Appendix B
Winterbourne Draft Joint Plan – 2013/14
Lambeth Clinical Commissioning Group and Lambeth Council
This joint action plan is being developed between Lambeth Clinical Commissioning Group (LCCG) and Lambeth Council, working with other key partners, to support our joint approach to ensure people across all ages from Lambeth with learning disabilities / autism / challenging behaviour receive safe, appropriate, high quality care. This includes all the key actions required to deliver the Winterbourne View Concordat. This is a working document that details the work streams and progress against key milestones.
Objective / Progress / key Milestone / Time-scale / LeadReview all current hospital placements and support everyone inappropriately placed in hospital to move to community based support as quickly as possible and no later than 1 June 2014
Develop and maintain a register of all people with learning disabilities or autism who have mental health conditions or challenging behaviour in NHS funded treatment
/ Achieved - Lambeth has put in place a register for people with learning disabilities or autism who are funded by the NHS for their care needs. / On-going / Laval Lebon
Senior Joint Strategic Commissioning Manager Learning Disabilities
Review the care of all people in hospital placements with learning disability or autism support everyone inappropriately placed in hospital to move to community-based support as quickly as possible and no later than 1 June 2014
All people with challenging behaviour in inpatient assessment and treatment services are safe and receiving services or treatment which is actively promoting an effective discharge plan / Initial reviews completed,
Everyone inappropriately placed in hospital will be supported to move to community-based
The majority of individuals are detained under the Mental Health ACT (MHA). For these individuals Lambeth CCG has commissioned SLaM to provide an out of area nurse led placement monitoring service. The service is guided by Mental Health Tribunals, who makes decisions about whether the individual remains under the Mental Health Act. In making its decision the Tribunal considers the right of the individual to receive necessary treatment, the loss of freedom that the individual experiences when they are treated involuntarily, and the interests of the community. It also considers the appropriateness of the current treatment plan and therefore these individual’s will need to be remain within a registered hospital provision while detained under the Mental Health Act.
Identify the local authorities responsible for S117 after-care for patients detained under Section 3 and 37. Recent case law has confirmed that the local authority responsible is the authority in whose area where the patient was actually resident immediately before they were detained. / 1 June 2014
September 2013 / Laval Lebon
Senior Joint Strategic Commissioning Manager Learning Disabilities
Laval Lebon
Senior Joint Strategic Commissioning Manager Learning Disabilities
Review existing contracts with providers to ensure they include an appropriate specification (based on the national care model), an absolute expectation of clear individual outcomes, appropriate interventions and sufficient resource to meet the needs of the individuals, and appropriate information requirements to enable commissioners to monitor the quality of care being provided
The National Commissioning Board(NCB) is working with Association of Directors of Adult Social Services (ADASS) to develop practical resources for commissioners of services for people with learning disabilities, including:
- model service specifications;
- new NHS contract schedules for specialist learning disability services
Review existing contracts /service specifications for low and medium secure units. / September 2013
August 2013
TBC / Laval Lebon
Senior Joint Strategic Commissioning Manager Learning Disabilities
NHS England
NHS England
NCB / ADASS
Locally agreed joint plan for high quality care and support services for people of all ages with challenging behaviour, that accords with the model of good care
Ensure that from April 2013, health and care commissioners, set out a joint strategic plan to commission the range of local health, housing and care support services to meet the needs of children, young people and adults with challenging behaviour in their area. / The Children’s Early Intervention & Prevention Strategy is now in place, informed by the Children’s JSNA. 3 year commissioning intentions against the agreed priorities are being developed
The Children & Young People’s integrated assessment tool is being developed (in line with SEN legislation)
Health and Social care commissioners to develop a joint strategic commissioning plan.
Develop short and medium term programme of organisational change, working jointly across Southwark, Croydon and Lewisham to look at how our specialist health services can and should be interacting with our social care services in order to provide ‘whole life’ supports – particularly for people who are labelled as challenging, with a refocusing resources away from bed based services into more responsive and joined up community based provision
Plan to be shared with the Health and Wellbeing Boards and Learning Disabilities Partnership Boards and considered as part of the local Joint Strategic Needs Assessment and Joint Health and Well-Being Strategy (JHWS) process.
