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Partnership & Governance

Partnership & Governance. The Hertfordshire Experience. PCT BOUNDARIES. Partnership & Governance The Hertfordshire Experience. Services Involved: Mental Health (MH) Learning Disability (LD) Drug and Alcohol (D&A) Child & Adolescent Mental Health (CAMH). AIMS.

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Partnership & Governance

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  1. Partnership & Governance The Hertfordshire Experience

  2. PCT BOUNDARIES

  3. Partnership & GovernanceThe Hertfordshire Experience Services Involved: • Mental Health (MH) • Learning Disability (LD) • Drug and Alcohol (D&A) • Child & Adolescent Mental Health (CAMH)

  4. AIMS To improve outcomes for Service Users: • Easier Access • Remove Duplication • Quicker Response • Shared Information • Named link person • User and Care Involvement

  5. Arrangements for Service Provision • Integrated Provision • MH, D & A & CAMH within Hertfordshire Partnership Trust (HPT) • Community LD within Adult Care Services (ACS) • Staff & Functions Transferred • Operationally, budgets pooled

  6. Arrangements for Service Provision • HPT Director of MH is member of Adult Care Services • ACS Assistant Director (MH&LD) is member of HPT Executive Committee • Head of Social Care now to be appointed in HPT

  7. Commissioning Arrangements (1) • Commissioners are County Council and 8 PCTs • Commissioning budgets pooled • Joint not lead commissioning • County Council host’s pooled commissioning budgets

  8. Commissioning Arrangements (2) • Decision making delegated to new Joint Body Joint Commissioning Partnership Board (JCPB) • Membership: • 8 County Councillors • 8 PCT Non-executive directors/chairs • Up to 4 co-opted members, e.g. SHA • Supported by Joint Commissioning Team

  9. PROPOSED JOINT COMMISSIONING ARRANGEMENTS FOR MH, LD, D & A, & CAMHS Who is it? What is it? PCT BOARDS COUNTY COUNCIL Commissioning services from Herts Partnership Trust and elsewhere using pooled budgets 8 County Councillors 8 PCT Board Members Coopted Members/ Observers JOINT COMMISSIONING PARTNERSHIP BOARD (JCPB) Advises JCPB. Hosted by HCC Links to PCT Commissioning staff. Facilitates Stakeholder input. Commissioning staff from Health Authority and HCC JOINT COMMISSIONING TEAM Commissioning continuing health care works alongside Joint Commissioning Team. Covers all care groups CONTINUING HEALTH CARE TEAM Continuing Health Care staff from E&N Herts Health Authority and West Herts CommTrust LOCAL IMPLEMENTATION TEAM MENTAL HEALTH (LIT) Responsible for planning the implementation of the NSF Stakeholder Groups incorporating statutory agencies, voluntary and independent sector groups, users and carers LEARNING DISABILITY STEERING GROUP (LDSG) Responsible for planning the implementation of the National Strategy for Learning Disability Responsible for identifying drug & alcohol treatment services to be commissioned JOINT COMMISSIONING GROUP FOR DRUG & ALCOHOL TREATMENT DRUG AND ALCOHOL ACTION TEAM (DAAT) Responsible for implementing the National Drugs Strategy CAMHS STEERING GROUP Responsible for planning CAMHS services

  10. Pooled Commissioning Budget 2002 / 03 £M MH 82 D & A 68 CAMH 3 Joint CommissioningTeam 0.5m _______ £159.5m

  11. Achievements • Arrangements in place on working model • Partnership Agreements signed • Clear place to take joint decisions • Clarify about baseline budgets and charges • Wide range of decisions taken • Service profiles raised e.g. CAMH, D & A • Issues identified

  12. Issues - PCT perspective (1) • Accountability to local area is • Focus of SHA performance management • Level of awareness of Chairs/Non Execs • Working through Joint Commissioning Team

  13. Issues - PCT Perspective (2) • Local Government meeting & Structure • Lack of understanding by HCC of purpose & role of PCTs and how they work • Membership of Board contentious • Role of PCT Exec Committees (PEC) • Involvement of Chief Execs/officers • Difficulty of splitting budgets/expenditure by PCT

  14. Issues - HCC Perspective • Inability to agree budget before start of Financial Year • Disputes over health budgets • Lack of budgets/actively monitoring information • Frustration re size of body • Anxiety re impact of health budget on HCC

  15. Common Issues • Complexity • Familiarisation with services • Need for Scheme of Delegation • Need for overarching Service Strategies • Need for mutual understanding of organisations and their processes • Co-ordination of Processes • Crucial role of Joint Commissioning Team • User/Carer Involvement

  16. Some Solutions • Arrangements reviewed • Scheme of Delegation to be written • Way of presenting budget/monitor revised • Partnership Executive set up • Local LITs • Presentations/Reports for information • Renewal of PCT Board membership • Work to improve information

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