Section 1 Executive Summary

Transcription

1 Section 1 Executive Summary 1.1 Programme description and background The Beyond Places of Safety grants scheme follows on from earlier Department of Health scheme to improve the provision, capacity and quality of health based places of safety to better support people detained under section 136 of the Mental Health Act (1983). The scheme will apply to England only. Since the publication of the mental health Crisis Care Concordat at the beginning of there has been a step change in services for people who need urgent and emergency mental health care. The Concordat brought together over 20 national organisations, including NHS England, the Home Office, the Care Quality Commission and the National Police Chiefs Council, to ensure that people in need of urgent and emergency mental health care would receive the care they need in the most appropriate setting. The Concordat saw the establishment of nearly 100 local Crisis Concordat groups, covering the whole of England, which have delivered improved practices and innovations and seen a considerable reduction in the number of people being taken to police custody following detention under the Mental Health Act. These local Concordat groups all published detailed action plans, which are available to view on the Crisis Care Concordat website. In May 2015 the Government announced a 15 million 2 capital funding for improving Health based places of safety provision with the intention of helping to reduce the inappropriate use of police cells for detentions made under S135 and s136. Projects led by NHS Trusts and Foundation Trusts, local government and the voluntary sector are currently being funded under this scheme, which is running over the 2016/17 and 2017/18 financial years. We have seen an 80% reduction in the use of police cells for holding those detained under section 136 since , with innovative local leadership in some parts of the country achieving zero, or single figure, use of use of police cells for holding people in crisis 3 In January 2017, the Prime Minister announced a further 15 million in extra funding available to support a wider range of preventative services in the community, and to ensure that charities, churches and community organisations can access funding to run them too 4. This, latest, capital grant scheme, therefore, both seeks to build on the success of the earlier scheme while broadening the scope beyond those who have been detained under the Mental Health Act, and reworking our focus, to include a greater proportion of initiatives that reduce the incidence of crisis experienced by people with additional mental health care needs through enhancing provision of excellent community-based 1 Mental Health Crisis Care Concordat, HM Government, Map of local Crisis Care Concordat groups and action plans

2 support. This document describes the kind of projects that the Department is hoping to fund from the new scheme, and explains how to make an application. 1.2 Scope of the project Beyond Places of Safety is also a capital grants scheme focussed on improving urgent and emergency mental health care by investing in facilities and infrastructure. The scheme will not provide any new revenue funding or cover the costs of employing staff. Examples of the kinds of investment that the scheme will support include: Enhancing or expanding NHS based facilities for responding to people in crisis. This can include, but is not restricted to, Places of Safety for people who have been detained by police officers under sections 135 or 136 of the Mental Health Act 1983 (e.g. to increase capacity). Enhancing or expanding non-nhs facilities and services to respond to people in mental health crisis that can help to prevent the need for admission, or compulsory admission to acute beds (e.g. crisis cafes, crisis houses or places of calm, support or sanctuary and drop-ins or even adapting crisis lodgings with trained families). Developing, via investment or improvement of capital assets, existing services to make them suitable for use by people aged 18 and under who are vulnerable to, experiencing or recovering from a mental health crisis. Rolling out innovative digital technology aimed at supporting users to avoid a crisis or for improved self-management following a crisis. Purchase or adaptation of vehicles for supporting people who are vulnerable to, experiencing or recovering from a mental health crisis. Capital investment to support initiatives to create more coherent local crisis pathways and systems, enhancing joined up working between statutory and nonstatutory service providers where these improvements are likely to deliver tangible benefits to service users vulnerable to, experiencing or recovering from a mental health crisis. The emphasis of the previous, Places of Safety, scheme was largely on improving the NHS provision of places of safety to ensure that places of safety available following use of S135 or 136 of the Mental Health Act are appropriately based in health settings; reducing the use of police cells to hold people in crisis. The majority of funding awarded was, therefore, to deliver improvements in NHS Trusts and Foundation Trusts to provide better facilities for crisis care. The further commitment of funds, made by the Prime Minister on the 9th January 2017, emphasises a greater role for preventative measures to avoid people with mental health problems from reaching crisis stage and the need for facilities to support those who are in recovery from a crisis, in addition to services for supporting people experiencing a crisis. The commitment also seeks greater involvement by the Voluntary and Community Sector (VCS) and civil society organisations in delivering these services. The scheme also supports NHS England s programme of work around improving urgent and emergency mental health care outside of hospital settings, and in particular the aims of national CQUIN 4 for , Improving services for people who present to A&E with mental health needs. The scheme seeks a reduction in the number of presentations by people who attend A&E departments frequently with primary and secondary mental health needs, as well as a reduction in the overall number of primary mental health presentations in 2018/19. While a proportion of capital projects will be 2

