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Winterbourne View: The Department of Health ReviewPatience WilsonDeputy Director – Mental Health, Disability and Equality
Overview The review has amassed a substantial body of information on: - what happened within Winterbourne View - quality and safety of care provided in other learning disability hospitals - the experiences of care users and their families - the realities of care for people with learning disabilities/autism and behaviours described as challenging
Where are we now? • CQC inspection of Castlebeck Care services and programme of inspection of 150 LD units • DH Interim Report published on 25 June 2012 • Serious Case Review published 7 August • All 11 former staff charged have pleaded guilty to all charges – sentencing expected week of 22 October • Panorama follow-up programme expected week of 22 October • DH Final Report due this Autumn
DH Review – Final Report • The final report will build on the interim report to set out the further actions to deliver change. • It will draw on all published investigations and reviews as well as extensive engagement with people who use services, their families, and the groups which represent them. • The aim is for the report to set out a programme of defined and timetabled actions to address failings in provision for people with learning disabilities/autism and challenging behaviours
DH Review: Concordat • Alongside the final report, we are publishing a Concordat setting out the programme for change • This will be agreed with key external partners • The Concordat will: • Commit all signatories to working together to deliver change for people with learning disabilities/autism and challenging behaviours and • set out the specific actions which each partner commits to deliver • We’re asking our voluntary sector colleagues to sign up to a commitment to hold all other signatories to account for delivery
DH Review: Programme for Change • The final report will set out a programme for change building on the actions in the interim report • This includes commissioning of an audit of current services, to be repeated in 12 months to assess progress • We commit to publishing a progress report on the programme for change one year on
DH Review: Programme for Change The programme will focus on action to: i. ensure joint health and care planning and commissioning of services to meet the needs of children and adults with behaviours described as challenging ii. incentivise the right model of local responsive personalised care • thereby prevent the placing of people inappropriately in in-patient settings • drive up quality in specialist health and care settings and v. establish robust monitoring of progress.
Actions:Planning and Commissioning • Aim is to develop genuine joint planning and commissioning of services around the needs of individuals and their families • DH will work with the NHS CB and ADASS on a model service specification by March 2013 • NHS CB will support CCGs to work together collaboratively in commissioning services for people with learning disabilities • Working with HealthWatch as champion for those who use services and family carers to ensure their needs are heard and understood by commissioners and providers
Actions:Delivering the right model of care • We will incentivise the right model of local, personalised care with every part of the system working together to develop responsive, preventive services so that people are not placed in in-patient settings unnecessarily • The LD Professional Senate will carry out a refresh of Challenging Behaviour: A Unified Approach • DH will work with providers to develop and promote a voluntary accreditation scheme • TLAP national market development forum will work with DH to identify barriers to providing effective local services • NICE will develop Quality Standards and clinical guidelines on LD and challenging behaviour and MH.
Actions:Driving up quality of care • Working with the NHS CB to embed Quality of Health Principles in the system (and with TEASC Quality of Life Principles into social care contracts) • Work with key partners to identify and promote good practice in personalised care in all settings • Work with advocacy partners to drive up the quality of independent advocacy • Produce a progress report by end 2012 on actions in the report of the UK Modernising LD Nursing Review. • CQC will commit to improving the quality of inspections including implementing the SCS recommendations • Plan for new guidance on positive behaviour support and physical intervention
Actions:Monitoring progress • We will work with the NHS Information Centre and NHS CB to develop measures and key performance indicators (to underpin A LD MDS) • Undertake an audit of LD services to establish baseline to measure progress • LD Programme Board to measure progress, monitor risks and challenge external delivery partners • Publish a follow up report in a year
Concluding Comments • We know there are examples of good practice (we described some in the interim report) and the commitment from external delivery partners to make changes • All parts of the system have a role to play in driving up standards for this vulnerable group of people • There should be zero tolerance of abuse or neglect • Together we can make a difference