20
Opportunities for Safeguarding Children in the New NHS Presentation workshop for London safeguarding Children Board Conference Briony Ladbury Senior Strategic safeguarding Children Advisor NHS LONDON December 2011

Opportunities for Safeguarding Children in the New NHS Presentation workshop for London safeguarding Children Board Conference Briony Ladbury Senior Strategic

Embed Size (px)

Citation preview

Page 1: Opportunities for Safeguarding Children in the New NHS Presentation workshop for London safeguarding Children Board Conference Briony Ladbury Senior Strategic

Opportunities for Safeguarding Children

in the New NHS

Presentation workshop for London safeguarding Children Board Conference

Briony LadburySenior Strategic safeguarding Children Advisor

NHS LONDON December 2011

Page 2: Opportunities for Safeguarding Children in the New NHS Presentation workshop for London safeguarding Children Board Conference Briony Ladbury Senior Strategic

Where do the opportunities spring from?

• NHS Reforms• Munro Review of Child Protection• Nosgrove Review (of Children in the family

Justice System)• Ofsted Review• Big Society

Page 3: Opportunities for Safeguarding Children in the New NHS Presentation workshop for London safeguarding Children Board Conference Briony Ladbury Senior Strategic

FundingAccountability

Local Health Watch

Local AuthoritiesHWB Boards

JSNA’sPublic Health

Parliament

Department of Health

NHSCommissioning

Board/sLocal bodies & senates

ClinicalCommissioning

Groups& Networks

Patients and Public – (adults and children)

Monitor Economic Regulator

IntegrationPatients interests

Competition safeguards

Care Quality Commission

(Any Willing/Qualified)Provider

Proposed NHS Reforms

Accountability for results

licencing

contract

Local partnership

Public Health England

Page 4: Opportunities for Safeguarding Children in the New NHS Presentation workshop for London safeguarding Children Board Conference Briony Ladbury Senior Strategic

NHS Structure post reforms

Main Changes

• Directly funded Public Health Service• Public Health situated in Local Authority• National Commissioning Board – senates• Clinical Commissioning Groups – members & networks• Health and Wellbeing Boards• Healthwatch

Much yet to be clarified

Page 5: Opportunities for Safeguarding Children in the New NHS Presentation workshop for London safeguarding Children Board Conference Briony Ladbury Senior Strategic

NHS Reforms Statement

• NHS Overall Accountability

– NHS Commissioning Board and Clinical Commissioning Groups to:

• Promote the NHS constitution • Core principles and values• 18 week waits • Duty to promote a comprehensive health service

Page 6: Opportunities for Safeguarding Children in the New NHS Presentation workshop for London safeguarding Children Board Conference Briony Ladbury Senior Strategic

Principle & opportunity

• Clinical advice and leadership

– GP consortia will become Clinical Commissioning Groups

– Demostrate LA alignment

– Governing Bodies must have a nurse and specialist doctor as members

– Commissioners supported by clinical networks and clinical senates

– Informed by health and social care professionals in discussion with patients, carers, voluntary sector and other partners

Page 7: Opportunities for Safeguarding Children in the New NHS Presentation workshop for London safeguarding Children Board Conference Briony Ladbury Senior Strategic

Principle & opportunity

• Choice and competition

– Promote patient choice– Level playing field – Best providers (public, private and voluntary sector)– ‘Monitor’ to protect and promote interests of patients (not

competition– Safeguards against cherry picking and privatisation– Commissioners and ‘Monitor’ have duty to promote integration

• Personal health budgets• Joint health and social care budgets

– Promote innovative integrated care

Page 8: Opportunities for Safeguarding Children in the New NHS Presentation workshop for London safeguarding Children Board Conference Briony Ladbury Senior Strategic

Principle & Opportunity

• Developing the workforce

– Robust safe transition for training and education– Deaneries to oversee training of junior Drs and

Dentists– Leadership and management training– Protected education and training funds

• Fairly distributed• Transparent process

Page 9: Opportunities for Safeguarding Children in the New NHS Presentation workshop for London safeguarding Children Board Conference Briony Ladbury Senior Strategic

Timetable for Change– Clinical commissioning groups established April 2013

– CCGs take control when ‘ready and willing’

• Aligned to LA boundaries – Clustered into ‘federations’

– Monitor have powers to 2016 to maintain standards of governance.

