Agenda Item: IFI1 FOI Exempt: N NHS Leeds West CCG Governing Body Meeting Date of meeting: 25 January 2017 Title: NHS Leeds CCGs Safeguarding Annual Reports 2015/16, Leeds Safeguarding Children Board (LSCB), and Leeds Safeguarding Adults Board (LSAB) Lead Governing Body Member: Jo Harding, Director of Nursing & Quality Category of Paper Report Author: Gill Marchant, Head of Safeguarding Children and Adults / Designated Nurse Reviewed by SMT: N/A Decision and Approval Information Tick as () Reviewed by Assurance Committee: 11 January 2017 Discussion Checked by Finance: N/A Approved by Lead Governing Body member (Y/N): Y Strategic Objectives that this report relates to Tick as 1. To tackle the biggest health challenges in West Leeds, reducing health inequalities 2. To transform care and drive continuous improvement in quality and safety 3. To use commissioning resources effectively 4. To work with members to meet their obligations as clinical commissioners at practice level and to have the best developed workforce we possibly can Joint Health & Wellbeing Strategy Outcomes that this report relates to Tick as 1. People will live longer and have healthier lives 2. People will live full, active and independent lives 3. People s quality of life will be improved by access to quality services 4. People will be actively involved in their health and their care 5. People will live in healthy, safe and sustainable communities Assurance Framework - to which risks on the GBAF does this report relate? 1. Failure to improve health outcomes and reduce health inequalities through improving the health of the poorest the fastest. 2. Providers fail to meet quality standards, leading to poor quality and unsafe care. 3. The cessation of the YHCSU will create a great deal of instability for CCGs which could in turn impact on the CCG s ability to deliver on its responsibilities. 4. The governance arrangements for collaboration, partnership working, risk sharing and commissioning across the Leeds CCG network, Local Authority, NHSE and other partner agencies are not robust. 5. System resilience shortfalls leading to a failure to meet patient needs. 6. Failure to achieve financial stability and sustainability. 7. Lack of member engagement and primary care capacity will impact on the Tick as Page 1 of 6
development and implementation of the CCG strategy. EXECUTIVE SUMMARY: 1. The NHS Leeds Clinical Commissioning Groups Safeguarding Children and Adults at Risk Annual Report for 2015-2016 provides information on the safeguarding arrangements in place, and to provides assurances of how the CCGs meet their statutory responsibilities for safeguarding. 2. The Leeds Safeguarding Children Board (LSCB) Annual Report 2015/16 was published in October 2016 and The Leeds Safeguarding Adult Board (LSAB) Annual Report 2015/16 was published in November 2016. These Reports provide an overview and analysis of the safeguarding partnership arrangements in Leeds. 3. The CCG Safeguarding Children and Adults at Risk Annual Report 2015/16 (Appendix 1) The Safeguarding Children and Adults at Risk Annual Report 2015-2016 has been agreed and signed off by the Director of Nursing for NHS Leeds West CCG, the Director of Nursing for Leeds North CCG and the Acting Director of Nursing for Leeds South and East CCG. The Report was received by the members of the Leeds CCG Safeguarding Committee on 17 th October 2016. 4. The Report provides an overview and analysis of the safeguarding arrangements in Leeds. The report outlines the key achievements and specific challenges for safeguarding in 2015-2016. Key highlights include: Revised CCG Training Strategy and Training Programme to reflect the NHS England Safeguarding Adults: Roles and competences for health care staff Intercollegiate Document which was published in February 2016. An increase in the numbers of health staff accessing Prevent training Strong commitment to improving GP engagement with the child protection process including the development of an electronic child protection conference report template that is compatible with both EMIS and SystmOne. Continued commitment to work closely with Primary Care and the Safeguarding Lead GPs, facilitating quarterly peer support meetings which meet level 3 competences (RCPCH 2014). Development of a SystemOne and EMIS compatible template to facilitate the flagging of patients electronic records if the patient is an adult at risk, or a victim of, or at risk of domestic violence or abuse (DVA) and recording the outcome of the routine enquiry. Additional investment in the CCG Safeguarding Team to increase its capacity and resources to respond to the co-commissioning of primary care. Page 2 of 6
Strong commitment to the development of the Front Door Safeguarding Hub and full integration between the health economy and social care. Strong commitment to partnership working and supporting the work of the LSCB and LSAB. Continued commitment to raising the profile of Safeguarding Adults, Mental Capacity Act (MCA), Deprivation of Liberty Safeguards (DoLS), Prevent and Domestic Violence and Abuse in primary care. Improved working between the CCG MCA/DoLS Lead and the Professional Lead/DoLS Manager within Leeds Adult Social to identify patients who receive care in their own homes, are funded through continuing healthcare and require a Court of Protection Order. Involvement in the cross CCG work to Break the Cycle : opportunities to reduce the risk of children entering care. Challenges include: To resolve the information governance issues in relation to the sharing of data between Children s Social Work Services and Health to enable the qualitative reviews of health economy contacts with Children s Social Work Services to continue. To continue to support health s contribution to the Front Door Safeguarding Hub. There is a recognised gap in health economy representation however, a secondment is planned for 2016/17 to scope out what is required to ensure the full integration between health and social care. To continue to support and manage the expanding field of safeguarding including the Prevent agenda, human trafficking, child sexual