Healthwatch England

1. Policy Forum 2 July 2019 Sarah Ambe Healthwatch England

2. Today’s agenda

3. Aims of today? Look at the NHS Long Term Plan with NHS England Look at how Local Healthwatch and Parent Carer Forums currently work well together Look at reasons why this not may be the case The Children and Families’ Act 5 years on – what are the top 5 issues What Next – pledges, next steps and actions from today

4. What does Healthwatch England do? • We are the independent champion for people who use health and social care services. • We’re here to make sure that those running services, and the government, put people at the heart of care. • Our sole purpose is to understand the needs, experiences and concerns of people who use health and social care services and to speak out on their behalf. • We focus on ensuring that people’s worries and concerns about current services are addressed. • We work to get services right for the future.

5. What does Local Healthwatch do? • We also provide information to local communities regarding • how to access health and social care services • how to make complaints • their rights in relation to health and social care • services and publish reports about those services (Enter and View) • We provide information to service providers and commissioners regarding • what local residents tell us • key themes that are raised by them • any recommendations residents suggest

6. What does Local Healthwatch do? • We also encourage local residents to get involved in shaping services by • facilitating our own consultations • highlighting other agencies’ consultations • holding focus groups • attending local community group meetings • support “Experts by Experience” to contribute • encouraging and supporting local people to volunteer • conducting Enter and View visits and putting forward recommendations to those providers

7. What do we cover? • We cover all publicly funded health and social care services such as • Hospitals • GP surgeries • Chemists • Health clinics & other community services • Dentists • Children and adolescent mental health services (CAMHs) • Care and nursing homes (even private ones if they have some publicly funded residents) • Home help • Services for those who are disabled • (But not children’s homes)

8. Our approach - Participation People's views come first - especially those who find it hardest to be heard. We champion what matters to you and work with others to find ideas that work. We are independent and committed to making the biggest difference to you.  We work just like Parent Forums – why not work together!?

9. Healthwatch making change • Working at North Bristol NHS Trust, South Glos and Bristol volunteers (including learning disabled volunteers/experts by experience) did an Enter and View visit: • Patients with Learning Disabilities to improve access for patients with Autism and other Learning Disabilities. • Made suggestions and recommendations to improve facilities in A&E, quiet areas, ear defenders • Rolling out of Autism Awareness training • Other Trusts around the country are also doing this. • We can only do this in partnership and by gathering intelligence from our SEND Partners!

10. A case for collaboration In Enfield the PCF: work really closely with their local Healthwatch who champion “Co-production” and both have ensured the Forum’s voice is heard by involving them in all their consultations Have taken on parents to be volunteers and sessional workers Parents/Carers are working with local providers such as the North Middlesex University Hospital Trust to deliver disability awareness sessions to staff Involved local adults with LD/ASD/ADHD and other disabilities as well as parent/carers and young people in sharing their experiences of health services as part of the Long Term Plan initiatives

11. A case for collaboration In Rotherham PCF: work really closely with Healthwatch and meet regularly. “One particular HW employee was nominated by one of our families at our recent “You Believed in Me” Awards, this person works tirelessly to support families of children and young people with SEND, particularly those accessing CAMHS” In Somerset Local Healthwatch – Emily Taylor Healthwatch Manager: “Ruth (Somerset PCF) is another member of the board, where she feeds intelligence from Parent Carers and local issues, which we can elevate both locally and nationally via our reporting.”

12. A case for collaboration Where things didn’t work: One Parent Carer Forum reported working with their local Healthwatch had been good, because of an individual champion who then left. The relationship was not the same afterwards so it needed some continuity of working together. Solution: Local Healthwatch to work with the PCF to identify new relationship, better handover of partnerships “We don’t have time for this!” Solution: If time is made, the time needed is minimal in the longer term, a regular update report, two way flow, ensuring data intelligence is highly valuable and not missed.

13. How Healthwatch can help? By maintaining pressure on local providers at local level, and at national level with NHS England We don’t know what we don’t know – where the public comes in. If you are refused an assessment– have you told Healthwatch? If you have had poor treatment – of any kind – have you told Healthwatch? If you have had excellent treatment – we like to tell providers to compliment them, helping other patients know. Our intelligence goes to NHS England, Local Authorities, Care Quality Commission (CQC) so the more we know about things, the more we can do something about it.

