Winterbourne View Concordat: Barking and Dagenham's ...

Winterbourne View Concordat: Barking and Dagenham’s Programme of Action 

Key Action: Health and Care commissioners will review all current hospital placements and support everyone 

inappropriately placed in hospital to move to community-based support as quickly as possible as and no later than 1 June 

2014 (page 6). 

Action Accountable 

body 

NHS Barking and Dagenham 

CCG will be required to have a 

register of all people with 

learning disabilities 

or autism who have mental 

health conditions or behaviour 

that challenges in NHS-funded 

care 

The list will say which council 

or Clinical Commissioning 

Group (CCG) looks after each 

person 

NHS ONEL as part of their 

handover and legacy 

arrangements to NHS Barking 

and Dagenham CCG will, 

ensure that they understand 

what is expected of them, 

including: in maintaining the 

Barking and 

Dagenham 

CCG 


Dagenham 

CCG 

Concordat 

reference 

(page) 

Page 6 

Page 6 

Key 

interdependencies 

• NHS Barking 

and Dagenham 

CCG 

• LBBD 

• NHS NELFT 



CCG 

• LBBD 

• NHS NELFT 

Deadline Progress / Update 

1st April 

2013 

1 st April 

2013 


Dagenham’s local 

register was completed 

by Ian Chapman and 

Kelvin Hankins for NHS 

ONEL (CHC). 

LBBD have requested 

from the above the final 

version of and 

confirmation that this has 

been handed over to 

NHS B&D CCG. 

1


local register from 1 April 

2013; and reviewing 

individuals’ care with the Local 

Authority and identifying who 

should be the first point of 

contact for each individual 

Through working together and 

with service providers, people 

who use services and families 

Barking and Dagenham will be 

required to review the care of 

all people in learning disability 

or autism inpatient beds 

(currently 6) and agree a 

personal care plan for each 

individual, based on their and 

their families’ needs and 

agreed outcomes 

Barking and Dagenham will 

need to ensure that in 

completing these reviews that 

we “ ensure that all individuals 

have the information, advice 

and advocacy support they 

need to understand and have 

the opportunity to express their 


Dagenham 

CCG 

LBBD Adult 

Commissioning 


Dagenham 

CCG 

LBBD Adult 

Commissioning 

Page 6 

Page 6 

• Services users 

• Family Carers 

• Assessment and 

Treatment Unit 

providers 

• NHS NELFT 

• Local advocacy 

providers 

• Safeguarding 

Adults Board 

• Healthwatch 

• Local Service 

Providers 





providers 

• NHS NELFT 


1 st June 

2013 

From 1 st 

June 2013 

and 

ongoing 

The five (5) identified 

Barking and Dagenham 

residents in Assessment 

and Treatment Units are 

currently being reviewed 

B&D CLDT using the 

guidance for reviews 

issued by Winterbourne 

View Joint Improvement 

Programme. These are 

all expected to be 

completed within the 

next 5 weeks. 

2


views” 

If the outcome of the care plan 

says the person does 

not need to stay in hospital, 

they will be helped to move 

back into the 

Community before 1 June 

2014. 

We will be expected to have a 

plan in “as soon as possible” 

(p.6) once the outcome of the 

reviews has taken place to 

ensure Barking and 

Dagenham achieve the 1 st 

June 2014 deadline of people 

being repatriated into the 

borough. 


Dagenham 

CCG 

LBBD 

Page 6 

providers 

• Safeguarding 

Adults Board 


• Local service 

Providers 





providers 

• NHS NELFT 


providers 

• LBBD 

Safeguarding 

Adults board 



Providers 

1 st June 

2014 

3


Key Action: Every area will put in place a locally agreed joint plan for high quality care and support services for people of 

all ages with challenging behaviour, that accords with the model of good care (page 6). 

Sub Action Accountable 

body according 

to the 


Barking and Dagenham are 

required put in place a locally 

agreed joint plan for high 

quality care and support 

services for people of all ages 

with challenging behaviour, 

that accords with the model of 

good care. 

