1. No category

MEETING:
DATE:
TITLE:
LEAD DIRECTOR/
MANAGER:
AUTHOR:
CONTACT DETAILS:
Haringey Clinical Commissioning Group
Governing Body Meeting
Thursday 28 November 2013
Winterbourne View Progress Report
Jill Shattock – Director of Commissioning
Tristan Brice – Adults Commissioning Manager (LD &MH)
Tristan.brice@haringeyccg.nhs.uk
020 3688 2733
SUMMARY:
In May 2011 the BBC documentary ‘Undercover Care: the Abuse Exposed’, revealed
criminal abuse by staff of patients at Winterbourne View, a private hospital in South
Gloucestershire. This resulted in the closure of Winterbourne View and a number of
subsequent inquiries and reports.
These culminated in the Department of Health putting in place a programme of action and
the establishment of the Winterbourne View Concordat across commissioners, providers
and Local Government agencies.
Following the signing of the concordat, there was a commitment to the production of a
report to provide national assurance on progress against the agreements made by the
signatories of that document. This process was carried out over the summer and the
resulting report was launched in October 2013, showing progress against eleven areas as
detailed in the attached paper.
SUPPORTING PAPERS:
 Winterbourne View joint improvement programme. Stocktake of progress report.
September 2013.
http://www.local.gov.uk/documents/10180/12137/Winterbourne+View+Joint+Improve
ment+Programme+-+full+stocktake+report/6cdf21b5-6a3a-4633-bef4a82d29801db0
http://arcuk.org.uk/wp-content/uploads/2013/10/WV-JIP-LGA-Stocktake-of-ProgressSep-13-Easy-Read-version.pdf
http://www.esd.org.uk/esdtoolkit/pdf/Stocktake+Haringey.pdf
 Department of Health (2012). Transforming care: A National Response to
Winterbourne View Hospital.
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/12731
0/final-report.pdf.pdf
 Department of Health (2012). DH Winterbourne View Review Concordat:
Programme of Action.
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/12731
2/Concordat.pdf.pdf
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RECOMMENDED ACTION:
The Governing Body is asked to:
 NOTE progress made in delivering the Winterbourne View Review Programme of
Action and Work Planning as evidenced through the stocktake of progress report.
Objective(s) / Plans supported by this paper: Supports the Learning Disability
commissioning work stream.
Audit Trail:
 Update on the local action plan was presented to the CCG Quality Committee on 17
April 2013.
 Update on the local action plan was presented to the CCG Governing Body on 16
May 2013
 Update on the local action plan was presented to the Health and Wellbeing Board on
9 July 2013
 Update from the national review was presented to the CCG Senior Management
Team on 30 Oct 2013
 Update from the national review was presented to the CCG Clinical Cabinet on 7
November 2013
Patient & Public Involvement (PPI): Family engagement is integral to the review process
and is client centred.
Equality Analysis: Being carried out as part of the engagement exercise.
Risks: Failure to meet the timescales for review and re-provision of services within
available options and financial resources.
Resource Implications: The assessment pathway and project management resources are
being drawn jointly from the CCG and Local Authority.
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Winterbourne View Progress Report
1.
EXECUTIVE SUMMARY
1.1
Following the signing of the concordat on Winterbourne View, there was a
commitment to the production of a report to provide national assurance on progress
against the agreements made by all the signatories of that document. This process
was carried out over the summer and the resulting report was launched in October
2013, this showed progress against eleven areas as detailed below.
1.2
This report details the feedback from the National Improvement Group to Haringey,
alongside national progress. Haringey was identified as performing strongly in
seven of the eleven areas. The main areas for further development include:
 Children and adults – transition planning
 Training local teams and services around mental capacity assessments
 Developing pooled funding arrangements
2.
INTRODUCTION
2.1
On 31 May 2011, an undercover investigation by the BBC’s Panorama programme
revealed criminal abuse by staff of patients at Winterbourne View Hospital near
Bristol. This resulted in the closure of Winterbourne View and the placement of the
remaining residents in other settings. The police launched their own investigations,
with 11 criminal convictions, and the Care Quality Commission (CQC) inspected all
hospitals and homes operated by Winterbourne View’s owners (Castlebeck Care)
and conducted a wider “health check”, inspecting 150 learning disability services
across England.
2.2
In addition, the Government set up its own Review, led by the Department of Health
(DH) to investigate the failings surrounding Winterbourne View, to understand what
lessons should be learnt to prevent similar abuse and explore and recommend wider
action to improve quality of care for vulnerable groups. An interim report was
published in June 2012, followed by the full Government response to Winterbourne
View in December 2012.
2.3
A Concordat between commissioners and providers of health care and Local
Government agencies was developed by the Department of Health following the
Winterbourne Review. The Concordat is a commitment to change and improve
services delivered to people with learning difficulties associated with challenging
behaviour. The document sets out its vision for a whole systems change by stating:
‘all parts of the system –commissioner, providers, the workforce, regulators
government, all agencies, councils and providers, the NHS and the police - have a
role to play in driving up standards for this group of people. There should be zero
tolerance of abuse or neglect.’
3.
WINTERBOURNE VIEW JOINT IMPROVEMENT PROGRAMME
3.1
The Winterbourne View Joint Improvement Programme (WVJIP) was established in
December 2012 with the purpose of providing national leadership and support to the
transformation of services locally. The team was established to work with local areas
to provide focused and lasting action across the system to ensure that the support
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and services that are commissioned throughout people’s lives are personalised, safe
and local. This programme is led by the Local Government Association (LGA) and
NHS England, and funded by the Department of Health.
3.2
The strategic objectives of the WVJIP include:
 To support the transformation of commissioning and provision of support and