3 completed after 2018/19, they may be able to help sustain the improvements in care driven by the CQUIN in future years. This new scheme will still disperse capital funding, either as Public Dividend Capital to the NHS or as grants to other providers. We want the scheme to achieve maximum impact by supporting the expansion of excellent services to support people who are vulnerable to, experiencing, or recovering from a mental health crisis. The scheme will, therefore, seek the participation of a wide range of partners from across the public, voluntary and civil society sectors to deliver innovative services with the following objectives. Prevention of admission and compulsory admission at the stage when the crisis is already in progress, by providing alternatives to admission (e.g. crisis houses), services for people in distress before they reach the threshold for acute admission (e.g. crisis cafes, sanctuaries) or enhanced facilities to provide rapid access to appropriate pathways, helping to avoid the need for admissions (e.g. psychiatric decision units). Capital expenditure to expand facilities or services to address destabilising social problems or to temporarily increase levels of support for someone whose symptoms have increased, or social functioning decreased, with a view to preventing them from experiencing a crisis. Expanding interventions delivered to people who are currently stable or have recovered from a crisis to prevent a repeat incident (e.g. relapse prevention and self-management interventions or support with resolving social problems to prevent crises). Our aim in providing capital for the expansion of these services is to achieve the following impacts for the longer term. A continued reduction in the use of police cells for those who are detained under S.135 and 136 of the Mental Health Act (aiming for near zero use of police cells as Places of Safety under the Act in line with the new legislation coming into effect by the end of the year). A reduction in the numbers of detentions under s.135 and s.136 of the Mental Health Act in participating CCC areas, resulting from better pre-crisis support for service users. A reduction in the numbers of people presenting at (or brought to) Accident and Emergency Departments as a result of a mental health crisis. A corresponding reduction to the overall number of inpatient mental health episodes as a proportion of total inpatient hospital episodes with better community-based support enabling people to avoid the need for inpatient stays. 1.3 Available funding The total amount of funding available under this scheme will be 15 million. Bids must come from a local Crisis Care Concordat group and be received by the Department by 11:59pm on the 21 st January Bids received after this time will not be considered. The main aim of the programme is to expand innovative approaches and services to mitigate against service users experiencing a crisis and to provide preventative 3

4 interventions, better crisis care and post-crisis support for people with mental illnesses. Bidders should bid for a reasonable sum taking into consideration our aim to maximise the impact of the available funding and our wish to fund schemes on a relatively but not strictly equitable geographical and regional basis. The minimum grant size for which bidders can apply is Funding is available for the financial years 2018/19 and 2019/ Eligibility As with the earlier schemes bids must come from local Crisis Care Concordat groups, as listed on the Concordat website at Bids should indicate how proposals form a part of, or otherwise support, action plans owned by the local Crisis Care Concordat group to improve crisis care services. Bids must involve local CCGs and be supported and sponsored by local STP groups. They must set out how the proposal fits into wider local plans to transform urgent and emergency mental health care. We reserve the right to seek a view from NHSE regional teams in relation to how well the proposal aligns with wider regional capacity and future plans. Bids will also nominate a lead organisation within the area that will receive the funding and lead delivery of the project. For this purpose, eligible organisations in England are: NHS Trusts and NHS Foundation Trusts. Local Authorities Third sector/voluntary/civil society organisations In two-tier Local Authority areas, counties are encouraged to work in partnership with relevant district authorities. Applications must show clearly how bidding organisations plan for the project to deliver improvements on a sustainable basis. As only capital funding is available through this scheme, proposals that require revenue funding (e.g. for staffing) will also need to set out the agreed local sources for revenue funding on a sustainable basis. We will also consider whether local areas have already secured capital funding for similar projects from other national sources. 1.5 Legal requirements Payments will be made in accordance with the legal provisions described in this section. NHS organisations NHS Trusts and NHS Foundation Trusts. NHS Trusts and NHS Foundation Trusts will be able to draw down capital funding as additional Public Dividend Capital 5 if successful. 5 Public dividend capital (PDC) is a unique form of Government financing provided to public sector organisations. PDC is recorded on the Statement of Financial Position of NHS Trusts and NHS Foundation Trusts (NHS FTs), and is an asset of the Consolidated Fund. Trusts should not assume they can automatically 4

