9. What happens if you don’t listen?
hundreds of patients died at the hospital because of an
obsession with meeting targets and a 'box-ticking culture'.
10. Strategic Focus on Children
In response to Report of Children and Young People’s
Outcomes Forum:
• Defining and agreeing national leadership and
accountability for children’s health in Children and
Young People's Health Outcomes Board led by the
Chief Medical Officer
• New Children’s Partnership
• New Children and Young People's Health
Outcomes Forum co-chaired by Christine Lenehan,
CDC
• Pledge to provide better care for children and young
people with long term condition and disability and
increase life expectancy of those with life limiting
conditions
• New Outcome indicators for children and young
people
11. DH
Ministers
Children and Young
People’s Health
Outcomes Forum
Children and Young
People’s Health
Outcomes Board
Children’s Health and
Wellbeing Partnership
LGA
HEE
Chair, Chief Executive
NHS England
Chair, Chief Executive
SOLACE
PHE
Chair, Chief Executive
Organisations accountable for
policy, commissioning and
delivery
Independent bodies
providing expertise,
challenge, advice,
recommendations
Partnership for policy,
commissioning and
delivery
ADCS
Themed Groups Sub Groups / Task & Finish Groups
Mediation & advice – with personal leadership
of CMO
Constructive challenge, advice,
recommendations
Response / decision
Request for advice
Two way communication
Update to
Recommendation from Children’s Partnership
to organisation leadership. Decision by each
member organisation’s governance
CYP Outcome Board
CYP Outcome Forum
Children’s Health and Wellbeing Partnership
Health Transition Task Group
Aligned Themed and Sub / Task & Finish Groups to
avoid duplication
National organisations which are members of
Children’s Partnership
NHS Contribution to Public Health Governance
System steward & secretariat role
secretariat
HWE
Chair, Chief Executive
DfE
Ministers
Health Transition
Task Group
NHS Contribution to
Public Heath Senior
Oversight Group
secretariat
secretariat
ADPH
NHS Clinical Commissioners
Chair, Chief Executive
13. National Health Leadership
Bodies
• Department of Health: Stewardship and
guardianship. Secretary of State retains
ultimate responsibility for NHS
• NHS England: National commissioning body
and system manager
• Public Health England: provide information
and intelligence to support local public health
services and lead on national public health
campaigns
• Clinical Networks: bring together experts on
particular conditions and service areas
14. Local Health Bodies
• Clinical Commissioning Groups: Led by GP Practices
with secondary specialists. Will commissioning local NHS
services and will set out their strategy for local health
services in annual commissioning plans
• Local Authority Directors of Public Health: lead on
local authorities’ new public health commissioning
functions.
• Health and Wellbeing Boards: bring local partners
together in each local authority will to plan health,
social care and public health services
• Clinical Senates: Hosted by NHS England, give expert
advice to the NHS Commissioning Board and CCGs in
each area of the country
15. Drivers for delivery
Specialised Service Specifications
NHS England Senate Clinical Reference Groups
to NHS England Commissioners
Specifies outcomes for specific service
Quality Premium and CQUINS
NHS CB to CCGs and providers
Additional quality specifications for additional
payment
Quality and Outcomes Framework
NHS Commissioning Board to CCGs and
providers
Standard framework for rewarding contractors
in the NHS for the provision of quality care
Commissioning Outcome Indicator Set
NHS Commissioning Board to Clinical
Commissioning Groups
Measures quality and outcomes to be achieved
by Clinical Commissioning Groups
NHS and Public Health Outcomes Frameworks
Department of Health to NHS Commissioning
Board
General outcomes to measure impact of NHS
The Mandate
Department of Health to NHS Commissioning
Board
Broad Objectives and Priorities
16. Regulation and Oversight
• Monitor: becomes economic regulator for all NHS
services. Will promote economy, efficiency and
effectiveness in the provision of services
• CQC: responsible for overseeing compliance with quality
requirements and powers to intervene to protect patient
safety
• Ofsted: responsible for regulation of children’s social
care
• Parliamentary and Health Services Ombudsman:
Investigates individual complaints about poor NHS
service
17. • Health Watch England: subcommittee of Care
Quality Commission. Will support Local Health Watch
and advise national health bodies. Can request CQC
investigate poorly performing services.
• Local Health Watch: Commissioned by LA, will
replace LINKs and some elements of Patient Advice
and Liaison Services. Will promote patient
involvement in local health system, and provide info
and advice about local services and choice
• NHS independent complaints advocacy:
commissioned by local authorities, accessible through
Health Watch
Voice and Involvement
18. Local Healthwatch
Provide information and advice to the public about
accessing health and social care services and choice in
relation to aspects of those services;
• make the views and experiences
of people known to Healthwatch
England helping it to carry out
its role as national champion;
• make recommendations to
Healthwatch England to advise
the Care Quality Commission to
carry out special reviews or
investigations into areas of
concern (or, if the circumstances
justify it, go direct to the CQC
with their recommendations, for
example if urgent action were
required by the CQC);
• promote and support the
involvement of people in the
monitoring, commissioning and
provision of local care services;
• obtain the views of people
about their needs for and
experience of local care
services and make those views
known to those involved in the
commissioning, provision and
scrutiny of care services; and
• make reports and make
recommendations about how
those services could or should
be improved.
