Commissioning Specialised Mental Health & Winterbourne Review Quality Assurance

1. Commissioning Specialised Mental Health& Winterbourne Review Quality Assurance . Jonathan Hepworth Snr Supplier Manager Specialised Mental Health Yorkshire & Humber

2. NHS England Values • Respect and dignity • Commitment to quality of care • Compassion • Improving lives • Working together for patients • Everyone counts

3. NHS England Vision • Enable everyone to have greater control of their health and their wellbeing, support people to live longer, to have healthier lives • To ensure that the care delivered is high quality and that care services are compassionate, inclusive and constantly improving

4. Our purpose • We create the culture and conditions for health and care services and staff to deliver the highest standard of care and ensure that valuable public resources are used effectively to get the best outcomes for individuals, communities and society for now and for future generations

5. Commissioning is the process of planning, agreeing and monitoring services. Securing services is much more complicated than securing goods and the diversity and intricacy of the services delivered by the NHS is unparalleled. Commissioning is not one action but many, ranging from the health-needs assessment for a population, through the clinically based design of patient pathways, to service specification and contract negotiation or procurement, with continuous quality assessment

6. NHS England commissions specialised services, primary care, offender healthcare and some services for the armed forces. There are 10 Area Teams across England with responsibility for commissioning Specialised Mental health services. Locally Yorkshire & Humber commissioning for specialised MH is delivered from the South Yorkshire and Bassetlaw area office with responsibility for Medium and Low Secure services, CAMHS T4, Eating Disorder services for children and adults, Perinatal, Neuropsychiatry, Gender Dysphoria and Tier 4 Personality Disorder

7. Quality Assurance • Case Management • Supplier Management • Contract Reviews • Area Team Quality and Governance • Working with regulators and experts by experience

8. The Winterbourne View Concordat is an action plan to ensure that all people with learning disabilities receive the health care and support they need in the most appropriate setting.  Too many people with learning disabilities end up unnecessarily in hospital and are staying there for too long. The Concordat aims to put measures in place to lead to a rapid reduction of this.

9. 31 March 2014: 35% of patients that were in hospital on 1 April 2013 have now been transferred. Of a total of 2,615 patients, 256 have a transfer date, of which 182 are before 1 June 1, 2014 1,702 patients do not have a planned transfer date due to a clinical decision preventing it. Many of these people have very complex needs. Some may be too ill or possibly a danger to themselves or the public. A total of 534 patients are in high or medium secure services and most are subject to Ministry of Justice order.

10. “We need to redouble our efforts and through the Winterbourne Joint Improvement Programme, we will continue working with our Area Teams and Clinical Commissioning Groups to ensure these patients receive the best possible care.” Jane Cummings, Chief Nursing Officer for England

11. NHS England wrote to its Area Teams in June setting out six priority actions to focus on: 1, All patients are on a register 2, A local care co-ordinator is assigned to each patient 3, Estimated transfer dates and care plan reviews 4, A patient tracking list to schedule reviews for people who have not been assessed for six months 5, CCGs with five or fewer patients should by the end of June 2014 ensure that all have a transfer date 6, Patients in non-secure hospital settings for two or more years should be prioritised for review

12. There has been a 100 per cent response rate from the 211 Clinical Commissioning Groups (CCGs) and 10 NHS England Area Teams responsible for specialised commissioning of secure mental health and child and adolescent mental health services who were asked to submit information. The information covers a number of key important areas including  the number of patients currently in inpatient care,  whether they have been transferred,  is there a planned date to transfer and how many  had been admitted in the last quarter.

13. NHS England recognises that more progress needs to be made to help more of these people move out of in-patient care into the community. Consideration now needs to be given to a new approach that places more control and direction in the hands of the people affected, their carers, and the expert advocacy and voluntary organisations involved.