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Care Services Improvement Partnership

Annual Review 2006–2007 Priorities 2007–2008

Annual Review 2006–2007 ■ Priorities 2007–2008

The South West Regional Development Centre is the regional arm of the Care Services Improvement Partnership (CSIP SW). CSIP is commissioned by the Department of Health and other government departments to support health and social care agencies in developing, transforming and improving services to the population of the South West. We work with people who use services, their families and their carers, and with people who provide services. From the beginning, we have built strong and close working relationships through our stakeholder and service providers networks. A significant part of our work is governed by policy priorities set out in the White Paper, Our Health, Our Care, Our Say. This includes supporting the introduction of new legislation – the Mental Capacity Act 2005, and the Mental Health Act 2007; the development of Local Area Agreements (LAAs) across the South West; and partnership working with people to enhance and improve the services they use so that they have greater choice and control over decisions which affect their health and social care.

CSIP SW aims to offer:

• strategic/whole systems understanding and
working – both across government, and across whole sectors

• outcome focused policy analysis,
development and implementation support

• whole systems, strategic leadership and
partnership development

• support to promote and enable service user
and carer involvement and community engagement

• client-specific expertise and practice guidance
based on the evidence

• support for socially inclusive service delivery
and local service implementation

• programme, project and knowledge
management, and

• expertise in service improvement and practice
development methodology.

Annual Review 2006–2007 ■ Priorities 2007–2008

This Annual Review summarizes highlights and achievements in the past year, and looks forward to priorities for delivery in 2007–08. One of our main objectives over the last year has been forging greater links with the Government Office in the South West (GOSW), the Regional Public Health Group and social care departments in local authorities in addition to maintaining the strong relationship with the Strategic Health Authority. This has been done while delivering an extensive work programme commissioned by the Department of Health with additional work negotiated and agreed with health and social care communities in the South West. We have provided support for the Local Area Agreement process, progressing health and social care in criminal justice services, improving services for children and young people, and collaborating in health promotion, smoking cessation, the reduction of obesity programmes, and the sharing of intelligence. We are pleased to support the transition to a Department of Health regional team over forthcoming months. Our work is focusing on strategic leadership, policy development and implementation, and system redesign, collaborating with Government Office policy and place leads, and working with stakeholders across sectors within the region itself, and nationally. The transition to a Department of Health regional team is challenging, but it is welcome. It allows us to bring together expertise, knowledge, resources and learning within the Government Office, to contribute to and make a real difference to improving health and wellbeing within the South West. I remain grateful to all the CSIP staff who have undertaken large and challenging workloads at a time of organisational uncertainty about the future.

Paddy Cooney
Regional Director, CSIP SW and Associate Transitional Director, DH South West


Annual Review 2006–2007 ■ Priorities 2007–2008

Lead: Carrie Morgan Senior Development Consultant 2006–07 – highlights and achievements

• Chaired a national conference on joint

• Coordinated regional launch conference
with the Department of Health of the Commissioning Framework for Health and Well-being, followed by focused events with specific stakeholders

• Prepared the CSIP SW team for the
heightened profile of commissioning through team based development workshops

• Established a CSIP SW website
page for commissioning

• Delivered a regional conference on Practice
Based Commissioning in partnership with the Improvement Foundation and Integrated Care Network

• Developed a quiz game tool for increasing
the knowledge of commissioning for noncommissioners, using it with local groups of third sector organizations

• Facilitated opportunities for mental health
commissioners to identify the issues and challenges presented as mental health trusts achieve foundation status

• Produced ‘Brief Facts for Busy
Commissioners’ for inclusion in the CSIP publication ‘Improving Primary Care Mental Health Services’

• Worked with public health specialist to adapt
policy and practice material into brief formats to inform commissioners for posting in the electronic commissioning book and CSIP SW website

• Supported initiatives to increase the take up
of Direct Payments across all mental health service areas


