Introduction

1. Introduction • Mainly Forensic??? (offending behaviours) • Issues and Possible Solutions • Aim, Objectives and Vision (Mine!) • Possible Gap Solutions • Definitions • What Next

2. M/C ? LSU and or step up Cheshire and Wirral (Soss moss and specialist outreach) Merseycare (local LSU) Rochdale PCT (Move on) North Cumbria and NE Private Sector (LSU etc) Turning Point (Step-down and move on) Private capital Access MH and LD Secure More OATs data Under 18s with NSCAG Also Region-wide Workshop being planned Professional Groups / roles National Group Calderstones (Step Up and outreach) Advocacy Matters Hindley, styal and Liverpool prisons IABA (Training) Valuing people / Prison Health St Martin's College (staff training) Cumbria MDO Group Liverpool John Moores Uni Sheila's group Lots of local good practice In Control Some of what's going on?

3. Prevention Loss of Money Lack of expertise Sharing Variable cost and Quality (OATS) Big Gaps in local zonal and Regional basic provision Ad hoc developments Capacity CJS Transfer 14 days Probation More Victims? Some of the issues

4. Aims of Developments • Other than Q,PC,VM, E • To balance personal choice with public protection • To develop cohesive local, zonal and regional services with agreed protocols and shared philosophies across the NW • Free Movement • To bring back patients/clients to the North West where appropriate (or off pathway) • To develop pro-active and re-active services across the North West • The Ring

5. How do we move on? • Within the framework (BC) • With local commissioners • With other key stakeholders • With users • With advocates

6. One Risk Assessment One Approach Balance between public safety and choice Free Movement Shared Expertise Joint Training Agreed Treatment Outcomes Mix of Providers Standards Principles

7. Medium Secure Low Secure Central Low Secure Community High Secure # Appropriate Adult Service # Staff # * Step Down E.A.S * Ordinary/specialist Housing # * Longer Term# Active Prevention Behavioural Support Team (SST) * Prison in-reach Support to Probation Support to Courts # Employment # * Education # * Transition workers # * Out-Patients # * Advocacy # * Provider rich # * ComponentsLocal, Zonal, Regional(1)

8. Medium Secure Low Secure Central Low Secure Community High Secure # Appropriate Adult Service # Staff # * Step Down E.A.S * Ordinary/specialist Housing # * Longer Term# Active Prevention Behavioural Support Team (SST) * Prison in-reach Support to Probation Support to Courts # Employment # * Education # * Transition workers # * Out-Patients # * Advocacy # * Provider rich # * Components Local, Zonal, Regional(2)

9. Under 18 3 - 5 15 -18 0 - 3 5 - 15

10. Virtual SSTMulti – disciplinary/agency • Located in Community Teams • Pro-active and re-active • Available to all parts of the network • 1 hour response time (excludes central LSUs and MSUs) - 24 hr service • “Experts” in IABA approaches and elements of CJS • Advice,direct support, capacity building • The Glue!

11. EAS Opportunity to explore a range of ideas/options A potential danger to others 6 month maximum stay Detailed behavioural analysis available to commissioners Assistance in finding future placements Step Down 2 year target stay All admissions from secure facilities Move-on plans to be in place before admission Most patients likely to be detained New In-Patient Services

12. MSU 2 year target stay (treatment) 3 month target stay (assessment) Robust physical security required in addition to relational and procedural security LSU 2 year target stay (treatment) 3 month target stay (assessment) Physical security required in addition to relational and procedural security In Patient Secure

13. Prison In-reach/Probation • Part of community (extension of SST function?) • Clear criteria to be set but generally as community • Where appropriate link to local services prior to release • Bridge between network and CJS • Establish service as part of community sentence (£) National Pilot?

14. Preferred Providers • Accredited Services Only • Standards to be agreed by NW Commissioners • Including minimum staff training • National Work underway (Kitemark) • No accreditation - no placements • Monitor with Local Commissioners • Monitor Via CPA • Discharge dates set on admission where appropriate • Assign treatment targets

15. Network Group(Commissioning) • To receive referrals • To look at matching • To Identify service required • Service Spec from current providers • In put from SST • Service spec from commissioner / Team • Service spec from potential provider (dev.team)

16. Development Group(Procurement) • Develop service as specified • Identify provider • Finance plan • Infra-structure element • Link with workforce development • Membership?

17. Monitoring Group • Maintain /adjust specifications • Agree network and individual standards • Maintain data base • Produce quarterly reports on all network services • Maintain data base • Set both pro-active and re-active targets/priorities • Membership?

18. Time to ACT • Same Issues • Early solutions concentrated on the wronng end of the spectrum • Problems are being Compounded (OATS) • Most Local Commissioners recognise the necessity to work together • Lets act (by securing agreements) before we all change again!!!

19. NEXT • Continue to explore gaps and look at developing joint procurement initiates (ASD) • Look at Common Solutions (E.g. Community Teams) with potentially different funding streams • Agree Project Management arrangements, with targets and delegated Authority from ALL key players(variety of options from existing to new) • How do we procure new developments? • Separately? Collectively?Specialist? Lead Arrangements? New Organisation?