14. NHS England SW Paul Spencer

15. NHS Long Term Plan and SEND

16. NHS Long Term Plan - SEND Strong focus on improving care for people with learning disabilities and autism. Commitments include: • increasing access to support for children and young people with an autism diagnosis • developing new models of care to provide care closer to home and investing in intensive, crisis and forensic community support • The aim is that, by 2023/24, inpatient provision for people with learning difficulties or autism will have reduced to less than half of the 2015 level NHS Long Term Plan and SEND

17. NHS Long Term Plan - SEND Commitment to a significant expansion of services for children and young people in line with the proposals outlined in the Green Paper on young people’s mental health including the creation of ‘mental health support teams’ in schools. To support these changes, the plan mandates that investment in children and young people’s mental health provision will grow faster than the overall NHS budget and total mental health spending NHS Long Term Plan and SEND

18. NHS Long Term Plan - SEND Integrated care and population health Confirms the shift towards integrated care and place-based systems ICSs will be the main mechanism for achieving this – the plan says that ICSs will cover all areas of England by April 2021 – and will increasingly focus on population health. Reducing Health inequalities: Commitment to a ‘more concerted and systematic approach to reducing health inequalities’, with a promise that action on inequalities will be central to everything that the NHS does NHS Long Term Plan and SEND

19. NHS Long Term Plan - SEND Participation..Participation… Need to create genuine partnerships between professionals and patients, it commits to training staff to be able to have conversations that help people make the decisions that are right for them. Nothing new to the Healthwatch Network or Parent, Carer Forums It is what we do! NHS Long Term Plan and SEND

20. NHS Long Term Plan – implementation framework June 2019 https://www.longtermplan.nhs.uk/implementation-framework/ Local systems are working hard to develop draft versions of their five-year strategic plans (by mid-September), with final versions submitted by November 2019. These plans will clearly describe the population needs and case for change in each area, then propose practical actions that the system will take to deliver the commitments set out in the NHS Long Term Plan. Local plans: • Be clinically led • Be locally owned • Include realistic workforce planning • Be financially balanced • Deliver all Long Term Plan commitments and national access standards • Be phased based on local need: • Consider how to reduce local health inequalities and unwarranted variation NHS Long Term Plan and SEND

21. NHS Long Term Plan – implementation framework June 2019 SECTION 5.10 is the only specific reference to SEND. There are other areas of interest locally to around other CYP transformation work and the support offer. Systems should clearly set out: • how proposals for people with learning disabilities and/or autism align with their plans for mental health, special educational needs and disability (SEND), children and young people’s services and health and justice NHS Long Term Plan and SEND

22. NHS England NHS Improvement Operating Model • Our new operating model brings together our organisations so collectively we can add greater value to the NHS. • It represents a strong shift to regional delivery supported by expert corporate teams • From 1 April 2019 we began to act as a single organisation. We are now in a period of transition. Information from Wider Organisation

23. Regions Map NHS Long Term Plan and SEND

24. CYP Transformation Programme Board • Reports to NHS England and NHS Improvement executive Boards • Chaired by Sarah Jane Marsh – CEO Birmingham Women and Children’s Hospitals • Vice Chair President RCPCH – Russell Viner who will also chair the stakeholder council that will be set up in after June (links to the NHS Assembly who met in April) https://www.england.nhs.uk/2019/03/nhs-assembly-announced-to-help-deliver-the-long-term-plan/ • The CYP Transformation Board met for first time on 10th April 2019 – meets again early July • SEND transition report will be presented at the Board later in the year TBC Published 7th Jan 2019 Implementation Guidance Due 27th June 2019 https://www.longtermplan.nhs.uk/ 3.42. A key message from stakeholders during the development of the Long Term Plan was that the needs of children are diverse, complex and need a higher profile at a national level. We will therefore create a Children and Young People’s Transformation Programme which will, in conjunction with the Maternity Transformation Programme, oversee the delivery of the children and young people’s commitments in this Plan.

25. CYP Transformation National Workstreams With Public Health England • “We will create a Children and Young People’s Transformation Programme which will, in conjunction with the Maternity Transformation Programme, oversee the delivery of the children and young people’s commitments in this Plan” With Health Education England With NHS Digital Key: With STPs & ICSs who are leading the way With the NHS Youth Forum and other partners With Clinical Networks and specialised commissioning

26. CYP Transformation – Our Aims Based on commitments made in the NHS Long Term Plan, The Children and Young People’s Transformation Programme, seek to improve outcomes and reduce health inequalities for all those aged 0 -25. This includes: Personalised care and involvement of children, young people and families Expanding mental health services for Children and Young People Reduce infant mortality rates NHS services that keep children well, including though digital technology Reduce hospital admissions by providing joined up care Improved cancer outcomes and experience Improve transition to adult services and move to a 0-25 service Improvements for long term conditions such as asthma, diabetes and epilepsy Understand the needs of children and young people with autism and SEND

27. SEND Workstream High level Timelines • Set workstream dates, membership and proposed governance using existing stakeholders from CCN SEND Board and sub groups by end of June 2019 • Confirm National funds and programme support by end of July 2019 • Define and confirm BAU SEND deliverables with government partners and regions by end August 2019 • Complete and present SEND Programme Transition Report to the CYP Transformation Board in October 2019 • Fully reporting to CYP Board in October 2019 • Draft next 4 years deliverables by end of January 2020