• SHAs Clustered from October 3rd 2011 (No change for London)

• Oct 2011 – NHS Commissioning Board Established

• April 2012 – Choice of Any Qualified Provider extended

• Oct 2012 – NHS Commissioning Board established & independent (limited functions)

• Oct 2012 – Monitor takes on regulatory functions

• Oct 2012 – HealthWatch England & local HealthWatch established

• April 2013– SHA’s & PCTs abolished (NHS Commissioning Board takes over) Public Health England established, CCGs fully established (expected to be ‘ready and willing’)

• April 2014 – Trusts are Foundation Trusts (any outstanding get new management)

Page 10: Opportunities for Safeguarding Children in the New NHS Presentation workshop for London safeguarding Children Board Conference Briony Ladbury Senior Strategic

Public Health

• Public Health England will fund services by:– Commissioning & providing services from itself, i.e vaccines, campaigns, health

protection– Asking the NHS Commissioning Board to commission services i.e screening –

elements of GP contract– Granting a ring fenced budget to local government– Each body will be required to comply with the Equality Act 2010 and expected to

undertake their functions in a way that is most likely to reduce health inequalities

Page 11: Opportunities for Safeguarding Children in the New NHS Presentation workshop for London safeguarding Children Board Conference Briony Ladbury Senior Strategic

Public Health Programme

HEALTH VISITORPROGRAMME ?

Page 12: Opportunities for Safeguarding Children in the New NHS Presentation workshop for London safeguarding Children Board Conference Briony Ladbury Senior Strategic

Funding Accountability

Local Health Watch

Parliament

NHSCommissioning

BoardLocal offices & senates

ClinicalCommissioning

Groupssupported ‘clinical’ networks

Monitor Care Quality Commission

(Any Qualified)Provider

Spheres of influence

Accountability for results

licencing

contract

Local partnership

Public Health England

LSCB

Department of Health

Patients and Public – (adults and children)

Page 13: Opportunities for Safeguarding Children in the New NHS Presentation workshop for London safeguarding Children Board Conference Briony Ladbury Senior Strategic

Reforms - NHS London

Where are we now in London?• Transition?

PCT Clustering

TCS and vertical integrationFT pipeline

Performance

• Commissioning Commissioning support

Clinical Commissioning Groups / Federations? & authorisation

• Clinical [Safeguarding] NetworkingDesignated Professionals, Named Nurses Acute, Named Nurses CommunityNamed Midwives

• Health Visitor Project

Page 14: Opportunities for Safeguarding Children in the New NHS Presentation workshop for London safeguarding Children Board Conference Briony Ladbury Senior Strategic

Munro 4 themes1. A system that values professional expertise

2. Sharing responsibility for the provision of early help

PRACTICAL APPLICATION IN NHSHealth Visitor Programme,MASH ProjectsSchool Nurse DevelopmentFamily Nurse PartnershipsIntegrated Early Help TeamsWorking in the community and other partners – Vol Sector & Social CarePeer Review and auditSharing good practice

MUNRO REVIEWImpact of NHS Reforms

Shared understanding of NHS roles & responsibilities Retention of professional expertise Relationship of LSCB & HWB Board

CCG development NHS (CQC) inspectionCoordinated effective early help assessment processes and services (JSNA)

MUNRO REVIEWLess beurocracy – remove assessment timescales etc Improve quality of assessment and services – locally determinedRewrite Working TogetherRemove constraints to local innovation (national - forms, KPIs, IT systems) Involving health in Joint unannounced Inspection ProcessData set agreed

