Archived decisions

Contact: Nick Georgiou - 01962 847211 - [email protected]

Gill O'Leary - 01962 847598 - [email protected]

1. Summary:

The following decisions are sought:

a) That the Executive Member endorses the actions required to implement the joint management arrangements for integrated Learning Disability Teams in order to better meet the needs of service users and their carers

b) That the Executive Member approves the consultation process for Hampshire Adult Services staff that will be required

c) That the Executive Member approves the development of a Section 75 Partnership Agreement with Hampshire Partnership NHS Trust to support the integrated service

d) That the Executive Member approves the decision to seek suitable premises in conjunction with Hampshire Partnership Trust to enable joint teams to be established

2. Reason

2.1 This decision will assist with meeting the Corporate Priority of `Maximising well-being' and will meet all of Adult Services' four objectives

3. Other Options considered and rejected:

3.1 The only other option is for the status quo which is to continue with service delivery from separate health and social care teams. This would not facilitate efficient services for users and carers and require multiple assessments and points of access.

4. Conflicts of Interest declared by the decision maker or other Executive member consulted - none

5. Dispensation granted by the Standards Committee - none

6. Reason(s) for the matter being dealt with if urgent - not applicable

Approved by: ....................... Date: .......................

Councillor Felicity Hindson

Executive Member for Adult Social Care

Contact: Nick Georgiou - 01962 847211 - [email protected]

Gill O'Leary - 01962 847598 - [email protected]

1. Summary

1.1. The purpose of this paper is brief the Executive Member on the progress of the project to integrate health and social care services in Learning Disability Community Teams in Hampshire and to gain endorsement for a range of actions that are required to complete the integration of services. The partner agencies are Hampshire Partnership NHS Trust and Hampshire Adult Services. Adult Services are the lead agency

1.2 Integration of learning disability health and social care community teams is supported by a plethora of government policies. Valuing People (2001) supports an integrated model of provision as a means by which fair access to holistic services can be delivered to service users with learning disabilities and their families.

1.3 The integration of services will assist with meeting the Corporate Priority of `Maximising well-being' by facilitating social inclusion and physical health for service users with learning disabilities and will meet all of Adult Services' four objectives.

2. Recommendations

2.1 That the Executive Member endorses the actions required to implement the joint management arrangements for integrated Learning Disability teams in order to better meet the needs of service users and their carers

2.2 That the Executive Member approves the consultation process for Hampshire Adult services staff that will be required

2.3 That the Executive Member approves the development of a Section 75 Partnership Agreement with Hampshire Partnership NHS Trust to support the integrated service

2.4 That the Executive Member approves the decision to seek suitable premises in conjunction with Hampshire Partnership trust to enable joint teams to be established.

3. Background

3.1 The project to integrate community learning disability teams for health and social care began in 2004. Hampshire Adult Services have been working in partnership with Hampshire Partnership NHS Trust with a jointly appointed Project Manager.

3.2 The integrated service across Hampshire will deliver a single point of access for service users, co-location of staff, integrated management and joint management of budgets but no pooling of budgets.

3.3 At this stage the project excludes the North east area of Hampshire which is served by Surrey and Borders Trust.

3.4 A report was presented to the Executive Member for Adult Social Care on 9 December 2005 giving the rationale for the project and requesting support for its development.

3.5 Following a recent period of organisational change the project has been given new impetus and focus. The project structure has been reviewed. A Project Manager has been appointed from within the Programme Office in Adult Services to support the change process supported by two Business Change Managers in Hampshire Partnership NHS Trust and Hampshire County Council and the Project Board.

3.6 Work streams to deliver the required outputs to deliver the project focus on Human Resources, Learning and Development, Buildings, Systems and Information, Finance, Policy and Processes, Communications, Performance management/Reporting, Administration and Governance and Legal issues (the Section 75 Partnership Agreement).

3.7 Adult Services will have lead responsibility for the delivery of community services across health and social care. This integrated model is in line with the aims of `Valuing People' (2001) and the recent update of this guidance, Valuing People Now (November 2007).

3.8 Integrated services will be better able to respond to the entire range of users' needs and will support the implementation of personalised services with Self Directed Support and Person Centred Planning, thereby enabling people with learning disabilities to have fulfilling lives with access to good health care, work, social activity, and housing in the same way as any other citizen.

4. Impact and Implications

4.1 The visible result at the end of the project will be multidisciplinary teams for health and social care providing a single point of access for service users and their families. The teams will be better placed to work in partnership with key agencies for example, housing authorities, Education, Children's Services as well as other County Council Departments, health providers, primary care and voluntary sector organisations. Considerable work has already been done on developing an operational policy for the future service. The integrated care pathway will benefit service users and carers by avoiding multiple assessments and providing a holistic approach to meeting needs. Assessment, care planning and service delivery in one place will reduce risk.