5 Local Authorities Capital awards will be made to successful bidders under the provisions of Section 31 of the Local Government Act 2003, unless otherwise advised. Third sector/voluntary organisations These organisations must meet the conditions set out in section 64 of the Health Services and Public Health Act 1968 (the 1968 Act ) to be eligible to receive funding. This includes the following legal requirements (which are a summary of the criteria in section 64 and not a complete description of the law). Your organisation must be carrying out activities that involve the provision of a service similar to a relevant service. A relevant service is defined in section 64(4) of the 1968 Act and means, broadly speaking, a service which must or may be provided under one or more of the enactments listed in section 64(3). The enactments in section 64(3) include the NHS Act 2006 which includes the provision of services to people who are mentally ill. This includes preventative, support and crisis-based services and extends to the provision of accommodation in or out of hospital. Clinical commissioning groups and NHS England have functions under the NHS Act 2006 relating to the provision of services and facilities to people with a mental illness. Please refer to Section 64 for the full definition. This does not mean that service providers must replicate an existing NHS service but that they should be looking to deliver outcomes that would be recognised by mental health professionals as supporting people who are vulnerable to, experiencing, or in recovery from a mental health crisis. A voluntary organisation is defined in Section 64 of the 1968 Act as an organisation whose activities are not for profit, but does not include any public or Local Authority. The 1968 Act gives the Secretary of State for Health the power to award grants to not for profit organisations in England whose activities support our priorities. In order to apply as the organisation within the CCC to receive funding third sector organisations must be at least one of the following: A Charity registered on the charity commission website A Corporate body company limited by guarantee (registered at Companies House) A Community Interest Company (registered at Companies House or CIC regulator) A co-operative An Independent Provident Society (we will need to see your governing documents) New Charitable Incorporated Organisation (CIO) access PDC and in view of the risk it carries, it should deliver a rate of return comparable to commercial equity investments carrying a similar level of risk. The department calculates and collects this return through the PDC dividend. Provisions in relation to financing for NHS trusts are found in Schedule 5 to the NHS Act 2006 and for foundation trusts under section 40 of that Act. Further details can also be found at 5

6 None of the above, but the organisation has a formal constitution (set of rules) or governing document which shows its objectives and management structure Other organisations may also be able to apply if they operates as a social enterprise and principally reinvests surpluses for social benefit 1.6 What happens if you are successful? If your application for capital funding is successful, the Department of Health will inform you by . Payment will be made under cover of a Memorandum of Understanding or Grant Agreement between the Department of Health and the lead organisation that is receiving the funding. The Department of Health will only transfer funding through approved financial accounting systems. To enable funding transfers, organisations must provide contact details for their finance department as part of their applications. Some bids may require staged payments, and in these cases the Department of Health will also ask you to confirm a funding profile. This should include information on when the project will start, when you expect it to complete, and any interim payment dates, including estimated funding amounts to be paid. The Department of Health will provide for each successful applicant: Department of Health capital allocation through Capital Grant or Public Dividend Capital A project monitoring framework 1.7 What happens if you are unsuccessful? If your application for capital funding is unsuccessful, the Department of Health will inform you by . Please note that costs incurred before funding agreement is issued are not eligible for repayment and are incurred at the bidder s risk. 1.9 Appeals The Fund is a discretionary scheme and you cannot appeal against the decisions made by Ministers. However, we do know that, at times, you may feel that we have not followed the application process correctly and you may want to raise a concern. We treat these requests as complaints and use our complaints procedure. The first stage is informal resolution where the Voluntary Sector Grants Hub would handle your complaint. If you are unhappy with the response, you can make a formal complaint to the Deputy Director of Departmental Financial Management and Partnering. The complaint will be investigated and the findings reported back to you. Deputy Director of Departmental Financial Management and Partnering Voluntary Sector Grants Hub 2S15 Quarry House Quarry Hill Leeds LS2 7UE If you are unhappy with that response, you can take this further within our complaints procedure by writing to the Head of Customer Service. 6

7 Complaints Manager - Customer Service Centre Department of Health Richmond House 79 Whitehall London SW1A 2NS This is a summary of our complaints procedure and you can find full details at 7

