Association for Real Change, as a signatory of the Winterbourne View Concordat, attended the presentation and discussions yesterday. Here are the notes from our Membership and Information Manager, Yvonne Furze.

Jon Rouse, the DG for Social Care at the DH, reiterated the firm commitment to transparency, stating that all the Programme Board minutes are publicly available, and that they especially wanted families and service users to be able to see them. He described the role of every signatory as vital if change is to be delivered, and said that we were all “…bound by a relationship of trust”.

Norman Lamb seemed passionate in his commitment to ensure that the Concordat delivers on its promises, saying it “…must not be a tick-box exercise” and that he will name and shame Local Authorities that don’t meet their deadlines for reviewing and moving all those people with learning disabilities who are currently in-patients in assessment and treatment hospitals.

The PCTs have developed registers and handed them over to the CCGs at the end of March, and Commissioners should have reviewed each individual and have a plan for moving them by June 2014. He was aware that this had not happened for everyone yet, and he found it totally unacceptable. “There will be no hiding place for commissioners who don’t do the right thing”, he said, and by that he meant “proper reviews and plans”. He did not want to see people being given unacceptable or inappropriate packages just to get them out of hospitals. The plans and support had to be built around the individuals’ needs, and be sustainable and good quality. Pooled budgets are the expectation everywhere, and if not then there needs to be a detailed explanation of why not.

The Programme Board, headed by Chris Bull (who will be speaking at Association for Real Change’s AGM Conference in October), has started a “stocktake” of progress through every Local Authority and NHS Commissioning group; letters and a progress assessment form went out last Friday (31st May) with a return date of 5th July, and follows close on the heels of a letter from Norman Lamb to every HWBB. The assessment form asks if all the reviews have been completed, and asks about the quality of the data within the registers. It clearly asks how they are working with providers to ensure the sharing of information and the development of risk assessments for people placed out of the area.

The Minister also talked about increasing corporate accountability for the quality of services. CQC will launch a consultation on proposals to change registration requirements, setting clear, legal baselines, below which quality must never fall. He encouraged providers to give their views, saying “providers and commissioners who fail to address quality of care should be on their guard!”. CQC will have a dedicated registration team who will implement the new registration requirements for new LD registration to start with, even though the new requirements will apply to all services.

In response to a provider’s question about the quality of placements for some of those individuals who have been moved from Winterbourne View, and the suggestion that commissioners were still phoning in-patient institutions to seek placements, he said, “If I discover that commissioners continue to do the wrong thing and place people in the wrong services I will come down on them like a ton of bricks”, pointing out that he could not do this alone, and needed everyone to help him to achieve this. He later added that “you can’t have requirements for providers if you don’t know what’s going on on the commissioning side”.

Another question was raised about the level of engagement with providers to develop the local Market Shaping/Positioning Statements. Again Norman Lamb was clear that, “where providers are keen to get involved we really must engage with them”. (e.g. HWBB) Chris Bull later acknowledged that their focus so far had been on supporting commissioners with the most pressing targets in the Concordat, but that he now wants to work to increase engagement between providers and commissioners. All LAs have been offered consultancy on how to engage to develop Market Position Statements, but I’m not convinced that providers have been adequately engagaed in many areas. He said he was happy to talk to organisations about doing this, and I think Association for Real Change should speak to him about organising some events/sessions to do just that. I would be keen to hear your thoughts on how that might work best for all of you and if any of you would be willing to host a meeting.

Alicia Wood, from the Housing and Support Alliance, pointed out that the current Housing Benefit system works against personalisation. The Minister said that “it makes no sense if policy is a barrier to offering better, and possibly cheaper, (bearing in mind that over £4000 per week was being paid to Castlebeck for those being abused at Winterbourne View) services for people”. Chris Bull later said that high level talks were already underway to discuss welfare benefits and reforms, and there was a commitment to talking with providers about these issues too (particularly in the housing sector). The lack of housing was also raised, and the ‘Bond’ model, being piloted by Mencap was held up as a good solution, but it really only supports shared tenancy arrangements and many of the people who need to be re-housed would be likely to need an individual service. Commissioners need to think about capital investment to support this too.

We were all given overviews of all the actions in the Concordat, with updates of progress made so far. I only have this in hard copy, but if anyone is interested in seeing it I can scan it and email it to you. I also have a copy of the “stocktake” form that has been sent to every LA, and can scan that and send it if anyone would like to see it.

If you have any questions or queries on this then please email me or give me a call and I will do my best to clarify.

Yvonne

Yvonne Furze
Membership and Information Manager
Association for Real Change