services for people with learning disability, autism and/or challenging behaviour
so that they are personalised, safe and local.
 To significantly reduce in the reliance on long term placements in Assessment
and Treatment (A&T) Centres.
 Development of more locally based provision enabling people to remain closer to
home throughout the pathway of their care.
3.3
To locally meet the requirements of the Winterbourne View Concordat Programme
of Action; the Haringey Winterbourne View Joint Improvement Board was set up.
4.
STOCKTAKE OF PROGRESS REPORT
4.1
In June 2013 the WVJIP asked local areas – specifically Local Authority Chief
Executives, and Clinical Leads of Clinical Commissioning Groups (CCGs) – to
undertake a local stocktake and self- assessment of progress against key activities
that support local delivery of Transforming Care and Concordat commitments. Sent
out on 1 June 2013, returns were requested by 5 July 2013.
4.2
The stocktake covered 11 key areas of enquiry:
 Models of partnership
 Understanding the money
 Case management for individuals
 Current review programme
 Safeguarding
 Commissioning arrangements
 Developing local teams and services
 Prevention and crisis response capacity
 Understanding the population who may need/receive services
 Children and adults transition planning
 Current and future market requirements and capacity
4.3
Haringey CCG and Local Authority submitted their response to the WVJIP within the
agreed timescale following approval by the Haringey Winterbourne View Joint
Improvement Board.
4.4
The national WVJIP team undertook an analysis of the submissions received from
local areas and produced the Stocktake of Progress Report on 17 October 2013,
which provided a summary of this analysis at a national and local level.
5.
NATIONAL PROGRESS ANALYSIS
5.1
The headline conclusions from a National perspective from the stocktake exercise
highlighted both the strengths and areas for development.
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5.2
Nationally the areas of strength included;
•
•
•
•
•
•
•
5.3
all localities engaging and working on the Concordat commitments
progress and leadership across the partners
HWBs being sighted on the Winterbourne priorities; many received detailed reports
in the autumn from their partnerships
skilled and committed staff at commissioner, care management, community and
provider levels and in leadership roles supporting change
service user and family carer engagement, although this was not always consistent,
nor evident everywhere
safeguarding practices being followed consistently
the engagement of newly formed CCGs is bringing fresh impetus and priority in
some localities.
The areas requiring further development include;
•
•
•
•
•
•
•
•
•
the development of whole life course planning
the need to rapidly improve engagement, understanding and joint working across the
various commissioning functions (specialist, forensic and health and social care)
the need for localities to work together both within and across geographical
boundaries to achieve longer term sustainable solutions
consistent application at local level of Continuing Health Care criteria
investment in behaviour support and community-based accommodation options to
enable safe and local support services
collaborative work with providers at national, regional and local level to develop
alternatives to current provision
increase the development of, and investment, in service user, family carer and
advocacy activity
increase the understanding and application of personalisation for all individuals,
notwithstanding the complexity of their situation
ensure wide understanding and application of the Mental Capacity Act (MCA).
6.
HARINGEY SPECIFIC ANALYSIS
5.1
Table 1 presents the national WVJIP team analysis of the Haringey submission
identifying areas of strengths and those that require further development.
Table 1: Haringey Analysis
Key Strengths
Areas for Development / Potential
Development
1 Models of partnership
Very good understanding of the issues
and are planning ways to deal with them
2 Understanding the money
May need support to develop agreed
pooled type financial arrangements
3 Case management for individuals
Strong case management
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4 Current Review Programme
Good evidence of progress on reviews
and understanding who is in scope
5 Safeguarding
Very strong safeguarding activities
6 Commissioning arrangements
Very good understanding of the issues in This may also be a development area
commissioning. May need support to
handle future financial implications
7 Developing local teams and services
Mental Capacity Assessments may
need some support
8 Prevention and crisis response
capacity
No comments provided
No comments provided
9 Understanding the population who
need/receive services
Very good understanding of population
needs
10 Children and adults – transition
planning
Strong focus on transition. Support This may also be a development area
needed for life course planning
11 Current and future market capacity
Some local market planning
6.
CONCLUSION
6.1
The findings from the Stocktake identify the progress that Haringey has made in
implementing the Haringey Winterbourne Review Joint Action Plan. In order for
Haringey to be compliant in meeting the actions included within the Concordat,
further work is still required and needs to focus on:



.
6.2
6.3
Children and adults – transition planning
Training local teams and services around mental capacity assessments
Developing pooled funding arrangements
While undertaking the stocktake returns, the national team have focussed on
preparing a status report for each locality. Although this will not provide a ranking or
benchmarking information per se, it will ultimately help to highlight which localities
are making more progress as well as those which may be less well developed,
particularly across the 3 dimensions of commissioning, funding and achieving the
June 14 Concordat target. This will be formally published on 13 December 2013.
Haringey Winterbourne View Joint Improvement Board working closely with the
national WVJIP team will continue to oversee implementation of the Concordat
ensuring Haringey is compliant in meeting the needs of this vulnerable group. The
local action plan will be strengthened where necessary as a result of the feedback.
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7.
RECOMMENDATIONS
7.1
The Governing Body is asked to:

NOTE progress made in delivering the Winterbourne View Review Programme of
Action and Work Planning as evidenced through the stocktake of progress report.
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