) case for implementing social prescribing, social investment, facilitating good practice, tying lose ends up for and with commissioners (eg interfaces between Health & Well-Being Board, Clinical Commissioning Groups, adult social care for the new 'Better Care Fund'), campaigning skills and forming partnerships with other local players, focusing on small (niche) providers and making sure people they support do not fall through the net between  specialist and CCG commissioning, eg seldom heard people, trans people and those with neurological conditions.  
  2. Supporting individuals and groups to micro-commission care and support by nurturing grassroots initiatives bottom-up, eg to pool personal (health) budgets to achieve economies of scale for innovative types of support. Such initiatives that are driven by patients and disabled people can enable them to join powerful activities that have previously been inaccessible to them. One example is a group of learning disabled people who have set up a cycle-powered smoothie bar to tour around community markets. This small social enterprise also enables people to tap into each others’ support networks and build up social capital. Information and insights will naturally flow between people themselves, which will enhance peer support way beyond the business of the smoothie bar. The win-win situation is that better health outcomes and greater quality of life and independent living can be combined with productivity gains, eg in reduced referrals for unplanned care.

We believe such user-driven examples can act as role models for the public sector as a whole. These initiatives also help make the voluntary sector more user-led and joined up. This is because people will wrap support around themselves across sectors, effectively acting as their own micro-commissioners. Then, there is scope for mainstream commissioning to pick up on the ‘choices’ personal budget holders have made and incorporate them into mainstream commissioning plans to reduce gaps in health inequalities.

To this end, people need to be recognised and rewarded for what they are doing already in giving peer support and for further contributions to the community. Strategic partners can help commissioners pick up on those contributions and tie in commissioning resources with people's own productive community networks. Furthermore, there is scope to work with patients and disabled people to support them to build up collective insights on ‘what makes me feel better?’ This can become the basis for co-produced and validated patient-reported outcomes and experience measures (PROMs/PREMs) which can be integrated in provider contracts and linked to payment. This way strategic partners can play a role in extending outwards accountability of services, a key lesson from the Francis inquiry for example.  

3. Kitemark for inclusive commissioning (following Stonewall's example)

Commissioners would be rated and rewarded by voluntary sector representatives for the degree to which they would be achieving some or any categories to be co-produced. Peer audits (between commissioners as peers) could be a central driver for this. The system could focus on both themes and localities. For commissioners this approach would help tackle several agendas for intelligent commissioning at the same time, eg social prescribing, writing the Social Values Act into tendering, looking to nurture powerful health partnerships with patients and the public. Potential partners could be the LGA's Knowledge Hub and the Commissioning Academy at Cabinet Office.  

NHS England to set out tendering process for personal health budgets support services

Informally, Disability Rights UK has heard of a tendering process for personal health budgets support services to be launched in spring 2014. From October 2014 people in NHS Continuing Care will have a right to have a personal health budget (the previous right to ‘request’ a personal health budget has been significantly strengthened). There are plans to extend this right beyond NHS Continuing Care to other care areas and a range of Clinical Commissioning Groups are already working on this.

Support services are needed to assist personal health budget holders across the different stages from accessing a personal health budget, advocacy, assessment through to monitoring.  Specifications of the service are likely to build on what has been established in Direct Payment Support services in social care. It has been recognised that disabled people’s user-led organisations should play a key part in this as they already do in social care. 

We will keep you up to date. If in the meantime you wish to discuss any of this as a Disability Rights UK member, please contact our Strategic Partnership Manager under Bernd.Sass@disabilityrightsuk.org .  

Chairs sought for NHS Continuing Healthcare independent review panels

NHS England is seeking a number of people to chair independent review panels which assess individuals’ eligibility for NHS Continuing Healthcare. Independent review panels can be requested by individuals or their representatives and they are co-ordinated by NHS England’s four regions. The panels comprise the chair and representatives from a clinical commissioning group and a local authority.

For more information, go to: http://www.england.nhs.uk/2014/01/08/chair-irps/ 

Informing CQC inspections - update on work in Southampton (Solent NHS Trust for both community and mental health: 27 February), Dudley (NHS Acute Trust: 28 February) Eastbourne (out of hours care at Station Health Centre: 4 March) - participants sought for survey and focus groups! 

Disability Rights UK has been asked by the Care Quality Commission (CQC) to help find disabled people in advance of the local CQC inspections who are happy to share their experiences in a discussion group and/or a survey. Participants in a discussion group will receive a voucher of £15 but they need to have used either acute care (at Dudley NHS Trust) or mental health or community health services (at Solent NHS Trust) or GP/Out of hours services (at Eastbourne Station Health Centre) in the last 12 months to be able to take part.

