Innovation in Commissioning Improving Access to Advocacy Angela - - PowerPoint PPT Presentation

Innovation in Commissioning

Improving Access to Advocacy

Angela Esslinger Strategic Customer Quality Manager

Why advocacy is so important

• 1. Improved decision making
• 2. Better outcomes
• 3. Be heard and learn from complaints
• 4. Human Rights for those who have no voice

(Principles of Freedom, Respect, Equity, Autonomy and Dignity are laid out in the NHS Constitution)

• 5. Equalities Act 2011
• 6. Partnership working

Advocacy in Lancashire 2003

Advocacy in Lancashire 2007

Advocacy in Lancashire 2013

Benefits of Advocacy Access

• 1. Simple, single point of contact
• 2. 0345 low cost number
• 3. Staffed by experienced practitioners with database

for signposting

• 4. Time and money saved
• 5. 1000+ clients referred and signposted 13/14
• 6. Protocols supporting effective delivery agreed

Health and Social Care Act 2012

• Additional commissioning responsibilities for

– Independent Mental Health Advocacy (IMHA) – Non-statutory Mental Health Advocacy services

• ffering support to voluntary patients

– Health Complaints Advocacy offering support for people to make a complaint about NHS funded treatment or care (includes CYP)

What research told us

• Confusion amongst professionals and public
• Guarantee of quality required
• Litigation Friends often requested by courts
• Half of eligible patients received IMHA
• Poor IMHA access for people on CTO’s
• Particularly poor take up overall for hard to

reach groups

• Out of area placements

Council and NHS agreements

• LCC, BwD and NHS Commissioners adopt a

strategy to run from 2013 to 2016.

– close gaps in provision – ensure statutory responsibilities met – ensure consistency of services

• Lancashire Clinical Commissioning Group (CCG)

Network agreement

Engagement

Two engagement days held in Oct 2012

• Seldom heard adult: partnership boards, service

user forums, carers and BME organisations.

• CYP: youth council and health / voluntary

groups in an evening after school

• Feedback used for service specifications and set

further questions / scenarios for tender questionnaire.

Procurement

• Separate panels for seldom heard adult and CYP

representatives

– short-listing the application forms from advocacy providers – scoring the applications – recommending contract awards

Contracts from April 2013

• 1. Generic adult social care and health advocacy,

including health complaints :£490,000 per annum: – n-compass and Lancashire Children's Rights Service across Lancashire (6 CCG's , 12 district councils)

• 2. Independent Mental Capacity Advocacy

(IMCA)/Relevant Person's Representative/6 day per week single point of access and IMHA/non-statutory Mental Health Advocacy: £500,000 per annum – Advocacy Focus across Lancashire and BwD ( 7 CCGs, 13 district councils)

New investment

• Non-Instructed Advocacy and Citizen Advocacy

service delivered by Empowerment across Lancashire : £100k per annum – specialist independent advocacy for people who lack mental capacity to instruct an advocate re specific health or social care decisions when an IMCA does not apply.

Cost and Efficiency

• Overall decrease in costs of across health and

social care systems this financial year compared with last

• Saving for the Council of £140k
• Better decisions and less complaints in 2013 /14

reduction from 278 to 189 in adult social care.

Overall increase in referral rates

Year on year increase

Specific advocacy delivery

1041 556 431 294 1093 620 471 384 1073 701 701 299 200 400 600 800 1000 1200 Generic & Health Complaints Independent Mental Capacity Advocacy Independent Mental Health Advocacy Mental Health Advocacy

2011/12 2012/13 2013/14

+26% +63%

Future developments

• Build actual take up into funding levels
• Further integration
• merge of Non-Instructed Advocacy with statutory

advocacy (IMCA and IMHA)

• NHS IMHA contracts in secure settings
• Care Act
• advocates to work across all strands
• assessments
• carers

• 1. Simple to use services for public and

professionals alike

• 2. Complaints in health and social care have a

joined up 2009 process

• 3. IMCA and IMHA have similar needs for

professional advocacy

• 4. Better use of scare resources across Councils

and NHS

• 5. Champion the Human Rights of the most

vulnerable members of society who literally have no voice

Why a whole systems approach to advocacy should be adopted

Any questions?