In implementing these new 

local plans the concordat 

states that “the strong 

presumption will be in favour of 

supporting this with pooled 

budget arrangements with 

local commissioners offering 

justification where this is not 

done 

Health and 

Wellbeing 

Board 

Health and 

Wellbeing 

Board 


reference 

(page) 

Page 6 

Page 6 

Key 

Interdependencies 



CCG 

• LBBD 

• LD Partnership 

Board 

• Service users 



Providers 


From 

2014/15 

From 

2014/15 

NHS London and the 

London Procurement 

Partnership are currently 

completing a London 

wide Market Positioning 

Statement across health 

and social care to 

support local areas in 

completing their local 

strategic plan. 

As part of our local 

autism plan LBBD have 

recently commissioned 

an organisation to 

undertake mapping on 

local ASD mainstream 

and specialist services. 

Outcomes from will feed 

into the local strategic 

plan and JSNA. 

4


Key Action: Planning will start from childhood (Page 7). 

Sub Actions Accountable 


to the 


Barking and Dagenham are 

required to introduce a new 

single assessment process 

and Education, Health and 

Care Plan to replace the 

current system of statements 

and learning difficulty 

assessments for children and 

young people with special 

educational needs; supported 

by joint commissioning 

between local partners 

(subject to parliamentary 

approval). 

The process will include young 

people up to the age of 25, to 

ensure they are supported in 

making the transition to 

adulthood; 

Children’s 

Trust 


reference 

(page) 

Page 7 

Key 




• LBBD 

• LD Partnership 

Board 



CCG 

• NHS NELFT 

• Education 


The 

Children 

and 

Families 

Bill, if 

passed in 

Parliament, 

is planned 

to become 

statutory 

by 2014. 

Work is ongoing within 

the Council around 

establishing a 

comprehensive work 

plan to deliver the key 

actions set out in the 

Children and Families 

Bill. 

The Bill has now been 

updated in March 2013 

to mandate health. 

5


Key Action: Improving the quality and safety of care (page 7). 

Sub Action Accountable 


to the 


Barking and Dagenham’s 

Safeguarding Adult Board will 

become a statutory body 

Safeguarding 

Adults Board 


reference 

(page) 

Page 7 

Key 


• Health and 

Wellbeing Board 


Not stated 

within the 

concordat. 

6


Concordat Programme of ‘non-direct’ actions and potential implications for Barking and Dagenham 

The following actions from the concordat do not place ‘direct actions’ on Barking and Dagenham but they will, however, have an 

impact on the borough which therefore need to be considered. These are:- 

Key Action: There will be national leadership and support for local change 

Action Concordat 

reference 

(page) 

Both the Local 

Government 

Association and 

NHSCB will establish a 

joint improvement 

programme to provide 

leadership and support 

to transform services 

locally. 

Page 6 

Possible 

impact 

Key Action: Planning will start from childhood 


reference 

(page) 

DH and DfE will work 

with the independent 

experts on the Children 

and Young People’s 

Page 7 

May result in 

further 

recommendation 

s for local 

authorities need 

to implement / 

consider. 

Possible 

impact 

Report may 

include 

outcomes and 

recommendation 

Deadline Update / Comment 

Board and 

leadership 

arrangements 

have been 

place from the 

end of 

December 

2012. 

The board is now in place and chaired by Chris 

Bull 

from the NHS Commissioning Board. A budget 

of £2 million has been allocated for 2013/14 and 

2014/14. 


Report due 

June 2013. 

N/A 

7


Health Outcomes 

Forum to consider how 

to prioritise 

improvement outcomes 

for children and young 

people with challenging 

behaviour and how best 

to support young people 

with complex needs in 

making the transition to 

adulthood. 

Ofsted, CQC, Her 

Majesty’s Inspectorate 

of Constabulary (HMIC), 

Her Majesty’s 

Inspectorate of 

Probation and Her 

Majesty’s Inspectorate 

of Prisons will introduce 

a new joint inspection of 

multi-agency 

arrangements for the 

protection of children in 

England 

Page 7 

s that Barking 


would need to 

implement and 

consider. 

From June 

2013. 

