Working Together - Foundation Trusts and Local Involvement Networks (LINks)

1. Working Together - Foundation Trusts and Local Involvement Networks (LINks) Foundation Trust Governors’ Association Development Day 8th October 2008, Leeds.

2. Stronger voice, better care • More people involved in a way that suits them • Pool of local knowledge & expertise • Evidence-based input & systematic feedback • Mechanism to facilitate ongoing engagement with whole population-a single system to involve communities • More responsive & accountable services • More effective use of resources

3. What is a LINk? • A network of local individuals, groups and organisations • Covers all aspects of publicly-funded health and social care • Offers flexible ‘participation’- reflecting the nature & diversity of local community • Builds on existing networks & community activity • Independently funded (grants based on local factors – i.e. population) • Supported by a ‘Host’ organisation (appointed by the local authority)

4. Legislation • Local Government & Public Involvement in Health Act 2007 • Established LINk’s & their activities from 1st April 2008 • Abolished patient forums & Commission for Patient & Public Involvement in Health • Placed duty upon Local Authorities (with social services responsibilities) to make contractual arrangements with a host organisation to support the LINk • Placed duties on commissioners & certain providers to respond to LINk’s & allow entry to services • Updated & strengthened the duty on NHS bodies to involve & consult

5. Anyone can get involved…. Neighbourhood renewal network Local Strategic Partnership Carers Network Youth Council Harder to reach groups/communities of interest Individuals Individuals Foundation Trust Governors Patients Transport Groups LINk Tenants Groups Older People’s Forum Individuals Minority Ethnic Groups Individuals Support Groups for Specific Service Users Faith Groups Patient Groups

6. Role of LINks • Promote & support the involvement of people in the commissioning, provision and scrutiny of local care services • Obtain the views of people about their needs for, and their experiences of, local care services • Enable people to monitor and review the commissioning and provision of care services • Convey people’s views to organisations responsible for commissioning, providing, managing & scrutinising local care services & recommend how services can be improved

7. Powers of LINks • Under legislation LINks can: • enter specified types of premises & view the care provided • ask commissioners for information & receive a response within a specified timescale • make reports & recommendations & receive a response from commissioners within a specified timescale • refer matters to an Overview and Scrutiny Committee & receive a response.

8. Regulations for LINks Duty on service providers to allow authorised LINk’s representatives to enter & observe: • Directions to commissioners to amend new contracts with independent providers • Safeguards & exclusions: • Compromises effective provision or privacy & dignity • Care provided in peoples’ homes • Childrens’ social care • Premises under tenancy/licence • Non-communal areas of care homes • Enter if invited

9. Regulations for LINks Make reports & recommendations: • Specific duty on health & social care commissioners to respond to LINk’s within 20 working days • Provide explanation of intended action or explain why no action is to be taken • Provide copy of report to any other relevant commissioner

10. How LINks work • Gather evidence: • Local needs & experiences • Existing sources + community outreach & engagement • Analyse information: • Identify & pass on trends • make recommendations to commissioners, providers, managers, Overview & Scrutiny Committees & regulators • Encourage & support users to participate

11. How LINks can help • Access to & understanding of community needs & aspirations • Inform health and social care commissioning decisions • Support contract management • Give providers ongoing systematic feedback • Intelligence on factors influencing choice • Help managers know if services meet local need • Help regulators access local information

12. How LINks can help • Inform Joint Strategic Needs Assessments • Vehicle for commissioned research • Allow Overview and Scrutiny Committees to base work plans & reviews on actual feedback • Help regulators access local information • Build community views into Local Strategic Partnerships in Local Area Agreement process

13. Implementation – where are we now? • The Department does not have direct control over LINks implementation, rather we seek to encourage and enable our delivery partners to aid the process along and feedback to us with regular progress reports. • Almost six months after the legislation came into force, we are now in a position where 128 local authorities (85.3%) have contracted with a host and 22 (14.6%) are still in transition.

14. First things LINks are doing… • Agreeing governance & accountability arrangements • Developing a community profile • Developing engagement & communication mechanisms • Agreeing a work plan • Identifying & developing relationships • Ensuring inclusion of diverse groups & interests • Agreeing annual budget & priorities • Agreeing training & support programme

15. How does a Foundation Trust engage with patients? • Directly - There are currently 105 NHS foundation trusts which have over 1.2 million members drawn from the public, patients and staff. Patient and public members elect the majority of the Board of Governors of each NHS foundation trust. • Via the LINk and other patient groups - LINk perspective will be wider than a single organisation and can take a view of services across whole community. The LINk will represent groups of people who may not be represented on Foundation Trust Board of Governors.

16. How does the role of a Board of Governors differ from that of a LINk? • Scope - a LINk serves to capture patient experience relating to all publicly funded health and social care services available in a given local authority area. • Reporting – a LINk shares information and intelligence with local commissioners and providers and reports annually to the Secretary of State for Health and the new Care Quality Commission. • Membership – membership arrangements for LINks are flexible and fluid. The LINk will be able to represent groups of people who may not be represented on Foundation Trust Board of Governors. It is likely that members of Foundation Trusts may wish to join LINks.

17. Developing relationships between Foundation Trusts and LINks • LINks are networks of individuals and organisations and are about bringing together work rather than duplicating it. • FTs can identify key decision making aspects LINks can support & process for engagement • FTs can develop processes for accessing & using intelligence from LINks • FTs themselves will see the benefit of developing relationships with LINks as a means of gathering additional information, to be used to inform the development of services.

18. Developing relationships A number of options have emerged: • The ‘membership’ of the Foundation Trust in its entirety becomes a LINk member organisation. Communication with the members could be through web-based means or could develop in synergy with the Foundation Trusts own communication channels. • A sub-group of the membership could be formed to become a LINk organisation. • Individual members of the Foundation Trust could be actively encouraged to become members of the LINk and take some responsibility for communicating with the wider membership.

19. Options continued… • The Board of Governors (elected by the members) could be engaged e.g. given a place on a LINk Board, considered as a member organisation. • The LINk could play a secondary role in Foundation Trusts and develop a relationship with them to enable them to signpost people and to pass on information that they collect as part of their day-to-day work • The LINk could, in the case of specialist Foundation Trusts e.g. mental health Foundation Trusts, treat the members as a specialist sub-group of the LINk. • There could be a combination of the above depending on the purpose of the engagement.