20. Making complaints in the new system
Stage 4
Judicial
Review
If the complaints process is unsuccessful then you could undertake Judical Review to challenge the
legality of the NHS actions. This is a big undertaking and you need legal advice.
Stage 3
Complain to
the PSHO
They will review the way your complaint was handled using the information you provide, and can
instruct the NHS to apologise or change its policies.
Stage 2
Complain to the
commissioner of the service
This will be a CCG or NHS England. They will have their complaints information on
their website
Stage 1
Complain to the provider: they will have complaints
manager or complaints policy
They must acknowledge keep you informed of the process of
your complaint
21. What is CDC doing?
• Providing clinician’s with tools to better help
them provide a service
– Spotting the Sick Child
– Managing My Way Clinic Poster
– Emergency Healthcare Plans
– RCPCH Neurodisability Portal
• Empowerment:
– Expert Parent Programme
– Constitution Project
– Developing methodology for involving severely
communication impaired young people in research
22. So?
• Grounds for considerable optimism
• But starting from a low base
• Lots of work to do
• But a significant number of levers to pull on in getting that work prioritised
• So we maybe at a tipping point
23. View our
resource bank,
events calendar
and table of
resources to
support the
implementation
of the SEND
Reforms
www.councilfordisabledchildren.org.uk
Hinweis der Redaktion
It’s not just fluffy stuff, it really does have an impact on outcomes and in fact if it’s all about outcomes, which it should be, then whose outcomes should the health service be working towards?
Symbiosis between compliance and experience with an important side order of autonomy
Crash points for children are in infancy and adolescence.
Reason for optimism?Children being taken seriously at a more senior level than ever before? Certainly within last 25 years. CMO report focusing on children with chapter on neurodisabled children – usually talks about MRSA – still some way to go, didn’t think could do any focus groups with neurodisabled children.Continued commitment to the Outcomes ForumForum recommended 4 new indicators government accepted recommendation – talk about under drivers
Understanding the health system so we can make it listen!!
Currently CCGs at sea with person centred commissioning
The Mandate – Dan Poulter wants significant read across to the pledge when the Mandate is refreshed ready for April 2015NHS Outcomes Framework, originally included very few outcomes directly related to children and young people and a number that could have related were not measured for under 16s. The Government have accepted the HOF recommendations and have included two new outcomes for 13/14Potential years of life lost for c&ypCancer survival rates for childrenAll data will be presented in 5 year age bands to enable effective transition to be monitoredPlaceholder for developing a PREM, this should be ready shortly according to DH.DH looking at best way to capture patient experience of integrated care across all age ranges.Also looking at measures of child development at 2-2.5 years and school readiness.Looking at feasibility of extending all relevant measures to cover children.Are also looking at outcomes in the following areas:Further work around PREMsIntegrated careTime to diagnosis or agreed treatment planTransitionImpact of poor health on educationPH Outcomes Framework can’t be altered until 2015Maternal mental healthMental health problems in C&YPQuality and Outcomes Framework – QOF How GPs earn extra moneyThe ‘quality premium’ is intended to reward clinical commissioning groups (CCGs) for improvements in the quality of the services that they commission and for associated improvements in health outcomes and reducing inequalities. CQUINS similarly are payment designed to reward improvements in the delivery of careSpecialised Service Specifications outline expectations around what a good service should look like and sets key service outcomes. NHS England have just finished a consultation around transforming participation in specialised services and are recommending making stronger connections between the patient/carer reps on different groupsWomen and Children is one of the five national Programmes of Care (PoC), which have been designed to organise the individual service areas into five functional groupings.The national Women and Children PoC covers services in women and children, congenital and inherited diseases; this relates to both specialised and highly specialised prescribed services, and includes both surgical and medical services.The services in the PoC are clustered into Clinical Reference Groups (CRGs) to support the national work in these areas. There are 13 CRGs in the Women and ChildrenPoC and each CRG has 4 patient and carer member places.
Francis has recommended that Monitor and CQC be combined.
Local healthwatch have been told on set up that they have to act as a champion for children and young people. NCB have produced a fantastic resource which aims to help local Healthwatchs learn from the LiNKS and Healthwatch Pathfinder experiences of engaging with children and young peopleLocal Healthwatch have a seat at their HWBB – will feed in evidence from their local community to HWBB and Commissioners – virtuous feedback loop
Currently running a campaign to find out what people think about their local complaints system with intention of improving process 3 – collect and collate evidence from local groups to inform HWBB and Commissioners
Lots of tips for local healthwatch on how to successfully engage children and young people.
Changing culture, NHS focusing a lot of attention on changing culture of staff and we need to do what we can to change the culture of being a patient. Supporting people to become empowered consumers of the health system and that means not only understanding what the system is and how it works, what our rights are, but also knowing how to complain if those rights and our needs are not being met.
‘many of the problems we face behave like epidemics. They aren't linear phenomena in the sense that they steadily and predictably change according to the level of effort brought to bear against them. They are capable of sudden and dramatic changes in direction. Years of well-intentioned intervention may have no impact at all, yet the right intervention - at just the right time - can start a cascade of change.’