N/A 

8


Key Action: Improving the quality and safety of care 


reference 

(page) 

Over the next 12 

months all signatories 

will work to continue to 

improve the skills and 

capabilities of the 

workforce across the 

sector through access 

to appropriate training 

and support and to 

involve people and 

families in this training, 

e.g. through selfadvocacy 

and family 

carer groups 

Page 7 

Possible 

impact 

Impact on 

Learning and 

Development 

teams 


“Over the next 

Months” and by 

December 

2013. 

The Learning disability Partnership Board will 

need to review workforce planning for staff 

across the sector putting in place, with support 

from skills for health and skills for care, 

appropriate local programmes. This could also 

be done as part our local strategic plan. 

Key Action: Accountability and corporate responsibility for the quality of care will be strengthened 

Sub Action Concordat 

reference 

(page) 

DH have said that they 

will immediately 

examine how corporate 

Page 7 

Possible 

impact 

Quality 

Assurance of In 

house services. 


Proposals will 

be set out 

spring 2013. 

N/A 

9


bodies and their Boards 

of Directors can be held 

to account for the 

provision of poor care 

and harm, and set out 

proposals during Spring 

2013 on strengthening 

the system where there 

are gaps. 

Local service 

providers 

Key Action: Progress in transforming care and redesigning services will be monitored and reported 

Sub Action Concordat 

reference 

(page) 

The Department of 

Health will publish a 

follow-up report one 

year on by December 

2013 and again as soon 

as possible following 1 

June 2014, to ensure 

that the steps set out in 

this Concordat are 

achieved 

Page 8 

Possible 

impact 


Dagenham will 

need to ensure 

that all the key 

actions set out in 

the first table are 

being met or 

have been 

achieved as we 

will be required 

to report our 

progress against 

these. 


Follow-up 

report one year 

on by 

December 

2013 and again 

as soon as 

possible 

following 1st 

June 2014. 

N/A 

10


Concordat Commitments from Statutory and Non statutory bodies: Potential Implications for Barking and Dagenham. 

In achieving the key actions the concordat also gains commitments from a number of statutory and non statutory bodies / 

organisations. The table below does not specify all the commitments specified within the concordat as some either duplicate the 

key actions and others would not have significance / direct impact on the borough. Therefore the actions identified and outlined 

below it is believed, could have a potential impact on Barking and Dagenham. 

Concordat Commitment from: The NHS Commissioning Board (NHSCB), NHS Clinical Commissioners, the Local 

Government Association (LGA), Association of Directors of Adult Social Services (ADASS) and Association of Directors 

of Children’s Services (ADCS) 


reference 

(page) 

There will be a review 

existing of contracts to 

ensure they include an 

appropriate specification, 

clear individual outcomes 

and sufficient resource to 

meet the needs of the 

individual and 

appropriate information 

requirements to enable 

the commissioner to 

monitor the quality of 

care being provided 

Individuals in Learning 

Disability services will 

Page 9 

Page 9 

Possible 

impact 

Could require 

either a service 

review or 

implementation 

of the new 

service model. 

Need to ensure 

everyone with 

Impact on: Deadline Update / comment 

• NHS Barking and 

Dagenham CCG 

• NHS NELFT 

• LBBD 

• Service providers 

1 st June 

2014 

• LBBD CLDT 1 st June 

2014 

11


need have a 

comprehensive health 

check within 6 months 

and a health action plan 

Ensure that everyone 

has a named care coordinator. 


will need to try and 

involve children, young 

people and adults with 

challenging behaviour 

and their families, carers 

and advocates in 

planning and 

commissioning services 

and seek and act on 

feedback about 

individual experience 

The strong presumption 

will be in favour of 

supporting this through 

pooled budget 

arrangements with local 

commissioners offering 

Page 9 

Page 9 

Page 9 

LBBD CLDT 

have an up to 

date health 

action plan in 

place 

• NHS NELFT 

• CLDT 

• Children, young 

people and adults 

with challenging 

behaviour 



service 

• LBBD 


Dagenham CCG 

• Health and 

Wellbeing Board 

1 st June 

2014 

1 st June 

2014 

1 st June 

2014 

12


justification where this is 

not done 

There will be an 

expectation CCGs and 

directors of adult social 

services to provide 

assurance to the Joint 

Improvement 

Programme that they are 

making progress in these 

areas and are 

commissioning safe and 

appropriate care 

Directors of children’s 

services will be 

responsible for 

overseeing the overall 

quality and delivery of 

health and wellbeing 

services for children and 

young people for local 

authority commissioners; 

and directors of adult 

services will have similar 

responsibility for the 

overall quality and 

delivery of health and 

wellbeing services for 

adults. 