Annual Review 2006–2007 ■ Priorities 2007–2008

2007–08 – priorities

• Complete work with Mental Health
Commissioners on foundation trusts

• Join with the Regional Public Health Group to
support Health and Wellbeing Partnerships in developing Joint Strategic Needs Assessments and in linking Local Area Agreement planning for commissioning

• Support the shaping and testing of a
mechanism to measure the delivery social inclusion outcomes in mental health services (national Mental Health Outcomes project)

• Support Regional Change Agents with
commissioning aspects of Every Child Matters and Our Health, Our Care, Our Say Challenges

• Disseminate the Commissioning Framework
implementation action plan and support regional and local organizations with preparations for implementation in 2008–09

• Work with commissioners on the development
of provider forums as a means to improve partnerships provider input to commissioning solutions

• We await clarity from the government about
leadership of and delivery of the development of commissioning for NHS organizations

• All organizations need to raise their game in
relation to commissioning; we need a coherent approach across regional organizations in order to make best use of limited development capacity.

• Support the Strategic Health Authority with
increasing the potential of social enterprise as a way forward for community services

• Link with Voluntary and Community Service
infrastructure organizations and support the development needs of the sector in the changing commissioning context


Annual Review 2006–2007 ■ Priorities 2007–2008

Social Care
Lead: Lynne Dean Regional Change Agent for Social Care 2006–07 – highlights and achievements The SW Regional Joint Improvement Partnership has now been successfully established and has a full work programme. This includes, There have been a range of successful regional events to consult on continuing health care and assist with the implementation of White Paper policy, including events with the Housing Local Improvement Network to promote the further development of housing with support services in the SW. We have worked closely with the Regional Public Health Group and the Commission for Social Care Inspection to ensure that the third round of Local Area Agreements benefited from social care policy and performance advice, and ended the year with a commitment to form a joint team to work with local authorities in 07–08.

• Supporting local authorities and providers to
develop action plans for the implementation of personalised services.

• Supporting local authorities to develop
integrated services for people with long term conditions.

• Continuing to support improvement in local
authority social care services to become among the best in the country.

• A regional forum for elected members
responsible for social care.

• A commissioning development work stream. • An integrated teams work stream. • The CSED efficiency work stream in the SW. • Work by the Centre for Excellence on improved
commissioning and procurement of Learning Disability services.

• Enabling the dissemination of learning from
the POPP projects.

• Developing whole population commissioning
2007–08: priorities and challenges These include: plans based on Joint Strategic Needs Assessments.

• Working with authorities to agree new Local
Area Agreements to start in 2008, and working across the Government Office South West on key themes, for example improving the quality of life of older people in the South West.

• Supporting the development of three new
Unitary Authorities in the SW in order to ensure the development effective new arrangements for social care services.

• A Direct Payments/personalisation network. • A programme of support for individual

• Supporting the development of Local
Involvement Networks (LINks).


Annual Review 2006–2007 ■ Priorities 2007–2008

Voluntary and Community Sector Partnerships
Rebecca Hardwick Lead for Voluntary and Community Sector Partnerships 2006–07 – highlights and achievements

• Support for the promotion and development of
social enterprise in health and social care, building relationships between NHS South West and Regional Infrastructure for Social Enterprise (RISE). Priorities 2007-08

• Delivered Commissioning for NonCommissioners “quiz” to third sector organisations to improve understanding of commissioning.

• Continued development of social enterprise in
the health and social care sector.

• Facilitated 4 workshops across the region to
consult with the third sector on the Commissioning Framework for Health and Wellbeing.

• In collaboration with Funding South West,
delivering training opportunities to infrastructure organisations in understanding commissioning, winning contracts and improving skills.

• Partnership with South West Forum and Black
South West Network in Change-Up funded research into support for sub-sectors (including health and social care) in the third sector.

• Development of provider forums for the third

• Brokering partnerships between NHS SW and
South West Forum (regional voluntary and community sector umbrella organization) on issues of mutual interest.


Annual Review 2006–2007 ■ Priorities 2007–2008

Older People’s Programme
Lead: Nye Harries Regional Change Agent, Older People 2006–07 – highlights and achievements

• Ongoing work to support the Everybody’s
Business agenda for services for older people with mental health needs in the SW.