PRACTICAL APPLICATION IN NHS Less practice guidance – local interpretation More [health] professional discretion in assessments and care planning – pilots in progress Use own initiative and professional expertise for developing and evaluating services, researching practice models, utilising evidence based practice Comprehensive observation of practice by Ofsted/CQC unannounced inspections

Page 15: Opportunities for Safeguarding Children in the New NHS Presentation workshop for London safeguarding Children Board Conference Briony Ladbury Senior Strategic

Munro 4 themes3. Developing [Social Work] Expertise and Supporting Practice

4. Clarifying accountabilities and creating a learning system. MUNRO REVIEW

NOT NHS SPECIFIC BUT SHOULD ALSO BE REFLECTED BY NHS

LSCB annual reports to CE & Leader of Council, Police & Crime Commissioner, Chair of HWBLSCBs to monitor effectiveness of CHILDRENS services and senior managersResearching options for using a systems methodology for SCRs

MUNRO REVIEW

NOT NHS SPECIFIC BUT SHOULD ALSO BE REFLECTED BY NHS

High quality practice placementsProfessional capability frameworkCPD framework & performance appraisalCareer pathwaysLeadershipRecognition of specialism

PRACTICAL APPLICATION IN NHS

Good NHS initial training in HEIs Good post graduate – in-service training Appraisals to reflect safeguarding competency performance and training needs Developing a career pathway – succession planning Leadership Courses

PRACTICAL APPLICATION IN NHS

Training for health staff on systems approaches including RCA NPSA assisting development with methodology and accountability

Ensuring lessons are learned and applying performance management to ensure improvement

Page 16: Opportunities for Safeguarding Children in the New NHS Presentation workshop for London safeguarding Children Board Conference Briony Ladbury Senior Strategic

Ofsted Review

• Unannounced inspections

• Ofsted and CQC combined – no longer parallel processes

• Pilots already underway

• Will review 50 not 20 cases – thoroughly!!!!!

• Map the child’s journey and experience of services

• Includes practice observation in the field

• 4 judgment areas– Effectiveness of service– Effectiveness of interventions (including early help)– Quality of practice

• Effectiveness of leadership and governance

• Regular peer review and audit will help you to prepare!

Page 17: Opportunities for Safeguarding Children in the New NHS Presentation workshop for London safeguarding Children Board Conference Briony Ladbury Senior Strategic

Nosgrove Review

• Review of children in family justice system

• Quicker timescales

• Less delays (expert witnesses)

• More emphasis on child’s wishes and feelings

• More reliance on good Social Work assessment

• Health Professionals able to be more involved in providing Social care colleagues with health aspects of assessment

• Multi-agency training

Page 18: Opportunities for Safeguarding Children in the New NHS Presentation workshop for London safeguarding Children Board Conference Briony Ladbury Senior Strategic

Big Society & localism

• Fits public health agenda well• Working with communities

– Meets needs of the most vulnerable– Enables community participation– Children’s voice heard in design and evaluation

• Health Visitor Programme Strands– Community– Universal– Universal Plus– Universal Partnership Plus

• Enables other skilled professionals to support community health system eg Children’s Charities and support groups

Page 19: Opportunities for Safeguarding Children in the New NHS Presentation workshop for London safeguarding Children Board Conference Briony Ladbury Senior Strategic

Parting Shot

Be the change that you want to see

in the world.

An ounce of practice is worth more than tons of preaching.

Mohandas Gandhi

Page 20: Opportunities for Safeguarding Children in the New NHS Presentation workshop for London safeguarding Children Board Conference Briony Ladbury Senior Strategic

Questions & Discussion

• What do YOU have to do as a children’s safeguarding professional (in any professional context) to ensure that the new NHS grasps the opportunities and improves safeguarding children services ?