Page 9 

Page 9 

• Director of Adult and 

Community 

Services 


Dagenham CCG 

• Director of Adult and 

Community 

Services 

• Director of Children 

Services 

1 st June 

2014 

1 st June 

2014 

13


Provider representative organisations 


reference 

(page) 

Bringing forward a 

pledge or code model 

based on shared 

principles along the lines 

of the Think Local Act 

Personal (TLAP) Making 

it Real principles for 

learning disability 

providers 

Provider services have 

committed to publishing 

plans that support our 

members to provide 

good quality care across 

health, housing and 

social care, as set out in 

the model of care and 

including: 

1. Safe recruitment 

practices 

Page 10 

Page 10 

Possible 

impact 

The borough 

will need to 

ensure that 

both 

commissioned 

and in house 

services are 

aware of and 

implementing 

the plans 

specified to 

ensure good 

quality of care. 

Impact on: Deadline 


• B&D Health and 

Social 

Commissioning 

• LBBD in-house 

services 

• NHS NELFT 


Social 

Commissioning 


• Learning Disability 

Partnership Board 

by April 

2013 

Not stated 

14


2. Having training in 

place of staff to 

work with people 

with challenging 

behaviour 

3. Having 

appropriately 

trained, qualified 

and experienced 

staff 

4. Providing good 

management and 

right supervision 

5. Having systems in 

place which 

assure 

themselves, 

service users and 

families, carers, 

local Healthwatch 

and the public that 

essential 

requirements are 

being met and 

that they deliver 

high quality and 

appropriate care 

6. Identifying a 

15


senior manager 

or, where 

appropriate, a 

Director, to ensure 

that the 

organisation pays 

proper regard to 

quality, safety and 

clinical 

governance for 

that organisation. 

Care Quality Commission 


reference 

(page) 

Take action to ensure 

the model of care is 

included as part of 

inspection and 

registration of relevant 

services from 2013. CQC 

will set out its new 

regulatory model in its 

response to the 

consultation. 

Page 11 

Possible 

impact 




Social 

Commissioning 

• CLDT 

• LBBD Safeguarding 

Adults Board 

• NHS NELFT 


Services 

From 2013 

and; New 

regulatory 

model will 

is due out 

spring 2013 

16


Assess whether 

providers are delivering 

care consistent with the 

statement of purpose 

made at the time of 

registration. 

Page 11 

Skills for Care and Skills for Health 


reference 

(page) 

Skills for Care will 

develop a framework of 

guidance and support on 

commissioning workforce 

solutions to meet the 

needs of people with 

challenging behaviour 

Page 12 

Possible 

impact 

LBBD would 

need to review 

the new 

framework 

against what is 

currently being 

offered. In 

house and 

commissioned 

services would 

also need 



Social 

Commissioning 

• CLDT 


Adults Board 

• NHS NELFT 


Services 

Not stated 


• Learning and 

Development teams 


Social 

Commissioning 



Services 

February 

2013 

Documentation has now 

been released by Skills for 

Care. 

17


Skills for Care and Skills 

for Health have been 

jointly commissioned by 

the Department of Health 

(DH) to develop a code 

of conduct and training 

standards that could be 

used by a body (or 

bodies) establishing a 

voluntary register(s) for 

healthcare support 

workers and adult social 

care workers in England 

as part of its standards 

for inclusion on a register 

from 2013. 

Page 12 

LBBD would 

need to ensure 

that providers 

are following 

the code of 

conduct and 

staff at our 

services are 

following this. 