• The breadth of the agenda, including the
wider health and well-being, personalisation, commissioning and involvement/engagement agendas which are all key for older people’s services.

• Intensive site work with health and social care
communities, offering:

• Joint work with NHS South West on
assessing progress against key milestones in the older people’s agenda nationally.

• ongoing support in Gloucestershire where
CSIP support has contributed to a sustained reduction in delayed discharges;

• Contributing to a CSIP SW programme of
work to support the key milestones in the White Paper, Our Health, Our Care, Our Say. 2007–08 – priorities

• There are new sets of key partners to develop
productive relationships with – notably the Regional Public Health Group, other Government Office SW colleagues.

• work in Wiltshire to rebuild partnership
relations, resulting in the development and formal sign-off of a partnership agreement on all aspects of delayed discharges by six leading partners in April 2007. Running workshops and supporting local action to improve care pathways for older people.

• Sustaining work on the older person’s mental
health agenda in the SW.

• Develop a work stream around the prevention
and promoting independence agenda.

• Develop regional work on the Dignity in Care

• Providing support to the three SW round one
Partnership for Older People Pilots (POPPs) and successfully providing support to prospective bidders such that three of the round two POPP schemes were awarded to SW communities.

• Provide enhanced support for the LAAs. • Deliver intensive site work in Cornwall.


Annual Review 2006–2007 ■ Priorities 2007–2008

Health and Social Care in Criminal Justice
Lynn Emslie Lead Consultant for SW HSCCJ Programme 2006–07 – highlights and achievements Advice Services to Magistrates' and Crown Courts, using the national Service Level Agreement (SLA) as a template for local implementation and in Partnership with HMS Court Services. Using a formal evaluation to inform future developments and implementation, this work may include changes in legislation and will support the development of court liaison schemes across the South West and nationally.

• Establish and maintain a system for
monitoring and implementing the recommendations from all inquiry/coroner’s reports following South West Deaths in Custody (Prison, Probation and Police).

• Established a pilot and formal evaluation to
test NHS commissioning of health services to offenders within police custody (Dorset).

• Work with partner agencies in order to
implement the Gender Equality Duty (Corston Report, 2007).

• Successfully implemented Assessment, Care
in Custody and Teamwork (ACCT), a new process for identifying, monitoring and supporting prisoners who are at risk of self harm and/or suicide, across all South West prisons.

• Launch the national Guidelines on Offenders
with Learning Disabilities (A Handbook for Professionals in the Criminal Justice System working with offenders with Learning Difficulties).

• Established effective working between
Delivering Race Equality (DRE) Leads from health and South West prisons in order to implement best practice across all agencies, including the completion of Race Impact Assessments and development of the Community Support Worker role within South West prisons and Courts. 2007–08 – priorities and challenges

• Successfully delivered mental health
awareness training to a target of 771 (20%) of South West key prison employees.

• Improve access to health services by
enabling the registration of offenders in licensed premises and on release from prison, with GP practices.

• Commissioned NACRO to support and
facilitate further the development of strategic groups to oversee the commissioning and use of Alternative Places of Safety (Mental Health Act, 1983), following the production of a Scoping Report, 2005/2006.

• Improve access to mental health services by
continuing the newly established relationship between Probation services and their local mental health service point of contact.

• Develop a plan for the roll-out of mental
health awareness training across all criminal justice agencies as well as maintaining the rolling target of 20% of all South West prison employees.

• Established management of the National Pilot
to implement Mental Health Assessment and

• Further support the Duty to Co-operate
requirement of health within the MAPPA and sub MAPPA processes of risk management.


