Transcript Document

Working in Partnership: Joint Commissioning
Anna Gardiner/Andrew Fellowes
4 March 2015
Council for Disabled Children Health and the SEND Reforms
Working with NHS England and Department for
Educations to develop resources for health
professionals.
• Briefings
• Conferences for health professionals
• Online e-learning resource modules
• Upcoming Designated Medical/Clinical Officer
Summit and regional seminars
www.councilfordisabledchildren.org.uk/makingithappen
Joint Commissioning Arrangements: An Overview
Why Joint Commissioning Arrangements
Matter?
What are Joint Commissioning
Arrangements?
Developing Joint Commissioning
Arrangements - Current Progress
Joint Commissioning Arrangements: The Children and
Families Act Local Roadmap
What Have You Got to Guide You?
• Children and Families Act 2014
• Regulations
• SEND Code of Practice
• Pathfinder Evidence
• Voluntary Sector Resources
• Developing Case Law
These are the:
• WHY
• WHAT
Each Local Area
needs to develop
the
• WHO
• HOW
Progress at Implementation?
• 50%: joint commissioning arrangements well developed.
• 14% fully in line with requirements of Code of Practice.
Implementation of Children and Families Act has focused on
operational aspects(e.g. EHC Plans and maintaining a Local Offer)
without Joint Commissioning Arrangements fully established in all
areas.
BUT…
Joint Commissioning Arrangements are required for strategic
changes required to support this delivery.
Without JCA there will be increasing pressure on operational
delivery and frontline professionals- potentially undeliverable.
What are Joint Commissioning Arrangements
The Children and Families Act is very clear that there MUST be
formal joint commissioning arrangements in EVERY local
area.(Section 25-30)
Between LA and relevant Clinical Commissioning Groups (CCGs) +
link to NHS England for specialist services commissioned a
regional or national level
+ Involve other partners
Joint Commissioning Arrangements are the detailed plans of how
education, health and social care services will work together to
deliver the Children and Families Act: The WHO and the HOW
JCA: Key Principles and Considerations
Participation: Children, young people with SEN and disability
and their families at the centre
Outcomes: Develop outcomes in partnership with children and
young people and their parents at strategic and individual
level- based on principles of participation and coproduction
Integration: How services across education, health and social
care will work towards more integrated services to achieve this
outcomes:
Information and Data: Lack of information and data
significant barrier to integrated working
What Must The JCA Cover: 1
• Must set out how Health, Education and Social Care Services will
be integrated
• How the education, health and social care provision reasonably
required by local children and young people with SEN and
disability will be secured and by whom
• What advice and information is to be provided about education,
health and care provision and who is responsible for providing it
• How complaints about education, health and social care
provision can be made and how these are dealt with
• Procedures for ensuring that disputes between local authorities
and CCGs are resolved as quickly as possible
What Must JCA Cover: 2
• How health services will support the identification of children and
young people with SEN and disability and inform the local
authority (including pre school age)
• How partners will respond to children and young people who
need to access services swiftly
• The joint commissioning must also include arrangements and
responsibilities for securing outcomes and personalised services,
specifically:
•
•
•
securing Education, Health and Care assessments;
securing the education, health and care provision
specified in EHC plans;
agreeing personal budgets
Joint Commissioning Arrangements Changing Context:
Legislation and Policy Change
HUGE
• Health and Social Care Act 2012:
Reorganisation of the NHS
• Care Act 2014: New health and social care duties for
transition planning
• Academies Act 2010 + 2012: New school structures
• Education Funding Changes
• Education Curriculum and Behaviour Changes
• Children and Families Act 2014
• Localism
• Austerity
This Changing Context Means:
• Local areas have very different structures
and processes
• Different population demographics and
policy priorities.