exploitation, forced marriage and female genital mutilation. To continue to work with GPs to improve the quality of child protection reports and the response to requests for child protection reports and attendance at child protection conferences. To continue to support the Break the Cycle : opportunities to reduce the risk of children entering care project. Co-Commissioning of Primary Care from April 2016: although the safeguarding team has had increased investment this year there remains the challenge in relation to the increased responsibilities and workload. For example NHS England will no longer continue to commission Serious Case Review, Learning Lesson Review, Safeguarding Adult Review and Domestic Homicide Review GP Report Authors post April 2016. To continue to embed learning into practice from national and local reviews, including the Independent review of deaths of people with a Learning Disability Page 3 of 6
or Mental Health problem in contact with Southern Health NHS Foundation Trust April 2011 to March 2015. To further the understanding of the Early Help Approach and the work of the Clusters and Targeted Service Leaders within General Practice. The Independent Inquiry into Child Sexual Abuse: CCGs and other NHS Providers are preparing for this Inquiry, however there is currently very little guidance available from central government. The recently published Review of the role and functions of Local Safeguarding Children Boards and The government s response to Alan Wood CBE (May 2016): will invariably pose a challenge to the LSCB and all partner agencies. The impending Law Commission Review of DoLS is likely to have significant implications for CCGs with regards to possible changes in terms of the responsibility for identifying a DoL shifting from the provider of the care to the commissioner. The safeguarding team and MCA lead will continue to work with colleagues in the LA and CCGs to contribute to future consultations and address and embed any changes which impact upon the CCGs. The LSCB Annual Report 2015/16 (Appendix 2) 5. The LSCB Annual Report was developed through consultation with all Board members. Leeds Teaching Hospitals NHS Trust (LTHT), Leeds Community Healthcare NHS Trust (LCH), Leeds and York Partnership NHS Foundation Trust (LYPFT) and the three Leeds NHS Clinical Commissioning Groups (LCCGs) submitted safeguarding annual reports to the LSCB in June 2016. 6. Some key findings from the individual health agencies reports are included in the LSCB Annual Report. 7. The Annual Report was ratified by the LSCB in September 2016. Key highlights include: Much improved internal and external challenge between partners on the Board. A strong degree of shared ownership and excellent co-operation. A strong, effective and challenging programme of work designed to consistently and continuously improve what it is like to be a child growing up in Leeds. Reviewing and refreshing the CSE sub group to ensure it captures the wider vulnerabilities that young people face such as Human Trafficking, Female Genital Mutilation (FGM) and Harmful Sexual Behaviour (HSB). Developing a Family Group Conference / ICPC reference group to explore a radical change in processes following a S47 enquiry. Page 4 of 6
Supporting the development of campaigns targeting young people through social media. Successful LSCB Conference in 2015 on Suicide and Self Harm. Assurance, through auditing, that children experiencing CSE are being ly protected and supported, and that children on Child Protection Plans (CPPs) are receiving good support with positive outcomes. Challenges include: Forthcoming legislation that will most likely remove the statutory requirement for LSCBs and extend legal responsibility for safeguarding across Children s Services, the Police and Health. The LSCB Report can be accessed here: http://www.leedslscb.org.uk/lscb/media/images/pdfs/lscb-annual-report-15-16.pdf LSAB Annual Report 2015/16 (Appendix 3) 8. Health agencies were engaged in the development and consultation of the LSAB Annual Report. LTHT, LCH, LYPFT and Leeds CCGs submitted their Safeguarding Annual Reports in July 2016 and some key findings are included in the LSAB Annual Report. 9. The LSAB Annual Report was ratified by the LSAB in November 2016. Key highlights include: The Board becoming a statutory body in April 2015 with specific duties and requirements as set out in the Care Act 2014. A review of the Board s membership to ensure that all key agencies were included, alongside Adult Social Care, Clinical Commissioning Groups and the Police, who became statutory members under the Care Act. Revised workstreams to ensure the work of the Board is driven forward and implemented: Citizen Engagement, Learning and Improvement, Safeguarding Adults Reviews and Quality Assurance and Performance. The establishment of a new Executive Group, made up of the Independent Chair and the Chairs of each of the Sub-groups. The Executive Group supports the Board by coordinating the work of the sub-groups, and by developing the strategic agenda for the Board. The implementation of new multi-agency safeguarding adults policy and procedures, reflecting the new Care Act duties to make enquiries, to provide representation and advocacy, and to be truly focused on the needs and wishes of the person at risk. Page 5 of 6
Revised Constitution which sets out the governance arrangements of the Board, and how the Board work together with partners. Challenges include: The realisation of the four key ambitions that will guide the work of the Board over the next three years: o Seek out the voice of the adult at risk o Improve awareness of safeguarding across all our communities o Improve responses to domestic abuse and violence o Learn from experience to improve how we work The LSAB Report can be accessed here: http://www.leedssafeguardingadults.org.uk/documents/board/leeds%20safeguarding%20 Adults%20Board,%20Annual%20Report%202015%2016.pdf RECOMMENDATION: The Governing Body is asked to: Receive the three reports for information and assurance of safeguarding systems and processes in place across the partnership in Leeds. Page 6 of 6