Annual Review 2006–2007 ■ Priorities 2007–2008

Children and Families
Lead: Linda Parker Regional Change Agent for Children and Families 2006–07 – highlights and achievements The Children and Families programme was new for 2006–2007 and integrated several work streams, including the existing work undertaken by the National CAMHS Support Service. During a year of both considerable policy activity and also structural upheaval in the NHS, the programme has been able to deliver some clear achievements:

• Working with key regional colleagues,
communities have been supported in their development of multi-agency commissioning mechanisms, in line with guidance that emerged during the year. 2007–08 – priorities The CSIP Children and Families Programme will work on the following priorities in the coming year:

• CAMHS; • embedding the work undertaken last year to
meet the PSA target;

• CAMHS – partnerships were supported to
ensure that the proxy measures for the PSA target were met.

• completion of the Tier 4 review and • The Regional Change Agent engaged
actively to strengthen both presence and understanding of the health input within key regional strategic partnerships. consequent recommendations;

• completion of the review of CAMHS services
in secure settings;

• As the programme has developed during
2006–2007, a greater degree of co-ordination of effort across agencies working at regional level has been created.

• children with disability; • support for the implementation of Aiming High
for Disabled Children across the South West;


Annual Review 2006–2007 ■ Priorities 2007–2008

• working with palliative care networks to
implement the findings of the palliative care review;

Challenges The challenge for 2007–2008 will be to continue to support the NHS in the South West to make best use of the system reforms and multi-agency levers to enable the effective implementation of Every Child Matters and the NSF for Children, Young People and Maternity.

• working with partners, including adult social
care, to support processes for improved transition for young people;

• maternity; • supporting services to redesign delivery in
line with Maternity Matters;

• safeguarding; • in conjunction with NHS South West and
GOSW, developing a support programme for designated doctors and nurses;

• social inclusion; • a wide-ranging work stream that includes the
roll-out of Children’s Centres, Extended Services around Schools, the Respect agenda and the implementation of Care Matters: Time for Change.


Annual Review 2006–2007 ■ Priorities 2007–2008

Mental Health
Kate Schneider Deputy Regional Director and Mental Health Lead 2006–07 – highlights and achievements The CSIP SW Mental Health Programme has offered bespoke support to mental health providers and commissioners across the SW, to ensure the delivery of mental health targets, the implementation of policy, and sharing positive practice. We have supported NHS South West in co-ordinating the Autumn Assessment of Adult Mental Health Services and the development of local improvement plans. Targets to be progressed in 2007–08 include Early Intervention Services, Crisis Resolution and Home Treatment teams, and the Community Development Worker role. We have established three sub-regional Mental Health Reference groups to ensure that our work is grounded in regional and local priorities, and that there is a link back to policy development in the Department of Health. Additionally, we have contributed to the review of Local Area Agreements across the SW to promote strategic planning which will improve mental health and wellbeing in local communities. Highlights from the range of work streams within the Mental Health Programme include: Social Inclusion

• Supporting and developing local employer
networks across the South West region (initially organizing these where local people may not have the time to do so) and nurture local support for local employers.

• Promoting the use of direct payments in
mental health through a series of regional workshops, and the commissioning of information for service users published in a range of languages.


Annual Review 2006–2007 ■ Priorities 2007–2008

Acute Inpatient Care


• Support for regional Acute Care Forums and
SW Acute Care Network.

• Facilitating the tender process and training for
Independent Mental Capacity Advocacy services.

• Piloting a capacity planning tool for inpatient

• Establishing SW network for legislation
implementation leads.

• Development and delivery of training for
inpatient staff.

• Delivering extensive briefings,
communications and knowledge management. Leadership

• Contributing to the development of a
web-based resource, the Virtual Ward (

• Offering training for facilitators using the • Support for the development of the Health
Care Commission’s audit tool for mental health inpatient services. Participation Effective Team Working and Leadership programme, and supporting the delivery of regional programmes.

• Establishing a national Leadership
Improvement Network. Psychological Therapies

• Offering bespoke consultancy, advice and
guidance to SW groups organisations.

• Developing training materials and policies as
part of the national portfolio for ‘Making a Real Difference’.

• Establishing a SW Psychological Therapies
Advisory Group.


Annual Review 2006–2007 ■ Priorities 2007–2008

• Co-ordinating annual conference on
Psychological Therapies.

