Actions speak louder: A second review of healthcare in ... - HMCPSI

FINDINGS
ACTIONS SPEAK LOUDER
Management board membership
In our last review, it was well publicised that one in six YOTs did not have a
healthcare representative on their management board. In phase 4, this has fallen
considerably, with only two YOTs not explicitly meeting this expectation. Actual
attendance by the health representative, however, was still an issue and 16% of the
YOTs inspected under this review pinpointed issues in this respect. The degree of
contribution by the health representative also varied and was found to be insufficient
in 12% of YOTs. For example, despite good attendance at board meetings, some
minutes have not demonstrated any contributions by health representatives.
Inspections also showed that changing health representatives could lead to a lack
of consistency and continuity, although this was sometimes explained as resulting
from significant changes in the composition of PCTs. Overall, however, these issues
demonstrated a lack of commitment by, primarily, a significant minority of PCTs to
the functioning of their multi-agency YOT, which can affect strategic direction,
oversight and accountability.
The first review report also recommended that the ‘drug action team and/or local
children and young person’s substance misuse service should ensure that they had
representation on the management board of the youth offending team’. It also
recommended that there should be ‘specific policies on the sharing of information
for substance misuse workers’.
Unfortunately, neither of those recommendations has, as yet, made a significant
impact, since representation on the board and policies on the sharing of information
between substance misuse workers and the YOT are still rare.
Good practice from inspection reports
“The service director of CAMHS and a public health consultant from the
PCT, along with the head of service for the drug action team, had
recently joined the reorganised management board.”
“The health sector provided an appropriate level of funding for the
youth offending service through the CAMHS and substance misuse
commissioning budgets. Despite great pressures on funding, they
have actively worked with other agencies to resolve financial
difficulties and sustain the resource allocation.”
In the best examples, where boards contained active and committed health
representatives, there were strong and shared views of governance, meaningful
performance targets, and a high level of scrutiny. In a very few YOTs, the health
representative was not of sufficient seniority to effectively influence decisions
within their own agency.
29