8 Section 2 Information relevant to all applicants. 2.1 Capital classification The funding provided within this scheme is only for capital expenditure. For the purpose of this programme, capital is classified as work that generates a physical asset, with an expected life of more than one year. Department of Health capital resources may only be used to finance the delivery of what, under International Financial Reporting Standards (IFRS), are regarded as non-current assets (tangible, intangible or investments). A key requirement of non-current assets is a reasonable probability these will deliver future economic benefit (i.e. valuable service) for more than one year, and in most cases many years. A non-current asset can be bought or enhanced (e.g.an extension to an existing property) with capital funds. Expenditure to maintain an asset at its current state (e.g. repainting walls) is not normally regarded as capital expenditure and cannot be funded with Department of Health capital. A threshold value of 5,000 per item inclusive of VAT must generally be reached before expenditure can be funded with capital. Exceptions may be allowed, where the assets form part of a group of assets that aggregates to more than 5,000. To qualify as a group, the assets must meet all of the following criteria: functionally interdependent (e.g. an equipment network) acquired at the same date and likely to be disposed of at about the same date under single managerial control each component asset of the group must cost 250 or more Only costs that are directly attributable to bringing a non-current asset into being and into appropriate condition for their intended use can be capitalised and funded with Department of Health capital. For example, professional fees associated with acquiring the asset, delivery costs, installation costs, site clearance and stamp duty can be capital expenditure. In-house costs, e.g. staff time that is directly identifiable to bringing a fixed asset into being, may be capitalised, but not general administration and wasted costs. Capital funding may be used to fund grants to non-nhs third parties, where the grantgiving power exists, and where funding will be used to deliver fixed assets in the recipient s books, i.e. assets that meet all of the above qualifying criteria, including the 5,000 de minimis threshold. 2.2 Examples of projects that could be eligible for funding The aim of the programme is to support coherent improvement schemes - these may include a number of improvements that combine to form one overall project. Examples of the kind of schemes that could be supported by the scheme are listed in section 1.2 8

9 above. Please note these examples are for guidance only and we encourage applicants to be innovative in their approach. Discrete elements of large capital projects or new builds are eligible. However, any Department of Health funded elements must be completed within programme timeframes (and be able to deliver its benefits, and be capable of providing evidence and findings to develop Department of Health policy even if the overall project may take place over a longer period). Additionally, you should make clear how the funding for the rest of the project (i.e. non Department of Health funded) is being secured. Evidence that statutory planning and building regulations applications (where applicable) are underway should be provided. Proposals that include digital activities will be subject to additional scrutiny as the Department of Health will need to be satisfied that the highest levels of value-for-money have been achieved. Proposals will need to demonstrate that digital activities demonstrate value-for-money in achieving specified, measurable benefits for the Department to consider the proposal for funding. Each bid will be considered on its own merit. All projects must demonstrate tangible improvements in their environments and show how these contribute to improved provision. 2.3 Examples of projects not eligible for funding The following are examples of projects that are not eligible for capital funding from the Beyond Places of Safety scheme: Refurbishment of staff rest rooms/kitchens or other ancillary areas that are not directly utilised by service users. Staff training and education or any other revenue funded activity. Routine building or equipment maintenance or provision of basic equipment required to deliver the normal core business of organisations applying for a grant. Statutory compliance upgrades are also excluded as these should be included within planned maintenance schedules. Safety compliance or enforcement issues, which should be part of the organisation s budgeted costs for delivering mental health crisis care. Improvements to services where work is already underway as part of an existing project to improve a facility. Digital initiatives that are already part of statutory service provision. 2.4 Shared learning The Department of Health exists to improve the health and wellbeing of people in England. It is committed to improving the quality and convenience of care provided by the NHS and social services. Its work includes setting national standards, shaping the direction of health and social care services and promoting healthier living. Therefore, once your project is complete: We will ask for a final report twelve months from the date your funding was awarded in which we will ask for information on the impact of the funding provided; what you have achieved and what wider differences the work has made to mental health crisis care. In addition, in order to increase and share the learning from projects that are funded under this scheme, the Department of Health may request information 9

10 required from applicants as part of the project monitoring and evaluation process, for example before and after photographs The Department of Health may ask for case studies for the funded projects and applicants should be aware that they might be requested to participate in their preparation, for example, by sharing supportive comments from people who have used the improved resources Successful applicants will be expected to acknowledge the Department of Health in any information that is circulated about the project. This could include advertisements, publications or other promotional materials. 10

