Monday 14 July 2014

The Winterbourne View Concordat and Bubb's challenge

I was surprised. I had gone for a meeting with Simon Stevens, the new NHS England Chief. As with all such meetings, I had my requests. But instead he got there first. "I have three asks", he announced.

The first was what the third sector could do to support the implementation of the Government's pledge on Winterbourne.  Following the Winterbourne View scandal, the Government promised to move all learning disability clients out of inappropriate in-patient facilities into the community. The appalling abuse of people with learning disabilities exposed by the Panorama programme in Winterbourne View, an institution meant to care for them had shocked a nation. Norman Lamb MP, the Health Minister rightly said that not only must there be serious consequences for the Winterbourne View abusers, but that there were also wider issues in the care system that needed to be addressed. In particular, he insisted that all clients in inappropriate in-patient settings should be cared for near their families and in community settings. It was a courageous move.

Sadly, the pledge that those people would be moved by 1st June this year was not met. Not only has that not happened but there are now more people in such placements.  Simon Stevens was clear that only the third sector could deliver the promise and he wanted me to look at a plan for "co-commissioning" between the NHS and my members.

A challenge, clearly, but one I was  up for. I gathered together my top provider members in learning disability for a breakfast to discuss our options . They were enthusiastic for the task; people like Jan Tregelles of Mencap, Steve James of Avenues Group, Robert Longley-Cook of HFT, Mark Lever of NAS, the indomitable Su Sayer of United Response and Ben Rick of the Social Investment Business.

Turning words and talk into a plan requires some skill. Fortunately I have the team at ACEVO that can do this. Mark Winter, my multi-talented Head of Health Commissioning wrote up our Plan on the back of that breakfast, which we characterised as a "national framework, locally delivered".

In essence this envisages the closure of most or all of the current inpatient facilities and the transfer of clients to appropriate community placements near their families . This will require investment in buildings,  converting houses or building new. However social finance can cover this on the back of sensible commissioning i.e. 10 year contracts.  With will,  it is entirely  doable. And if we all share the interests of the 3,250 clients we need to move into better community settings we will do it. Of course with any such task there will be a multitude of views and interests but I've been pleased so far that we all seem to be on the side of sorting it out : and that means being client focused.

We submitted The Plan and it was accepted. And I have now been asked to Chair the Steering Group that will guide the development of that, "national plan, locally delivered". The deadline is October. I report to Simon Stevens.  The group first meets on the 28th but already we are working on outlines and challenges.

I'm both pleased and daunted by this task. So far the system has been unable to implement the Government pledge - so what makes me think I and my third sector colleagues can? I guess it's my strong belief in the power of the third sector and our ability to deliver against the odds, as well as our passion to succeed for our people.

The task is in fact not  dissimilar, if  smaller, than that faced in the 80s when it was determined that all mental health asylums be closed and people cared for in the community. A patchy programme but one everyone now knows was exactly right. I chaired Tooting Bec Hospital (a large asylum in South London) then and I worked to ensure its closure but with a proper community provision in and around Lambeth. We know that institutional care is not the answer and if we put the needs of the citizen first we will work to support them in the community whatever their challenges.

If we do succeed we show the NHS what our sector can achieve.  This is the first time the NHS has undertaken "co- commissioning" with the voluntary sector so it's a challenge for us and for them. Many of the challenges faced by the NHS require the fuller involvement and commissioning of the third sector. This may prove a model for wider use. Central to delivery not peripheral to it.

Jan Tregelles, the determined CEO of Mencap, organised a visit for me and my ACEVO colleague Mark to the home of five people in London where Mencap provide support. What I saw was incredibly positive and made me determined that we will succeed because this is ultimately about better lives for people who have not had the life chances many of us enjoy and who are to open to abuse or neglect. Our sector has the skill to give them a better life and the stronger outcomes that hospitals and places like Winterbourne View have not always given them.

So just as well I haven't got any holidays booked over the next few months!


Well I see that my blog has attracted some attention! Good. This issue needs as much energy behind it as possible. However, just to be very clear, we are at the early stages of scoping the remit of the steering group. We have already contacted user led organisations and will be contacting families and people with learning disabilities today, as we had planned to do all along. It would be quite unthinkable to do otherwise.


The Mother. said...

Shame there were no service users or family members /carers at the breakfast!

Shame too that people's lives are going to be deposited into covenient 'charity case' slots- forget charity and focus on rights!

Zoe said...

Exactly what I thought - where are the service users and carers. Please PLEASE read what's been written as part of the #107days campaign. Mark Lever certainly knows all about it if you don' guessing you don't (or you wouldn't have left us out) which in itself is worrying. We are fed up with being left out and being 'done to'.

Anonymous said...

We are CHANGE a national user led organisation.We work for the human rights of all people with learning disabilities.
We have some questions we would appreciate your answers to:Were there any user led organisations at the breakfast?
'Investment in buildings'sounds like a proposal for a residential care model,not'investment in housing'which would be required for supporting people to live in homes of their choosing.
10 year contracts:what happened to choice and control?Isn't this a block contract?
Where has this plan been consulted on by those without a financial stake in the outcome of commissioning?
What is the legal underpinning for this?How can charities be commissioners, when the law envisages the NHS and /or local authorities to commission care and take responsibility for care plans?
Is there any proposal for people with learning disabilities from user led organisations to be involved in developing the plan or in commissioning?
We look forward to hearing from you.

Unknown said...

What they said. plus "Jan Tregelles, the determined CEO of Mencap, organised a visit for me and my ACEVO colleague Mark to the home of five people in London" - nice. When was the last time someone organised a visit of two complete strangers to YOUR home????? If you don't get that this is inappropriate then you need to get someone working with you who does.

ArchieBoy said...

Oh I'm thrilled that you and a few business pals got together and enjoyed some croissants at the taxpayers expense. How arrogant to believe that you and your 'in crowd' can sort out the complexity of chronically under resource LD provision and decades of cack handed support planning. And I bet none of you have spoken to a person with a learning disability this year!

Virginia said...
This comment has been removed by the author.
Unknown said...

I have written an open letter to Sir Stephen on my blog
This is read by a number of the critical LD community on Twitter and I amended it in response to comments.
I hope it is clear, concise and constructive.