Contact: Glyn Jones, ext 7257

1 Original scope of the review

Services for Adults / Older People with a sensory loss who require social care intervention for their support. This will include the interface between health and social care to examine best practice in this area and look at approaches where integration may be more effective. This review will also cover administrative support for sensory services.

1.1 Details of the services contained within this review are contained in Appendix 1 and their work is illustrated through several case studies

1.2 This review will link into the parallel Best Value activity examining services in the community to support people to remain at home and to services with children with a disability. It will also inform the work to be commissioned subsequently in support of reconfiguring the management and team structures within the physical disability sector.

2 Team

2.1 The review group initially met on the 10^th April 2002 and is meeting on a monthly basis throughout the course of this review. The membership of the core group is as follows:

Project Leader: Glyn Jones

Project Managers: Peter Knight, Angela Harris

Strategic Advisors: Angela Watwood and Roz Godfrey

Staff Representative: Robert Saunders

Corporate Performance Team Officer: Penny Velander

Administrative support: Heidi Mosling

Service users: service users will be an integral part of the review team throughout the main improvement options formulation part of the review

2.2 In addition dedicated Topic Groups will be set up to examine key areas for improvement within the service and to report their findings to the Core Group. The Group Leaders will form part of a wider review team which will meet with the Core Group to integrate their findings.

2.3 A dedicated Challenge Group composed of external stakeholder; users and carers will challenge the work of the Core group and the Topic Groups throughout the review.

2.4 Elected members have already contributed to the process through their active participation in a large stakeholder consultation event. Nominated Councillors for this review are:

Cllrs: Mrs E. Randall, P. Heath, G. Davies-Dear, and Mrs. V. Steel.

Cllrs A. Ludlow and J. Frankhum have also demonstrated their interested through active participation in the stakeholder day.

2.5 It is proposed that we continue Elected Member involvement throughout the course of the review through their participation in review activities.

3 Visioning

3.1 Visioning statement from the review team:

"Sensory services need to operate within the social model of disability, recognising that barriers need to be removed to ensure people who are Deaf, hard of hearing or visually impaired have the opportunity for full inclusion into society"

Within this, staff involved in sensory services need to offer a consistent, high quality and accountable service which manages the care pathways across agency boundaries"

3.2 The vision of how internal and external stakeholders believed services should be and the issues they identified for attention by the review team are contained in detail in Appendix 2.

3.3 Summary of key issues identified

3.3.1 The "whole systems approach" needs to be developed across agency boundaries and the role of rehabilitation in sensory services clarified

3.3.2 Strategic direction and planning needs to be developed in support of greater consistency throughout the County

3.3.3 Working relationships need to be improved with providers and all partners

3.3.4 The profile of sensory services needs to be raised

3.3.5 Meaningful involvement and consultation with users and carers needs to be achieved

3.3.6 The following human resource issues also need to be addressed:

- staff qualification and competency based awards

- career pathways

- clinical supervision

- role and practice of contracted posts

- management of sensory teams in the recently remodelled department

- competence of managers within specialist teams

4 Approach to the review

4.1 This review will follow the revised, streamlined Best Value process and focus on areas where there is potential for achieving improvements, avoiding duplication of work already carried out within normal service planning.

4.2 However the review team is still committed to the rigorous application of the "4 C's" of the Best Value process, in that it is necessary to:

- Challenge

- Compare

- Consult

- Compete

This will be achieved in the following ways.

4.3 Challenge

4.3.1 The review team will ensure there is a strong challenge to the way in which services are currently deployed, including:

- investigating why a service is provided

- how is it currently provided and

- how else it could be provided

4.3.2 A dedicated challenge group will be set up composed of users and carers, voluntary organisation representatives, a Health and Education representative and an officer from another Local Authority. This will in operation throughout the lifespan of the review to afford challenge at every step of the process.

4.3.3 Other models of service delivery will be examined including outsourcing directly provided services.

4.3.4 The legislative base for the service is under Section 2 of the Chronically Sick and Disabled Persons Act, Section 4 of the Disabled Persons Act 1986, and the Disability Discrimination Act 1995 which place a duty on Local Authorities to arrange for the provision of appropriate services for people with a sensory loss. We also have a statutory duty to assess the needs of anyone who may require a service under Section 47 of the NHS and Community Care Act 1989.

4.4 Compare

4.4.1 The review team will compare Hampshire's performance with the best alternatives. This will require examining the outcomes of services in the public, private and voluntary sectors.

4.4.2 The review will compare the performance of Hampshire services against those of other similar authorities in key performance areas through both site visits and analysis of published information. We will also undertake an International Literature Review to establish best practice.