Please get in touch with Bernd if you fulfil any of these requirements and are interested in taking part OR know someone who might do to whom you could forward this info. You can email him: Bernd.Sass@disabilityrightsuk.org or call his mobile: 07906 521536. 

The CQC wishes to build up local and regional disability networks, and Disability Rights UK feels the forthcoming CQC inspections provide a valuable opportunity for disabled people to have their say and – in the longer term - shape how services will be commissioned. The CQC has issued a ‘Statement of Involvement’. More details about this can be found here: http://www.cqc.org.uk/public/sharing-your-experience/involving-people-who-use-services/launching-our-statement-involvement

Care Quality Commission’s new approach to inspecting community healthcare

The Care Quality Commission (CQC) have published their ‘fresh start’ document, which sets out new ways for inspecting health care in the community. This will include more inspections carried out by larger teams and spending more time observing care. Health services are now increasingly likely to be delivered in people’s homes, health centres and community hospitals and this makes joined up care so important.

The new approach to inspecting these services will see teams include:

  • expert CQC inspectors
  • sector specialists and clinicians – for example nurses, health visitors, allied health professionals such as occupational therapists, GPs, paediatricians, sector directors and managers
  • experts by Experience – our comprehensive inspections will always involve people who have experience of using care services.

Read more about the new plans here: http://www.cqc.org.uk/public/news/new-approach-inspecting-community-health-care

Prime Minister's Challenge Fund project: patients invited to assess pilots

In October 2013, the Prime Minister announced that there would be a new £50 million Challenge Fund to help improve access to general practice and stimulate innovative ways of providing primary care services.  The Challenge Fund will support at least nine pilots covering up to half a million patients, with at least one in each region of England to support spread of innovation. This will include extended opening hours, greater use of web-based and mobile technology, and joining up urgent and out-of-hours care.

The Government has asked NHS England to lead the process of inviting expressions of interest and overseeing the pilot schemes.  The project is now live and Expressions of Interest are being sought on a national basis.

They are keen to ensure we have representation from patient groups on the assessment panel.  They have developed a detailed timeline for this project and the assessment panel will need to assess applications in the first two weeks of March, with two x two-hour assessment meetings taking place 17 and 18 March. If you or any members of your organisation are interested in being involved please can you contact Kate Tattershall on:  kate.tattershall@nhs.net

The Patient and Public Voice Assurance group for Specialised Services: recruiting a Chair and up to 8 Members

The Patient and Public Voice Assurance Group (PPVAG) is an NHS England committee and accountable to the NHS England Specialised Commissioning Oversight Group.  PPVAG will help NHS England put the patient and carer perspective at the heart of commissioning, including working together on plans, advising, and offering constructive challenge.

For further information on this opportunity please visit http://www.england.nhs.uk/ourwork/commissioning/spec-services/vac/

The closing date for applications is midday on 19 February 2014.

The Care Bill: factsheets

Please see the link below which contains 19 factsheets and a glossary that accompany the Care Bill. For the factsheets, go to: https://www.gov.uk/government/publications/the-care-bill-factsheets 

Adult Social Care Outcomes Framework (ASCOF) – a local campaigning tool?!

With the support of a number of Strategic Partners (including Disability Rights UK), the Department of Health (Sam Pryke) has made outcomes information on adult social care services more accessible to people who use care and support services, and the wider public.

A key role of the Adult Social Care Outcomes Framework (ASCOF) is to support improvement in adult social care services, by enabling local people to hold their council to account for the quality of the services they provide.  To this end, an online tool was assessed to present data from the ASCOF in a user-friendly way for use by the public to enable them to find out about their local authority’s social care services, and to support them in conversations with their local authority about these.

Together with the Health and Social Care Information Centre (HSCIC) the ASCOF website was launched on 11th November and can be accessed at: http://ascof.hscic.gov.uk/. It can also be accessed at: https://www.gov.uk/ or http://www.nhs.uk/carersdirect/social-care/pages/how-local-authority-social-services-perform.aspx. The website to be highlighted on NHS Choices to ensure easy access to the general public.

On the ASCOF website, users can select their local authority from the map or drop-down menu, or type in their postcode to find information on outcomes including quality of life, satisfaction with care services and feeling safe. Local authority performance is shown against national, regional and similar local authorities’ performance.

There is continuing work with the HSCIC to scope the options for further enhancing the functionality and presentation of the tool. This will be informed by a programme of engagement to reach members of the public and people who use care and support and also local authorities, voluntary and community sector, local Healthwatch organisations, and national stakeholders including the Association of Directors of Adult Social Services and Local Government Association.