APPENDIX 2 2008-2011 HSCWBS and CYPPs - Examples of Progress Blaenau Gwent Locality HSCWBS Smoke Free Blaenau Gwent This is a project funded by a grant from the British Heart Foundation. The aim of which is stop young people from smoking, through a range of activities from working with Trading Standards through to targeting families. Hospital developments Ysbyty Aneurin Bevan opened in October 2010 and provides additional local services for the people of Blaenau Gwent. Integrated multi professional/agency rehabilitation teams have been established with the aim of maximising independence and reducing length of stay for the in patient and mental health units. Respiratory Services Services for patients with Chronic Obstructive Pulmonary Disease have been a specific focus with the development of oxygen assessment services and local one stop clinics now held in Ysbyty Aneurin Bevan. This has enabled the development of a Blaenau Gwent Respiratory Team and has reduced the length of stay for patients admitted with this condition. Rapid Response and Reablement Services These two services have been have been expanded to provide extra capacity and maintain 7day services. There has been a collaborative project with the Local Authority Occupational Therapy Service to develop an integrated service. Mental Health Act: (Joint Working Health & Five Local Authorities) joint Health & Local Authority consortium to pool resources to implement the Mental Health Act. Development of Health & Social Care Mental Health Act training team to cover Mental Health Act and interface with Mental Capacity Act and Deprivation of Liberty Safeguards. This Team will train across both Health & Social Care (jointly). Agreed and commissioned jointly Expert Legal Advice Line for all agencies to access (supporting Best Interests Assessors and Approved Mental Health Professionals) across the partnership and commissioned and planned training in relation to Mental Health Act with the provision for multi agency training. This joint project approach has supported cross agency implementation of the Act; Mental Health Services (Adults) the following are examples of progress made: 1
Developed Joint Adult Mental Health Commissioning Strategy in partnership with Health, Social Care, Supporting People, Third Sector, Service Users etc Health & Social Care joint working on monitoring and commissioning Third Sector service level agreements, regardless of funding organisation Joint health & social care collaboration to decommission health services in order to provide an appropriate socially inclusive 24 hour supported living home for adult and older adult mental health service users to meet their needs. Tendered and Commissioned jointly Third Sector provision. Jointly monitor and support third sector to support service users. Multiagency working across health, primary care, social services and users and carers to design, monitor, support and identify future needs and demands. Service funded totally by Social services; Older Adults Mental Health the following is an example of progress: Collaborative working across health & social care to move social services day service from local authority building to release capacity for 8 additional respite beds. The day service was reaccommodated in the EMI hospital. Substance Misuse Services the following are examples of progress made: Joint Substance Misuse Commissioning Group includes representation from the police, probation services, children & young people partnership, social services, health, community safety partnership Development of Co-occurring Mental Health & Substance Misuse pilot service for Blaenau Gwent. Collaborative working to service development, shared practice, protocols and procedures in partnership with: health, social care, service users, carers, substance misuse and mental health services, Welsh Assembly Government; Learning Disabilities Services the following are examples of progress made: Joint LD commissioning Group and Planning Group. All agencies involved and representation includes strategic planning and operational staff Have your Say Day for Learning Disabilities. Three events held across health & social care to provide opportunities for service users, carers and providers (both statutory and non statutory) to 2
have their say in the service development priorities for LD services in Blaenau Gwent. This will be an annual event. Development of Joint LD Commissioning Strategy with yearly review of progress and priorities built on Have your Say events. Blaenau Gwent Locality CYPP Sexual Health Strategy - development and implementation of the Sexual Health Strategy has enabled the Young People s clinic in Abertillery to be sustained and the development of a free emergency hormonal contraceptive (EHC) service to be provided via pharmacies in Blaenau Gwent; Blaenau Gwent Children and Adolescents Mental Health Services (CAMHS) Strategy for 2008-9 - development and implementation of the Strategy has included clear referral pathways and the provision of a Primary Mental Health Team. Recruitment to a key post within the Team has been made possible by funding from the South East Wales Specialist CAMHS Planning Network; Autistic Spectrum Disorder (ASD) Strategy and Action Plan - implementation of the Strategy and Action Plan, which is aimed at young people and adults, has included the setting up of a local group which has enabled the development of services and the provision of support to young people with ASD and their families; MEND (childhood obesity project) Following the implementation and successful evaluation of a multi-agency childhood obesity project in Blaenau Gwent, which included nutritional support, counselling and activity for children and their families, a further programme called Shift It was set up. This built on the first programme and evidence from the Institute for Child Health at Great Ormond Street Hospital, which underpins the MEND programme currently being rolled out in England and Wales. This programme was also successful and Blaenau Gwent is now a pilot area for the MEND programme in Wales supported by the Welsh Assembly Government. These projects have been made possible through joint work across organisational boundaries and the partnership provision of physical and staff resources. The programme is run by Dietetics staff from Aneurin Bevan Health Board, with the Exercise Development Officer from the Local Authority providing the fitness and play activities. The courses are run from community settings, mostly Local Authority premises such as sports centres; Common Assessment Framework/ Team Around the Child - The Common Assessment Framework has been implemented in Blaenau 3