11 Section 3 Application Process 3.1 Application process Under the umbrella of the local Crisis Care Concordat group, we encourage local organisations to develop innovative approaches to delivering integrated care and to consider opportunities to make a joint bid to deliver tangible improvements to mental health crisis care. Within the wider group, one organisation must be nominated to receive funds, with the agreement that it will own the asset when completed or improved. This organisation must demonstrate the agreement of its Chief Executive or Director of Finance to receive the funding. The bid must indicate how it satisfies local need and will result in improved care for people who are vulnerable to, experiencing or recovering from a mental health crisis. Applications should show how a project supports its local Crisis Care Concordat group s action plan and how this will result in improved care for people who are vulnerable to, experiencing or recovering from a mental health crisis. The bid evaluation framework criteria (Table 1) are structured to establish how your bid meets the main themes of the funding allocation. Bids will be scored against each of these criteria. Some of the criteria are essential, for which a score of zero will prevent the bid from being further considered, others are additional/desirable criteria which give bidders the opportunity to increase their overall evaluation score. 3.2 How to apply Bids must come from a local Crisis Care Concordat group and specify the lead organisation who will be responsible for receiving payment of the grant. The lead organisation will be legally accountable to the Department of Health for how the grant is spent. Bids must involve local CCGs and be supported and sponsored by local STP groups. Bids must be received by the Department of Health by 11:59pm on the 21st January Bids received after this time will not be considered. To apply please download the supporting documentation and application form, from the website. Completed applications and supporting documentation should be returned to bpos@dh.gsi.gov.uk All applications must be clearly marked Beyond Places of Safety 2017 Application. Applicants will be notified by confirming receipt of their application. When filling your application form, please give concise answers. There will be a limit on the number of words you can write for each section and you must not exceed this. Where indicated the word count for each section should be entered at the end of the section. If you are successful, we will ask you to report back periodically, and may refer to the responses you provide in your application form. Post-award reviews and audits will be undertaken to oversee use of funding provided, ensure probity and evaluate the impact of funding from a capital perspective so it is important to be realistic in the answers you provide. 3.3 Application Assessment 11

12 Applications will be assessed and ranked by an evaluation panel against the criteria set out in Section 4 below. These criteria are not listed in order of importance; however it is important that you address each criterion in your application. 12

13 Section 4 Bid Evaluation Framework The bid must come from a local Crisis Care Concordat group, with evidence that it has been developed and agreed by that group as a whole and reflects local partnerships and joint planning arrangements. Essential Does the application demonstrate a strong commitment to partnership working and joint planning? Does the project comply with relevant legislation? How the project meets any shortfall in current or projected demand for mental health crisis related services locally. Does the application demonstrate how the project will further help to reduce the demands on other public sector partners including o Reducing the likelihood of detentions under sections 135 or 136 of the Mental Health Act (1983) o Reducing the inappropriate use of police cells for those detained under the Act. o Reducing attendances at (or use of) A&E Departments by people experiencing a mental health crisis. o Reduced use of inpatient acute beds. Sustainability of the project o Do commitments exist to provide an ongoing funding stream for a sustained service that will remain fully operational after the capital funded project completes. Delivery o Commitment of CCC partners to deliver the project on time, and by 31st March 2020 at the latest. o The plan includes how qualitative and quantitative data will be collected to measure the impact of the project. A commitment on the part of a CCC partner organisation (or organisations) to underwrite any discrepancy between the funding being applied for and the actual cost of completing the project, should the Beyond Places of Safety grant funding not cover the total cost. Qualitative assessment of proposal How the project will provide improved access to services for children and young people or adults who are vulnerable to, experiencing or recovering from a mental health crisis. o Numbers of people expected to benefit from the project o expected outcomes for beneficiaries o Numbers of target population for this funding already supported by bidding organisation within the CCC locality. Evidence base supporting the approach o Is there evidence in support of efficacy of proposed service/approach o Evidence of project alignment with local and National priorities Quality of plans for investing the capital funding e.g. o level of granularity and detail of the plans for delivering the project o consultation with key stakeholders 13

14 o quotes from contractors Longevity of proposal o Will the asset(s) be suitably robust to support continued service provision for 1, 3, 5, 10, 20 years or more? Costs and overall value for money. o absolute cost of proposal. o cost per expected beneficiary Innovation (allocating a score against the following criteria) o Proposed use of new technology to deliver benefits to service users o Diversity of partners involved in the development and/or eventual use of the capital asset (e.g. NHS, police, VCS, Civil Society organisations) o Use of new, evidence based, approaches to deliver benefits to service users. o Proposed improved ways of working between partners to deliver benefits. Legislation The bid must ensure that its project would be compliant with relevant legislation, including but not limited to, planning law, the Public Sector Equality Duty, and Health and Safety law. Underspend Any funding from the scheme that remains unspent at the end of the project will either be retained by, or returned to, the Department of Health. 14