andrew w dawson. partner and co-founder brunswicks llp councillor for frodsham & helsby ...
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Andrew W Dawson
Partner and co-founder Brunswicks LLP Councillor for Frodsham & Helsby Chairman of Overview & Scrutiny
Committee Cheshire West & Chester Council
Brunswicks LLP 56 Hamilton Square Birkenhead CH41 5AS 08455 190691 07970 635629 07855 855 588 – 24 hours
A “network of local people and organisations, funded by the Government and supported by independent organisations known as a Host to promote and support the involvement of people in the commissioning, provision and scrutiny of local health and social care services.”
DH definition Local Involvement Networks = LINks
Replace old NHS patients’ forums
1 April 2008 (piloted in 2007)
One per local authority area (social
services)
Gvt funding of £84m (£26m pa) runs to
2011
Will this be a priority going forward?
Local Government and Public Involvement
in Health Act 2008 s221(2)
Duty on local authorities:
To promote and support the involvement of
people in the commissioning, provision and
scrutiny of local care services
...
Local authority has to retain “host
organisation” to set up and support their LINk
◦ Promote
◦ Encourage participation
◦ Make LINk work well
◦ Budget
◦ Advice and Support
◦ Report and Communication
All LINks will be different
Host is accountable to the LINk
LINk expected to report to community and
Secretary of State on activities undertaken
Anyone – ideally with an interest in care
Aim entire community involvement
Q – usual suspects?
The more people get involved...
The stronger they are
Individuals
Carers, service users, community leaders,
patient representatives
Groups – charity, faith groups, residents’
associations
Anyone... So... (declare any conflicts)
Flexible involvement
Adult care services as well as NHS
Investigating specific issues of concern to
the community
Suggest ideas to improve the care people
receive
What citizens want from local services
Monitor and review care provided
Inform commissioners what the community
thinks
Ask local people what they think of local health and social care
Give opportunity to suggest ideas to care professionals that may improve services
Consider issues of local concern Make recommendations to those who plan
and run services and expect a response Ask for information and expect answers Carry out visits Refer matters to Council O&S Committees
Seek out views of more people
Richer feedback
One-stop way to engage the community
Avoid duplication of effort
Assist in prioritising services that local
people value
Inform decision making
Single system to involve communities Help and inform commissioners decisions Support NHS duty to involve Assist “World Class Commissioning” Ongoing feedback Help with knowing whether services meet
needs Allow O&S committees to base reviews on
actual feedback Assist regulators with local information Build community views into LSP and LAA
processes
LINks can Enter specific services and view the care
provided Ask commissioners for information about
services and expect a response Make reports and recommendations and
expect a response from commissioners Refer matters to the Council’s Overview &
Scrutiny Committee
From commissioners and regulators
Within
20
working days
Through your contract with local authority
Code of Conduct◦ Does not have force of law
◦ Is not even statutory guidance
◦ Background principles and practical considerations
◦ Made up by DH
Authorised representatives to observe the
delivery of services and to collect views of
those directly using the services.
CRB Check undertaken and considered
satisfactory
LINk must maintain a comprehensive and
up to date list of all authorised
representatives
Compromises effective provision of a service or
the privacy or dignity of any person
Where premises are:
◦ a person’s own home
◦ solely accommodation for employees
◦ non-communal parts of a care home
Where health and social care services are not
being provided (eg offices or closed)
Where in the opinion of the provider the
representative is not being reasonable or
proportionate
Does not provide evidence of right to enter
Does not apply to services delivered for
children
Constructive relationship Enable ongoing improvement Not to seek out fault but to consider the
standard and provision of care services and how they may be improved
Duty to allow entry on:◦ NHS Trusts, Foundation Trusts, PCTs, Local
Authorities, GPs, dentists, opticians, pharmacists, bodies contracted with local authorities or NHS Trusts etc to provide care services...
Or unannounced! Recommended to set out reasons in advance
◦ Date, time, length;◦ Underlying intelligence (anonymised if from a
patient or user)◦ Purpose of visit◦ Shape and format of proposed visit:
Who, what, when, how, accompanied etc◦ Names of authorised representatives◦ Identification and verification◦ Availability of draft findings
Hints for LINks – preparatory work◦ Think through aim and desired outcome◦ Could the visit be co-ordinated with someone else
eg CQC◦ How will objectives be met?◦ Pre-visit checklist◦ Special support needs?◦ Mix of authorised representatives?◦ Allocate topics in advance◦ Timing of visit re service delivery?◦ Relevant research
Visit findings should be documented
Evidenced reporting identifying sources
Inform staff and perhaps service-users of
findings
Balanced assessment of service
Recommendations for improvement
Delivered first in draft – 14 days for comment
Commissioners
Overview & Scrutiny Committee
Regulators
Via your contracts
Duty on those commissioning services to
ensure that contracts made with independent
providers after 1 April 2008 allow for
authorised representatives to enter, view and
observe the carrying on of activities owned
or controlled by the independent provider
See www.dh.gov/LINks
Anything about permitting LINks entry?
Do you have a written contract in any
event?
Does this affect pre 1 April 2008
arrangements?
What if post 1 April 2008 arrangements are
silent?
LINks provision
s
Must we let them in?
Likely consequences of refusal
No written contract
No probably not Written contract offered
Written Contract pre 1/4/08
No probably not Revised written contract offered
Written Contract post 1/4/08
Yes yes, subject to compliance with regs
Breach of contract consequences
Written Contract post 1/4/08without provisions
No probably not Revised written contract offered
LINks provision
s
Must we let them in?
Likely consequences of refusal
No written contract
No probably not Written contract offered
Written Contract pre 1/4/08
No probably not Revised written contract offered
Written Contract post 1/4/08
Yes yes, subject to compliance with regs
Breach of contract consequences
Written Contract post 1/4/08without provisions
No probably not Revised written contract offered
Our survey said ...
What pearls of wisdom do we expect?
Bureaucracy gone mad?
The usual suspects
Tribe of the ill-informed and over-zealous?
NHS & Local Authority obligations already
LINks could be:◦ Advocates for your service-users◦ Advocates for you and your business
Don’t forget◦ Commissioners◦ Regulators
have to take what they say into account
The Lion’s Roar?
Your own local select committee
Martini style
◦ Anytime, anyplace, anywhere
When done well ...
Mental health provision
Obesity
Extra-care housing
Learning Disabled Care Provision
Local Authority Moratoriums on admissions
Know your Councillors
Councillors love care homes
Councillors run scared of social services
Councillors want the best for their
communities
Make friends with them – or ...
Stand for election yourself!
LINks - do we really need them?
Partner and co-founder Brunswicks LLP Councillor for Frodsham & Helsby Chairman of Overview & Scrutiny
Committee Cheshire West & Chester Council
Brunswicks LLP 56 Hamilton Square Birkenhead CH41 5AS 08455 190691 07970 635629 07855 855 588 – 24 hours