LINks – What will they mean to you
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Transcript LINks – What will they mean to you
Andrew W Dawson
Partner and co-founder Brunswicks LLP
Councillor for Frodsham & Helsby
Chairman of Overview & Scrutiny Committee
Cheshire West & Chester Council
Brunswicks LLP
56 Hamilton Square Birkenhead CH41 5AS
08455 190691
07970 635629
07855 855 588 – 24 hours
A “network of local people and organisations,
funded by the Government and supported by
independent organisations known as a Host
to promote and support the involvement of
people in the commissioning, provision and
scrutiny of local health and social care
services.”
DH definition
Local Involvement Networks = LINks
Replace old NHS patients’ forums
1 April 2008 (piloted in 2007)
One per local authority area (social services)
Gvt funding of £84m (£26m pa) runs to 2011
Will this be a priority going forward?
Local Government and Public Involvement in
Health Act 2008 s221(2)
Duty on local authorities:
To promote and support the involvement of
people in the commissioning, provision and
scrutiny of local care services
...
Local authority has to retain “host
organisation” to set up and support their LINk
◦ Promote
◦ Encourage participation
◦ Make LINk work well
◦ Budget
◦ Advice and Support
◦ Report and Communication
All LINks will be different
Host is accountable to the LINk
LINk expected to report to community and
Secretary of State on activities undertaken
Anyone – ideally with an interest in care
Aim entire community involvement
Q – usual suspects?
The more people get involved...
The stronger they are
Individuals
Carers, service users, community leaders,
patient representatives
Groups – charity, faith groups, residents’
associations
Anyone... So... (declare any conflicts)
Flexible involvement
Adult care services as well as NHS
Investigating specific issues of concern to the
community
Suggest ideas to improve the care people
receive
What citizens want from local services
Monitor and review care provided
Inform commissioners what the community
thinks
Ask local people what they think of local
health and social care
Give opportunity to suggest ideas to care
professionals that may improve services
Consider issues of local concern
Make recommendations to those who plan
and run services and expect a response
Ask for information and expect answers
Carry out visits
Refer matters to Council O&S Committees
Seek out views of more people
Richer feedback
One-stop way to engage the community
Avoid duplication of effort
Assist in prioritising services that local people
value
Inform decision making
Single system to involve communities
Help and inform commissioners decisions
Support NHS duty to involve
Assist “World Class Commissioning”
Ongoing feedback
Help with knowing whether services meet needs
Allow O&S committees to base reviews on actual
feedback
Assist regulators with local information
Build community views into LSP and LAA
processes
LINks can
Enter specific services and view the care
provided
Ask commissioners for information about
services and expect a response
Make reports and recommendations and
expect a response from commissioners
Refer matters to the Council’s Overview &
Scrutiny Committee
From commissioners and regulators
Within
20
working days
Through your contract with local authority
Code of Conduct
◦ Does not have force of law
◦ Is not even statutory guidance
◦ Background principles and practical considerations
◦ Made up by DH
Authorised representatives to observe the
delivery of services and to collect views of those
directly using the services.
CRB Check undertaken and considered
satisfactory
LINk must maintain a comprehensive and up
to date list of all authorised representatives
Compromises effective provision of a service or
the privacy or dignity of any person
Where premises are:
◦ a person’s own home
◦ solely accommodation for employees
◦ non-communal parts of a care home
Where health and social care services are not
being provided (eg offices or closed)
Where in the opinion of the provider the
representative is not being reasonable or
proportionate
Does not provide evidence of right to enter
Does not apply to services delivered for
children
Constructive relationship
Enable ongoing improvement
Not to seek out fault but to consider the
standard and provision of care services and
how they may be improved
Duty to allow entry on:
◦ NHS Trusts, Foundation Trusts, PCTs, Local
Authorities, GPs, dentists, opticians, pharmacists,
bodies contracted with local authorities or NHS
Trusts etc to provide care services...
Or unannounced!
Recommended to set out reasons in advance
◦ Date, time, length;
◦ Underlying intelligence (anonymised if from a
patient or user)
◦ Purpose of visit
◦ Shape and format of proposed visit:
Who, what, when, how, accompanied etc
◦ Names of authorised representatives
◦ Identification and verification
◦ Availability of draft findings
Hints for LINks – preparatory work
◦ Think through aim and desired outcome
◦ Could the visit be co-ordinated with someone else
eg CQC
◦ How will objectives be met?
◦ Pre-visit checklist
◦ Special support needs?
◦ Mix of authorised representatives?
◦ Allocate topics in advance
◦ Timing of visit re service delivery?
◦ Relevant research
Visit findings should be documented
Evidenced reporting identifying sources
Inform staff and perhaps service-users of
findings
Balanced assessment of service
Recommendations for improvement
Delivered first in draft – 14 days for comment
Commissioners
Overview & Scrutiny Committee
Regulators
Via your contracts
Duty on those commissioning services to
ensure that contracts made with independent
providers after 1 April 2008 allow for
authorised representatives to enter, view and
observe the carrying on of activities owned or
controlled by the independent provider
See www.dh.gov/LINks
Anything about permitting LINks entry?
Do you have a written contract in any event?
Does this affect pre 1 April 2008
arrangements?
What if post 1 April 2008 arrangements are
silent?
LINks
provisions
Must we let
them in?
Likely consequences
of refusal
No written contract
No
probably not
Written contract
offered
Written Contract
pre 1/4/08
No
probably not
Revised written
contract offered
Written Contract
post 1/4/08
Yes
yes, subject to
compliance
with regs
Breach of contract
consequences
Written Contract
post 1/4/08
without provisions
No
probably not
Revised written
contract offered
LINks
provisions
Must we let
them in?
Likely consequences
of refusal
No written contract
No
probably not
Written contract
offered
Written Contract
pre 1/4/08
No
probably not
Revised written
contract offered
Written Contract
post 1/4/08
Yes
yes, subject to
compliance
with regs
Breach of contract
consequences
Written Contract
post 1/4/08
without provisions
No
probably not
Revised written
contract offered
Our survey said ...
What pearls of wisdom do we expect?
Bureaucracy gone mad?
The usual suspects
Tribe of the ill-informed and over-zealous?
NHS & Local Authority obligations already
LINks could be:
◦ Advocates for your service-users
◦ Advocates for you and your business
Don’t forget
◦ Commissioners
◦ Regulators
have to take what they say into account
The Lion’s Roar?
Your own local select committee
Martini style
◦ Anytime, anyplace, anywhere
When done well ...
Mental health provision
Obesity
Extra-care housing
Learning Disabled Care Provision
Local Authority Moratoriums on admissions
Know your Councillors
Councillors love care homes
Councillors run scared of social services
Councillors want the best for their communities
Make friends with them – or ...
Stand for election yourself!
LINks - do we really need them?
Partner and co-founder Brunswicks LLP
Councillor for Frodsham & Helsby
Chairman of Overview & Scrutiny Committee
Cheshire West & Chester Council
Brunswicks LLP
56 Hamilton Square Birkenhead CH41 5AS
08455 190691
07970 635629
07855 855 588 – 24 hours