Social 

Commissioning 


LBBD in-house 

Services 

Professional bodies that make up the Learning Disability Professional Senate8 and other professional bodies 

Action Concordat Possible Impact on: Deadline Update 

reference 

(page) 

impact 

to carry out a review of 

Challenging Behaviour: 

A Unified Approach to 

support professionals in 

community learning 

disability teams to deliver 

actions that provide 

better integrated services 

Page 12 

LBBD will 

need to 

consider 

impact of 

guidance when 

produced 

• CLDT 

• NHS NELFT 

‘early 2013’ 

Still to be released by 

RCPSYCH 

18


Royal College of Nursing 

will take forward the 

recommendations in 

Strengthening the 

Commitment, the report 

of the UK modernising 

Learning Disability 

Nursing Review, with a 

focus on workforce, 

leadership and 

education. 

The Joint Commissioning 

Panel of the RCGP and 

the Royal College of 

Psychiatrists, to produce 

guidance on working with 

people with learning 

disabilities who also 

have mental health 

conditions; 

Royal College of 

Psychiatrists, to issue 

guidance about the 

different types of 

inpatient services for 


disabilities, including 

Page 12 

Page 12 

LBBD will 

need to 

consider 

impact of 

guidance when 

produced 

LBBD will 

need to 

consider 

impact of 

guidance when 

produced 

Page 12 LBBD will 

need to 

consider 

impact of 

guidance when 

produced 

• NHS NELFT 

• CLDT 

• B&D Health primary, 

community and 

secondary providers 


Dagenham CCG 

• LBBD (CRT’s / 

CLDT’s) 

• NHS NELFT 


Dagenham CCG 



Social Care 

Commissioning 

• LBBD (CRT’s 

/CLDT’s) 

Not stated 

by March 

2013 

Not stated 

19


some guidance aimed at 

commissioners. • NHS NELFT 

College of Social Work, 

working in collaboration 

with BASW and other 

professional 

organisations and with 

service user led groups, 

to produce key points 

guidance for social 

workers on good practice 

in working with people 

with learning disabilities 

who also have mental 

health conditions. 

British Psychological 

Society, will provide 

leadership to promote 

training in, and 

appropriate 

implementation of, 

Positive Behavioural 

Support across the full 

range of care settings; 

Page 12 LBBD will 

need to 

consider 

impact of 

guidance when 

produced 

Page 12 

LBBD does not 

currently have 

a policy or 

have a provide 

training on 

positive 

behavioural 

support and 

80B will 

become a 

challenging 

behaviour unit 

• LBBD (CLDT) Not stated 

• LBBD (CLDT) 




Not stated 

20


Royal College of Speech 

and Language 

Therapists, will produce 

good practice standards 

for commissioners and 

providers to promote 

reasonable adjustments 

required to meet the 

speech, language and 

communication needs of 


disabilities in specialist 

learning disability or 

autism hospital and 

residential settings 

Page 12 

LBBD will 

need to 

consider 

impact of 

guidance when 

produced 

• LBBD (CLDT’s 

SaLT) 

• NHS NELFT 


Social Care 

Commissioning 


Not stated 

The National Institute for Health and Clinical Excellence (NICE) 


reference 

(page) 

impact 

NICE will publish Quality 

Standards and clinical 

guidelines on challenging 

behaviour in learning 

disability 

Page 13 

LBBD will 

need to 

consider 

impact of 

guidance when 

produced 

• NHS NELFT 

• CLDT 


Social Care 

Commissioning 


Summer 

2015 

21


NICE will publish Quality 

Standards and clinical 

guidelines on mental 

health and learning 

disability 

Page 13 

Healthwatch 


reference 

(page) 

Healthwatch England will 

work with the 

Department of Health 

and the Local 

Government Association 

on how local 

Healthwatch will involve 


disabilities and their 

families, including 

working with Learning 

Disability Partnership 

Boards 

Possible 

impact 

LBBD, NHS 


Dagenham 

CCG, provider 

and the LDPB 

will need to 

ensure this in 

place from 

contract award 

and review 

during 

monitoring 

process. 

Could also 

consider 

• NHS NELFT 

• CLDT & CRT’s 

• Health and Social 

Care 

Commissioning 


Summer 

2016 

Impact on: Deadline Update 


From 1 st 

April 2013 

B&D Healthwatch is now in 

place and being delivered by 

Harmony House. 

22


variation to 

specification 

and contract to 

ensure this is 

achieved. 