NHSE and ADASS will implement a joint Health and Social Care Learning Disabilities Self Assessment Framework (H&SC LD SAF) to monitor progress of key health and social care inequalities from July 2013. The results of progress from local areas will be published. / July 2013 April 2014
1 June 2014 / Emma Stevenson
Assistant Director Children & Maternity Joint Commissioning
Lambeth CCG/ LB Lambeth
Laval Lebon
Senior Joint Strategic Commissioning Manager Learning Disabilities
Mike Corrigan
Head of Joint Commissioning
Learning Disability Services
Croydon
Heather Hughes
Joint Commissioner – Learning Disabilities - Lewisham
James Roberts
Senior Mental Health Commissioning Manager
Southwark CCG
Laval Lebon
Senior Joint Strategic Commissioning Manager Learning Disabilities
Gareth Davies
H&SC LD SAF - Project Officer
Ensure that the right local services are available, for children, young people and adults with learning disabilities or autism who also have mental health conditions or behaviour that challenges / Review current service provision
Develop competency framework across Lambeth, Southwark, Lewisham and Croydon to encompass the following:
- A multi-disciplinary approach to the assessment and treatment of challenging behaviour in order to meet the individual needs of a person
- A range of assessments to inform how individualsare supported with a clear focus on recovery and personalisation
- Staff adequately trained and supervised
- Good supportive environments
A key focus for Learning Disabilities is to signal to the market the intention to work with providers to ensure cost effective support packages are available for people with complex needs, some of whom will often display challenging behaviours. / 1 June 2014
1 January 2014 / Laval Lebon
Senior Joint Strategic Commissioning Manager Learning Disabilities
Mike Corrigan
Head of Joint Commissioning
Learning Disability Services
Croydon
Heather Hughes
Joint Commissioner – Learning Disabilities - Lewisham
James Roberts
Senior Mental Health Commissioning Manager
Southwark CCG
Alex McTeare
Assistant Director Commissioning Health and Well Being
Laval Lebon
Senior Joint Strategic Commissioning Manager Learning Disabilities
Review funding arrangements for these people and develop local action plans to deliver the best support to meet individuals’ needs / Agree how funding will need to be arranged to ensure appropriate services are in place including consideration of use of pooled budgets.
The strong presumption will be in favour of pooled budget arrangements with local commissioners offering justification where this is not done. The NHSE & ADASS will promote and facilitate joint commissioning arrangements.
The C&YP Tripartite funding panel is operational and reviews all complex cases were a jointly funded care package is required. The aim in line with the Early Intervention Strategy is to commission a range of evidence-based interventions that where appropriate may prevent residential placements / 1 June 2014
Ongoing / Laval Lebon
Senior Joint Strategic Commissioning Manager Learning Disabilities
Alex McTeare
Assistant Director Commissioning Health and Well Being
NHSE
ADASS
Emma Stevenson
Assistant Director Children & Maternity Joint Commissioning
Lambeth CCG/ LB Lambeth
All patients requiring an assessment for autism have access to a diagnostic service. Those people newly diagnosed with autism receive individual support response and where appropriate, support services which respond to their individual needs. / Autism Steering Group established to scope the requirements for an Autism Diagnostic Service across Lambeth and the appropriate support services for people diagnosed with autism. / 1 April 2014 / Autism Steering Group
Review current community learning disability provision / The Strategic Transitions Group is developing a Life long Disabilities service which will integrate Children and Adult LD services. This will provide a clearer picture of emerging needs (incl. behaviour that challenge services) and allow more efficient and joined up commissioning across Children’s and Adult services to help improve quality, pathways of support and holistic needs planning.
A key consideration within this service modelling will be the pathway and local provision for supporting individuals who have complex needs and will involve reviewing pathways and multi disciplinary approaches to effectively respond and commission effective, local services. / 1 April 2014 / Mel Brooks
Interim Assistant Director Adult Social Care
Andrew Wyatt
Assistant Director
Multi-Agency Assessment, Family Support and Child Protection
CYPS