4.1.1 New people and people enquiring about services will access the integrated service through the Contact Centre

4.2 Legal

4.2.1 The integrated management arrangements will be supported by a Section 75 partnership agreement, which is already under discussion with Legal Services. The project will draw upon the experience of a similar agreement that has been in place in Adult Mental Health services for some years which is currently under review. It is anticipated the agreement will be in place during 2008. The integrated management structure will be implemented within current financial resources and detailed in the Section 75 partnership agreement

4.3 Financial

4.3.1 The integrated staff structure will be implemented within current financial resources.

4.3.2 The 2008/09 budget has had £115,000 pressure built in towards the cost of relocating 3 teams to joint bases with associated IT costs. There is an agreement in principle with Hampshire Partnership NHS Trust that they will contribute to the costs.

4.3.3 For 2009/10 an estimated £292,000 has been built into the budget for relocating the remaining teams. The Section 75 partnership agreement will detail financial commitments from both agencies.

4.3.4 There will be other associated costs linked to this project which have yet to be fully assessed. These would be for example related to training for individual staff taking up new roles, team building programmes, use of additional Human Resources time for the project.

4.3.5 The finance work stream will undertake any tasks associated with reconfiguring budgets to new areas.

The 5 Area Service Managers will be managing budgets from both health and social care and will need training on systems and budget management so that they are competent to deal with systems from both organisations. Budgets will not be pooled. The budgets involved are for the staff from both agencies and for social care purchasing and will be detailed in the Section 75 partnership agreement

4.4 Personnel Implications

4.4.1 It is proposed that the integrated service will be headed by the County Head of Service (provisional title) for Learning Disabilities . Reporting to that post will be five Area Service Managers to manage the integrated community teams and Adult Services day services for the County. The Area Service Manager appointments will be made from a defined number of ring fenced staff from Adult Services and Hampshire Partnership NHS Trust. The 5 new areas will be based on district council boundaries:

New Forest

Eastleigh / Test Valley

Winchester / Fareham / Gosport

Havant / East Hants

Basingstoke / Hart/ Rushmoor

The 5 service areas were decided upon after consideration of a range of options. These looked at the population of people with learning disabilities to be served, relative geographical size, natural community clusters and affordability. District and Borough Council boundaries were adhered to in order to facilitate partnership working with, for example, housing authorities, other Adult Services teams, Childrens' Services and primary care. (A map of the new service areas is available as Appendix 1)

4.4.2 The numbers and locations of teams and team managers is yet to be decided. The decision will need to be informed by consultation with frontline staff and team managers in both agencies. The configuration and location of teams will need to have regard to achieving the best possible outcomes for service users. It is intended to implement the new arrangements in a way that will minimise disruption to teams as they take on their extended role.

4.4.3 The teams will need to be co-located. The Eastleigh / Romsey team is already successfully integrated and is based at Russell House Eastleigh. Work is underway to provide joint bases in Winchester, Havant and Fareham / Gosport to be achieved by the end of 2008. Co-location will need to be done in a phased way and costs built into forward planning for the budgets in Adult Services and the Trust.

4.4.4 The modernisation of Learning Disability day services which is already underway will be taken forward by the 5 Area Service Managers.

4.4.5 Formal consultation with Staff and Unions will be undertaken.

4.4.6 HR support from both organisations has been secured in managing the process of implementing the new management arrangements. Its anticipated that following consultations with affected staff the appointments to the Service Manager level will be completed by April 2008.

4.4.7 Thereafter the newly appointed Service Managers will be involved in the appointment of the Team Managers in the new structure.

4.4.8 Services for young people in transition, the majority of whom receive their services from Learning Disability teams will be incorporated into the new arrangements. Transition Social Workers will work closely with the integrated teams. One of the 5 Area Service Managers will take a lead for transition. Integration of health and social care teams will improve the care pathway for young people with complex health and social care needs.

4.5 Impact Assessment

4.5.1 The broad strategy for modernising Learning Disability services has been impact assessed.

4.5.2 People with Learning Disabilities are disadvantaged in comparison to the rest of the population in terms of their access to ordinary housing, work, community participation and healthcare. People from black and ethnic minorities are doubly disadvantaged.

4.5.3 Locally based teams delivering multidisciplinary support will improve access to the right care at the right time. These teams will also be better placed to facilitate access to housing through links to district and borough councils and to local community resources.

4.5.4 Governance issues for the integrated service will be robustly addressed through an Integration Partnership Board and include democratic accountability through the Executive Member for Adult Social Care.

5. Conclusion

5.1 The purpose of this report is to brief the Executive Member on the current progress in the project to integrate Community Learning Disability Teams in Hampshire and to gain endorsement for the actions required to complete the project which is now entering a critical phase.

5.2 The change is designed to ensure a more effective service for users and their families, with better outcomes and a more efficient use of resources.

Section 100 D - Local Government Act 1972 - background documents

The following documents discuss facts or matters on which this report, or an important part of it, is based and have been relied upon to a material extent in the preparation of this report.

NB: the list excludes:

1. Published works

2. Documents which disclose exempt or confidential information as defined in the Act.

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