NHS Commissioning Board in partnership with ADASS and providers 


reference 

(page) 

impact 

Introduce new model 

service specifications 

(inpatient) by March 

2013 

(It is assumed that this is 

for inpatient services and 

if this is the case then 

both NHS NELFT and 

NHS Barking and 

Dagenham will need to 

consider the impact of 

the requirements) 

New NHS contract 

schedules for specialist 

learning disability 

services and models for 

rewarding best practice 

through the NHS 

Commissioning for 

Quality and Innovation 

(CQUIN) framework 

Page 13 

Page 13 

NHS NLEFT 

and NHS 


Dagenham 

May impact on 

any pooled 

budget and 

joint 

commissioning 

arrangements 

which are 

decided 

• NHS NELFT 


Dagenham CCG 

• CLDT 



Dagenham CCG 

• NHS NELFT 

• CLDT 

March 2013 B&D service users and 

officers attended workshops 

delivered by NHS London to 

help design model service 

specifications for inpatient 

services. Awaiting final 

version. 

1 st April 

2013 

These have now been 

published. 

23


A joint health and social 

care self-assessment 

framework to support 

local agencies to 

measure and benchmark 

progress 

Page 13 

Need to be 

done 

collaboratively 

with Health. 


Dagenham CCG 

• LBBD 




Need’s 

completing 

for 2013-14 


have completed the 

consultation response for 

the proposed Public Health 

England’s Health (PHE) and 

Social Care Self 

Assessment Framework 

(SAF). 

In their report (PHE) have 

said that the SAF should act 

as a vehicle by which the 

Health and Wellbeing Board 

can quality assure itself that 

the relevant actions are 

being progressed locally. 

However, in recent 

correspondence the National 

Commissioning Board 

acknowledged that the 

Health and Social Care SAF 

is the wrong vehicle and this 

is for Health and Wellbeing 

Boards to determine 

24


Association of Directors of Adult Social Services (ADASS) and Association of Directors of Children’s Services (ADCS) 


reference 

(page) 

impact 

LBBD and their local 

safeguarding partners, 

including the police and 

NHS organisations, 

should take action from 

now, ensuring that they 

have robust 

safeguarding boards and 

other arrangements in 

place 

LBBD Safeguarding 

Adults and Children’s 

Boards should review 

their arrangements and 

ensure they have the 

right information sharing 

processes in place 

across health and care to 

identify and deal with 

safeguarding alerts 

Pages 13- 

14 

Pages 13- 

14 


Adults board 


Children’s Board 


Adults board 


Children’s Board 

Ongoing 

Not stated 

25


DH 


reference 

(page) 

DH will work with DfE to 

develop and issue 

statutory guidance on 

children in long-term 

residential care (s85 and 

s86 of the Children Act 

1989) 

DfE is revising Working 

Together to Safeguard 

Children, statutory 

guidance on how 

organisations and 

individuals working with 

children should work 

together to safeguard 

and promote their 

welfare. Report will make 

clear that professionals 

will be required to 

recognise and consider 

the differing needs of all 

Pages 14- 

15 

Pages 14- 

15 

Possible 

impact 

LBBD would 

need to review 

current 

arrangements 

of long term 

residential 

care in 

response to 

the new 

statutory 

guidance 

Impact on: Deadline Update 

• Children Services 



Children’s board 

• 


states “in 

2013” 


states 

report will 

be 

published in 

“due 

course” 

This new version was 

released in March 2013 

26


children - babies, 

disabled children and 

older children - so that 

they can offer them the 

most appropriate help 

and support at the right 

time; 

DH will review the 

regulatory requirements 

in respect of criminal 

records checks and 

whether providers should 

routinely request a 

criminal record certificate 

on recruitment 

DH will update the 

Mental Health Act Code 

of Practice during 2014 

and this will take account 

of findings from this 

review 

Pages 14- 

15 

Pages 14- 

15 

LBBD will 

need to 

implement this 

across social 

services and 

ensure that 

providers are 

following this 

also 

• Service Providers 

• Health and Social 

Care 

Commissioning 


• LBBD 



• NHS NELFT 


Dagenham CCG 


states 

“from 

2013 once 

the impact 

of the new 

service is 

understood” 

During 

2014 

27

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