28. Top 5 Issues

29. Coffee

30. Healthwatch SomersetEmily TaylorRuth HobbsSomerset Parent Carer ForumLynn HoppenbrouwersStrategic Health Lead - Contact

31. Emily Taylor Manager Lynn Hoppenbrouwers Strategic Health Lead Ruth Hobbs Director

32. What is a parent carer forum? • SEND Code Of Practice 1.13  Parent Carer Forums are representative local groups of parents and carers of children and young people with disabilities who work alongside local authorities, education, health and other service providers to ensure the services they plan, commission, deliver and monitor meet the needs of children and families. Parent Carer Forums have been established in most local areas and local authorities are actively encouraged to work with them. • Parent forums are made up of: • Parents/Carers • Grandparents • Adoptive parents • Foster parents • friends and wider relatives of Children and Young people who have a Special Educational Need or Disability. • We recognise all forms of disability which include children with learning difficulties as well as those with physical disabilities. You do not need to wait for a formal diagnosis to join the forum.

33. Somerset’s Parent Carer Forum • Somerset Parent Carer Forum is an independent not for profit Community Interest Company formed by parent carers in 2016.   • Somerset Parent Carer Forum’s activities are carried out for the benefit of Parent Carers and families of children and young people with special educational needs and disabilities (SEND) in Somerset. The work we do is focused in the following areas: • Enabling families to have a voice • Enabling families to support themselves • Enabling families to support each other 17 Parent Carer Reps

34. Current Position 806 twitter followers 1489 Facebook followers reach of between 29,000 to 40,000 per month. Membership 1745 817 virtual support group

35. Current work we are involved in • Focus for the forum 2019-2020 • Improve feedback to families via weekly updates • Continue to strengthen links with existing groups • Coproduction events inc Local Offer, PIMS, HI & Vi • Improved information for local families • Produce detailed reports based on the survey results • Local Offer development • Somerset’s Engagement and Participation strategy- involved in writing, implementing and monitoring • Local Area Improvement network including Somerset's Ofsted readiness action planning • Children and Young people mental health Strategy group • Autism Strategy- SPCF representatives sit on all the sub groups • Short breaks • Local Offer (Somerset Choices) • SEND- SPCF representatives sit on the strategy board and all the subgroups • Somerset Engagement Advisory Group • Speech, Communication and Language Needs strategy group • Building emotional resilience including Behaviour that challenges pathway • Redesign of PIMS, HI and VI service

36. Somerset Parent Carer Forum are part of the National Network of Parent Carer Forums. Throughout England there are 151 forums which are split into 9 regions. The NNPCF have direct contact with the Department of Education, the Department of Health and other government organisations such as OFSTED and NHS England. We encourage consultation on policy and we maintain a good level of communication to influence decisions at a national level.

37. How we work together • Healthwatch Somerset has a special advisor role for a Parent Carer Forum representative on our board to ensure that we are well informed about local issues affecting families of children with special educational needs. • Both organisations attend events to ensure we are able to listen and advise local families. • Both orgaisations raise awareness of each other this can be to the public or to providers • Ensure the other organisation gets a seat at the table or feeds in the experiences of the other organization

38. How to work together • Develop a good understanding of what each organization does. What is different and what overlaps. • Decide together how to work together to best utilise the limited resources each organisation has. • Communication – establish a clear route to keep lines of communication open. This is essential for when things arise.

39. Benefits • Ensure local families experience is used to improve local provision • Working together means we have more opportunities to influence • We can collectively reach a larger group of families.

40. Healthwatch Somerset • New contract in October 2017 • Represented at 26 strategic meetings across the County including Health and Wellbeing Board and CCG Governing Body. • Regular meetings with key organisations that also gather feedback including Parent Carer Forum, Carers Voice and Maternity Voices Partnership • Partnership working embedded in everything we do • Participation meeting established in Somerset by SCC

41. Healthwatch Somerset Board The aim is to try and ensure we are well informed about as many areas of health and social care as we can be and that feedback is received by the right people.

43. UK-wide • Pan-disability

44. Contact Provide information, advice and support to over 340,000 families each year through our: Helpline - free phone 0808 808 3555 has a team of advisors and experts. Website - offers a range of resources, publications, local information and support.

45. https://contact.org.uk/ HELPLINE 0808 808 3555 Information and resources

46. Supporting 152 local parent carer forums and NNPCF. • Regional advisors • Information, learning events, webinars • An annual event hosted by Contact and the NNPCF, which is open to all parent carer forums. • Support forum's engagement with health partners locally, and routes to provide feedback to NHS England and other national health bodies via our Strategic Health Lead.

47. For more information see: contact.org.uk • Contact details: • Regional Advisors • parent.participation@contact.org.uk • Strategic Health Lead: lynn.hoppenbrouwers@contact.org.uk

48. Lunch and networking

49. Healthwatch England www.healthwatch.co.uk @healthwatchE Tel: 03000 683 000 Healthwatch England