Gwent Team Around the Child approach that involves all relevant agencies working with children and young people including voluntary sector organisations, Aneurin Bevan Health Board staff, Police, Community First organisations, Social Services, Education, Leisure and Housing. Protocols for information sharing and joint working have been developed and partners work together in a coordinated manner to provide improved outcomes for children and young people. Caerphilly Locality HSCWBS Targeted Health Improvement Activities 100% of schools within the Locality are now involved in the Healthy School Programme. A Healthy Early Years and Healthy Colleges scheme have been piloted in the borough. The Healthy College scheme is the first of its kind in Wales. Between 2006 and 2008 the Smoking Cessation Service enable 473 people to give up smoking and all schools have implemented the Active Young People Programme; Reducing Health Inequalities implementation of 7 Health Living Centres within deprived communities across the borough involving over 3,000 people in activities such as healthy cooking, guided walking and keep fit, improvements to the income level of those in the over 75 years age group with over 1 million now claimed by older people entitled to additional benefits and the implementation of a mental health early intervention service which proactively supports those with mental health problems; Implementation of Community Based Health and Social Care Services examples include funding the Alzheimer s Society to provide information and direct support for carers and implementation of a Joint Hospital Discharge Team to support vulnerable patients and aid timely discharge from hospital; Protecting Vulnerable Groups - Multi-agency education and awareness raising sessions in relation to the Protection of Vulnerable Adults (POVA) have been rolled out across the borough and information made available, in both hard copy format and via the inter/intranet. Robust POVA processes have been put in place and the POVA team received a positive CSSIW inspection in Sept 2009. Caerphilly Locality CYPP Joining up Services - Health Visitors are now included in Pre-school age multi-agency meetings. An Integrated Services for Children with Additional Needs multi-agency Team (ISCAN) and referral process has been established; 4
Baby Friendly, community based initiative - has been rolled out on a Borough wide basis; Improving information on services - data collection process for the Flying Start core programme for Health has been implemented including collection, monitoring and impact assessment elements. Monmouthshire Locality HSCWBS People with Dementia and their Carers Living Independently for Longer Implemented a Saturday Club in February 2010 in Severn View Resource Centre with residential care, as part of a range of support services including rapid response and befriending services. The service gives carers the opportunity to pursue their own interests while the person with dementia is participating in enjoyable social activities. During 2010/11 further in-house community based services will be developed to support people with dementia and their carers as part of the Locality partnership focus on reablement and dementia; Action to Enable People to Experience Improved Mental Health A mental health inpatient bed use and care review has been undertaken to identify why patients are in hospital and what prevents them being discharged. Action that followed has enabled a reduction in the numbers of Delayed Transfers of Care (DTOC) from 121 in 2008 to 45 in 2009 over the same 4 month winter period. The Home Treatment Team service aims to further reduce hospital admission; Patients can Expect Safely Delivered Services Monmouthshire County Council has worked closely with health and other partners, particularly around a number of care settings with concerns (including the coordinated closure of one home and re-provision of appropriate care for the residents) which has enabled a reduction in Protection of Vulnerable Adults (POVA) cases within the Locality; Assistance to Improve Health - More than 90 leisure centre classes are available for GP exercise referral scheme leavers, and in 2009/10 there were 1403 visits from GP Referral members; People influence and inform services - A Dignity in Care manifesto was developed following a conference in March 2009, and has been promoted throughout Monmouthshire, with accompanying literature. 5
Monmouthshire Locality CYPP Disabled Young People enabling individuals to achieve their full potential through the development and implementation of personcentred plans and the provision of a Transition Handbook ( Ready, Steady, Go! ) aimed at preparing young people with a disability for adulthood; Improving the Health of Children and Young People a range of food and fitness initiatives have been implemented across the borough, the Smoke Bugs initiative has been implemented within schools, a Sex and Relationships Education Toolkit has been developed and implementation of the School Based Counselling Toolkit, developed by the Welsh Assembly Government, has enabled further development of counselling services within schools; Safeguarding Children implementation of safeguarding awareness raising and training of multiagency staff and an audit and review of safeguarding arrangements across agencies has been completed and recommendations for improvement identified. Newport Locality HSCWBS Health and Well Being - 50+ Activity Directory updated, printed and distributed. - Promotion of walking in Newport by the development of four selfsustainable walking groups in Newport, production of 40 walks for the public across