• Changing workforce and relationships
Result
• No single model of implementation that can
be applied across all areas of the country
• This is reflected in drafting of the Children
and Families Act
CCG Lead
Commissioner
Designated
for children/
Medical/Clinical
disabled
NHS England
Officer
children
Local Area
Team
Representative
SEND Joint
Commissioner
Parent and
Young People
Representatives
Local
Authority
Head of SEN
and
Disability
Director of
Adult Social
Care
Local
Authority
Officer
responsible
for schools
Joint Commissioning
Arrangements
Local
Authority
Officer
responsible
for early years
Local
Authority
Officer
responsible
for Post-16
Provision
Who should be around
the table?
SEN Reform
Implementation
Lead
Schools Forum
Representative
Youth
Offending
Team
Director of
Public
Health
Building Effective Joint Commissioning Arrangements
Children and Families is primarily education
legislation
To be as effective as possible Joint Commissioning
Arrangements must build engagement with health
and social care professionals as part of wider shared
approach
Designated Medical/Clinical Officer potentially key
role
Not Just the Children and Families Act
• The Health and Social Care Act 2012: Health and
Wellbeing Boards and Joint Strategic Needs
Assessment
• The NHS Mandate: Support EHC Plans and Joint
Commissioning.
• National Health Service Act 2006: Integration of
services to improve services. Section 75 Pooled
Budgets
• Children Act 2004: Promote cooperation with
partners to promote the wellbeing of children and
young people under 18
Alignment with wider local processes in education
health and care
• Joint Strategic Needs Assessment and Joint Health
and Wellbeing Strategy
• Personalisation and Personal Budgets
• Implementation of Care Act
• Reform of National Framework for Children and
Young People’s Continuing Care
• The implementation of the supporting pupils at
school with medical conditions guidance
• Better Care Fund integration of NHS Funding with
Local Authority Social Care Funding
Making It Work Locally.
The Children and Families Act requires
professionals all levels of the system to
contribute to the implementation of the
reforms:
• System Leaders and Decision Makers
• Service Commissioners and Service
Managers
• Frontline Professionals
How do Joint Commissioning Arrangements involve each system level?
Strategic
Leaders and
Decision Makers
Joint
Commissioning
Arrangements
Frontline
professionals
Service
commissioners
and service
managers
Workshop Discussion
What needs to be done at each level of the
system to improve outcomes for children and
young people like Lucy?
How is this developing in your area?
Challenges and Practical Solutions
Joint Commissioning Decision Making Structures
Professional SEND Working Groups
Strategic Leadership and Decision Makers: Setting Direction
and Providing Support
•
Who
•
Key
Stakeholder
Groups
•
•
Key
Responsibilities
•
•
Provide clear leadership and support for
reform agenda
Overall responsibility for development
commissioning strategy
Take decisions about resource allocations to
support reforms, including alignment of
funding streams from the local authority
and the CCG (Section 75)
Set direction of personalisation and
personal budgets
Support development of a clear process for
Education Health and Care plans
Support establishment of process for
complaints and redress for EHC Plans
The SEND Joint Commissioning Cycle
Joint Analysis of
Need
Joint Review of
progress against
outcomes
Partnership with
children and young
people with SEN and
disability and their
parents
Joint Delivery of
provision
Agreeing
Outcomes and
Planning
Service Managers and Commissioners: Planning and Delivery
Who
Key
Stakeholder
Groups
Key
Responsibilities
• Develop strategic outcomes
• Develop participation and engagement
strategy
• Service commissioning and delivery
strategy to achieve strategic outcomes
• Agree process of monitoring progress
against outcomes
• Review Local Offer
• Identify workforce development needs
across services
• Support cultural change
• Make decisions about EHC Plans
• Deal with EHC plan dispute resolution
Frontline Professionals
Frontline Professionals: Delivering Change
Who
Key
Stakeholder
Groups
Key
Responsibilities
• Deliver EHC Plan Assessments
• Deliver services set out in EHC Plans
• Work with children and young people
and their families using person
centred approaches to improve
outcomes
• Input into the Local Offer
• Culture change
• Willing to take initiative
• Open to collaborative working
Available Support Around Joint Commissioning
www.councilfordisabledchildren.org.uk/makingithappen
http://www.sendpathfinder.co.uk/