4.4.3 We will undertake an internal evaluation to determine the relative performance of different teams within Hampshire, taking into account different referral routes, care pathways and management structures that currently operate.

4.5 Consult

4.5.1 The review team will listen closely to what our communities and stakeholders have to say. In undertaking this we shall be clear about the process and product of such consultation activities.

4.5.2 Within the review we will initially collate and profile pre-existing user feedback, which has been routinely gathered by the Deafened and Hard of Hearing services.

4.5.3 Based on this we will be engaging in structured consultation activity with users, carers and external stakeholders to develop responses to the issues identified above in order to inform the options formulation process. Options developed by the review process will be validated through formally presenting these to interest groups to ensure they will make a significant improvement and address key result areas.

4.5.4 The review team particularly welcomes the active close involvement of Elected Members in the Review who will be in a position to represent the views of the community.

4.5.5 The review team will convene countywide focus groups in order to gain user and stakeholder perspectives and involvement. We will also approach the media in order to reach the general public to feed into the debate, and hope to invite comment through an article in "Hampshire Now". We will also seek to develop web conferencing.

4.6 Compete

4.6.1 The review team will examine the role of strategic commissioning and the development of the market to encourage intelligent commissioning

4.6.2 The review team will investigate approaches to stimulate the private sector to offer specialist sensory equipment

4.6.3 The review team will evaluate our internal resources and current contracts and contrast those with other models of service delivery in order to deliver the vision for sensory services

4.7 How current performance will be evaluated.

The review team will use the principles of the EFQM Excellence Model framework and relevant Department of Health guidance to evaluate performance. Thus we will be addressing the following questions:

· What are the key aims and objectives of the service?

· What service standards are currently in place?

· How well are services currently performing?

· What are the government priorities for this service?

· What are the local needs and stakeholder's interests?

· What resources are available and how well are they currently managed?.

4.8 Specific areas that the review will be analysing to answer these questions, employing the principles of the Excellence model, are contained in Appendix 3.

4.9 The critical tasks that the review team will be engaged with in support of the review process are contained in Appendix 4

5 Factors to take into account

5.1 Other organisations

5.1.1 Sensory Services operate within the mixed economy of care and there are a number of key voluntary sector players with whom we have relationships and have negotiated partnership approaches to delivering services jointly and to provide advice, information and equipment, working within the resource centre approach. These services compliment the work of our specialist workers. We have contracts with Seeability, RNIB, HACB, Deaf Plus and DeafBlind UK.

5.2 PEST analysis to consider external factors

5.3 Corporate policies

5.3.1 This review will be informed by the Corporate Strategy, including:

- the Sustainability Strategy

- Equalities Policy

- e-government

- crime and disorder

6 Resource requirements

6.1 Opportunity costs in support of this review have been estimated at 150 days of Officer time and 25 days of administrative support.

6.2 Actual costs in support of the review have been estimated as being £8,650.

6.3 A detailed breakdown of these costs is attached at Appendix 5

7 Outputs from the review

7.1 Options report to PRC on 16^th May 2003 which will identify service improvements and options for service delivery

Appendix 2


Messages from the consultation event with internal and external stakeholders

In order to identify areas for improvement, the services strengths and weaknesses and to develop the vision of the future of sensory services in Hampshire, internal and external stakeholder consultation events were held on Thursday 30^th May.

All fieldwork staff were invited to the internal event. Delegates attending represented a cross section of staff within the Department who work in sensory services.

The event for external stakeholders were attended by representatives from Health, the Police, Education, and a range of voluntary organisations, and a user and carer.

Each group was asked a range of questions using the European Foundation for Quality Management (EFQM) Excellence Model approach.

Elected Members attended both workshops.

1 Vision for the service

1.1 Visioning statement

· Sensory services should deliver quicker and surer services within which workers take responsibility for managing the care pathway across agency boundaries. They also need to offer a consistent, high quality and accountable service This will be achieved through:

o Strong and effective links with partner agencies, who understand the processes and range of services offered by sensory services

o Meaningful involvement and consultation with users and carers

o A skilled, suitably qualified and demonstrably competent workforce that receives professional supervision

o Clear strategic plans that are widely understood and worked to

o Clear standards of service

2 Consultation activity was conducted within the EFQM Excellence Model framework, which is reproduced here.

2.1 Internal stakeholders

2.2

2.3 External stakeholders

Appendix 3

Aspects of the service to be evaluated during the review

Employing the principles of the EFQM Excellence model, the review team capturing and critically analysing data in the following areas.

Appendix 4

Project Plan

Estimated Opportunity and Actual Costs of Undertaking the Review

Opportunity Costs