Transcript LINks – What will they mean to you

Andrew W Dawson
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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
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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
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Replace old NHS patients’ forums
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1 April 2008 (piloted in 2007)
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One per local authority area (social services)
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Gvt funding of £84m (£26m pa) runs to 2011
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Will this be a priority going forward?
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Local Government and Public Involvement in
Health Act 2008 s221(2)
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Duty on local authorities:
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To promote and support the involvement of
people in the commissioning, provision and
scrutiny of local care services
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...
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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
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All LINks will be different
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Host is accountable to the LINk
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LINk expected to report to community and
Secretary of State on activities undertaken
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Anyone – ideally with an interest in care
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Aim entire community involvement
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Q – usual suspects?
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The more people get involved...
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The stronger they are
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Individuals
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Carers, service users, community leaders,
patient representatives
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Groups – charity, faith groups, residents’
associations
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Anyone... So... (declare any conflicts)
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Flexible involvement
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Adult care services as well as NHS
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Investigating specific issues of concern to the
community
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Suggest ideas to improve the care people
receive
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What citizens want from local services
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Monitor and review care provided
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Inform commissioners what the community
thinks
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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
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Seek out views of more people
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Richer feedback
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One-stop way to engage the community
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Avoid duplication of effort
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Assist in prioritising services that local people
value
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Inform decision making
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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
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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
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From commissioners and regulators
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Within
20
working days
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Through your contract with local authority
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Code of Conduct
◦ Does not have force of law
◦ Is not even statutory guidance
◦ Background principles and practical considerations
◦ Made up by DH
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Authorised representatives to observe the
delivery of services and to collect views of those
directly using the services.
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CRB Check undertaken and considered
satisfactory
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LINk must maintain a comprehensive and up
to date list of all authorised representatives
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Compromises effective provision of a service or
the privacy or dignity of any person
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Where premises are:
◦ a person’s own home
◦ solely accommodation for employees
◦ non-communal parts of a care home
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Where health and social care services are not
being provided (eg offices or closed)
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Where in the opinion of the provider the
representative is not being reasonable or
proportionate
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Does not provide evidence of right to enter
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Does not apply to services delivered for
children
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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...
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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
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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
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Visit findings should be documented
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Evidenced reporting identifying sources
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Inform staff and perhaps service-users of
findings
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Balanced assessment of service
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Recommendations for improvement
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Delivered first in draft – 14 days for comment
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Commissioners
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Overview & Scrutiny Committee
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Regulators
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Via your contracts
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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
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See www.dh.gov/LINks
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Anything about permitting LINks entry?
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Do you have a written contract in any event?
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Does this affect pre 1 April 2008
arrangements?
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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
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Our survey said ...
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What pearls of wisdom do we expect?
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Bureaucracy gone mad?
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The usual suspects
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Tribe of the ill-informed and over-zealous?
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NHS & Local Authority obligations already
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LINks could be:
◦ Advocates for your service-users
◦ Advocates for you and your business
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Don’t forget
◦ Commissioners
◦ Regulators
have to take what they say into account
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The Lion’s Roar?
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Your own local select committee
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Martini style
◦ Anytime, anyplace, anywhere
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When done well ...
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Mental health provision
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Obesity
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Extra-care housing
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Learning Disabled Care Provision
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Local Authority Moratoriums on admissions
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Know your Councillors
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Councillors love care homes
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Councillors run scared of social services
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Councillors want the best for their communities
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Make friends with them – or ...
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Stand for election yourself!
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LINks - do we really need them?
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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