Newport and a walking festival which is planned to become an annual event. - Workplace Activator Project implemented to promote physical activity interventions in the workplace in Newport. - Stop smoking promoted through the establishment of the Stop Smoking Strategic Group and education, support and help provided for giving up Smoking. - Oral Health Promotion Group established in Newport to investigate and introduce effective ways of improving oral health. - Health, Social Care & Wellbeing Voluntary Sector Forum established to assist with exchange of information and advice. - Provision of information for Homeless through the Tenancy Support Scheme. - Junior Explorer Scheme a family based activity to see the sites of Newport while being active outside has been implemented. - Substance Misuse Education Programme in and out of school in line with Quality Approved toolkit developed. - Sex and relationship education programmes in and out of schools in line with Newport Quality Approach toolkit developed. 6
- The Sure Start programme and the Healthy Schools approach have continued to be extended to playgroups and all registered early years education providers will be required to achieve Healthy Playgroup status. - Exercise Referral Scheme implemented in Newport. - Continuation of the COPD Programme. - Introduction of a Housing Floating Support Service (Lighthouse Project). - Continuation of the Expert Patients Programme. - Newlink Community Transport scheme reviewed by consulting with passengers. - Newlink Community Transport service now offered to carers. - Exercise Referral sessions provided across the city to reduce travel / transport as a barrier to participation. - Provision of Information to Landlords and assistance to enable then to provide healthy homes through training and advise. - Introduction of an additional house of multiple occupation licensing scheme to improve housing conditions. - Newport are now part of the Landlord accreditation scheme to ensure landlords have adequate knowledge and tools to provide and maintain their housing stock; Mental Health Services The following are examples of progress in the development of services in recent years: - Newport Mental Health Promotion and Wellbeing Strategy developed and launched. - Newport Mental Health Strategy in place and good progress made against the National Service Framework (NSF). - Working in partnership with Mind Cymru Mental Health First Aid Training is now in place. - Working in partnership with Mind Cymru Applied Suicide Intervention Skills Training is now in place - Hafal provides training in the Recovery Model and a Mental Health Carers Resource Centre together with and Outreach Service and a fortnightly Carers Group - Initial steps in Mental Health Liaison Service for older people with mental health problems - Alzheimers Society Memory Café and carers groups now meet regularly; Involvement of Carers in the Joint Planning Process In December 2009, the Carers Strategy Group was formally accepted into the Health, Social Care & Wellbeing Strategy Partnership joint planning process and, as such, now plays a crucial role in the planning of services to ensure that carers needs are always considered. A 7
Carers Forum has been set up and is currently meeting quarterly. Representatives from the Forum will also sit on the Carers Strategy Group. Newport CYPP Areas of success include the Integrated Family Support Programme, Flying Start Programme, Sure Start Family Support Project, MEND childhood obesity project (as part of the Going for Gold Scheme) and Integrated Child & Adolescent Mental Health Services Torfaen Locality HSCWBS Hearty Lives Programme In 2009, the British Heart Foundation awarded Torfaen Locality 1.5 million over a 3 year period to establish services to prevent and tackle obesity in adults and children, based on the risk factor for heart disease that obesity represents. The Programme is in the process of being implemented; Implementation of Have Your Say Forum provides service users with a platform that enables them to have a strong voice in Torfaen s Health, Social Care and Wellbeing Board. The Forum provides support to service users who sit on the Joint Strategic Implementation Groups which are responsible for addressing the priorities identified in the HSCWBS; Outcomes Focus the HSCWBS articulates the priority outcomes to be delivered across seven target areas including education, skills and training, substance misuse, healthy living, vulnerable adults and carers, promoting independence and choice, long term conditions and inequalities. In order to support a focus on outcomes, the Local Service Board and other key partnership groups have adopted an outcomes based accountability approach for which an extensive training programme has been put in place for key staff. Torfaen Locality CYPPs Autism Support Post this joint, Cymorth funded post, is responsible for providing information, signposting and advice to autistic children and their families. The post also provides support during transition from child to adult services; New Statementing System - Working in partnership with Torfaen Education Department, Torfaen Locality are helping to set up a multiagency assessment system to take the place of the current 8
statementing process. This system has been commissioned by the Welsh Assembly Government and has seen the development of a new IT based system which facilitates child and parent involvement at the heart of the assessment process. Person centred planning and intervention training has been provided to therapists across health, social care and education which has enabled the development of a common language and understanding across the agencies; Core Aim 3 - Health lead on the Core Aim 3 agenda. The planning structure has been redesigned to reflect the key priorities identified in the needs assessment: Health Promoting Schools, Emotional and Behavioural Wellbeing and Children with Complex Needs - these groups will take forward the work to deliver the agreed outcomes for these priorities; Communication - Work is ongoing to improve communications across health, social care and the police to better support families in need. 9