• Bespoke support for organisations to develop
workforce planning and development. Personality Disorder

• Supporting local commissioning and service
redesign across local services, including prison services.

• Commissioning training programmes. • Supporting a SW Personality Disorder
Training Network.

• Establishing a range of practice development
sites across the SW.

• Extensive communications and knowledge
management. Carers Development

• Supporting the development of local
commissioning strategies.

• Facilitating service user participation.
Suicide Prevention

• Support, advice and consultancy offered to
individuals and groups across the SW.

• The DH CSIP Suicide Audit Tool for PCTs
commissioned from Peninsula Medical School and developed in partnership with other regional development centres was launched as a national tool to support PCTs with a comprehensive system to support their suicide prevention strategies.

• Delivery of an annual regional conference. • Establishment of a Carers’ Development
Workers’ Network in the SW. Workforce planning and development

• Support for implementation of: • New Ways of Working for Psychiatrists • Implementation of new roles including the
Support, Time, Recovery Worker, Graduate Primary Mental Health Care Worker, Community Development Worker.

• We supported Devon Partnership Trust with
the development of a national document – Multi-Agency Guidance for the Management of Suicide Hotspots.


Annual Review 2006–2007 ■ Priorities 2007–2008

• A research study commissioned from
Peninsula Medical School into the needs of prisoners on release from prison delivered its findings which were reported in a number of national and international journals. The findings are with HSCCJ agencies as evidence to guide the improvement of community responses to individuals who are at a higher risk of suicide in the period after release.

• Developed and expanded the health
promotion presence on the CSIP knowledge community.

• Produced a guide for employers on the
needs and issues for carers in relation to employment.

• Led an event on Social Marketing for the
Mental Health Promotion and Social Inclusion networks.

• A regional conference held in October 2006
focused on new national and local initiatives in suicide prevention and highlighted the valued role of the community and voluntary sector. Mental Health Promotion

• Continued to support regional smoking
cessation activity. Mental Health – priorities for 2007–08 Much of this work carries over into 2007–08.

• Held a regional event to promote Physical
Activity for people with mental health needs with the University of Gloucester and Department of Health at which the CSIP SW commissioned study undertaken by the university was launched.

Specific additional priorities include: Social Inclusion

• Facilitate the establishment of a SW Regional
Employment Team and implementation of regional employment strategy.

• Continue to map positive practice in social


Annual Review 2006–2007 ■ Priorities 2007–2008

• Offer bespoke support to commissioners and
providers to secure social inclusion outcomes. Acute Inpatient Care

Psychological therapies

• support the Children’s team with two
conferences on Suicide and Self Injury Risk.

• Co-ordinating the tender for, and supporting
the delivery of a regional Pacesetters Project.

• survey MH trusts to see what internal audit
and clinical governance activity in taking place and share learning and good practice. Mental Health Promotion

• Facilitating a SW prison-based psychological • Support HealthCare Commission audit of
inpatient services, review of findings and development and delivery of improvement plans. therapies project.

• Extending the programme to across the SW
to ensure that psychological therapies services are commissioned for, and delivered to a range of groups including people from Black and other minority ethnic groups, children and young people, and older people. Legislation

• engage with commissioners to ensure mental
health promotion outcomes feature in commissioning strategies.

• Provide advice, guidance and support to
Acute Care Forums in SW.

• Offer bespoke service improvement support
to providers. Workforce planning and development

• facilitate local mental health promotion
improvement projects.

• support SW Social Inclusion and Mental • Supporting the regional implementation of the
Mental Health Act 2007, the Mental Capacity Act, and the implementation of the Deprivation of Liberty guidance. Suicide Prevention Health Promotion Network.

• Regional launch of New Ways of Working for
Everyone (2007).

• promote smoking cessation in inpatient

• Establishment of regional learning sets. • Training for trainers in Creating Capable
Teams process to support workforce and service redesign.

• refresh our data bases and connect with
those responsible for suicide audits and strategies in the reformed PCTs.

• Dissemination of positive practice via regional
conference and networking.


Annual Review 2006–2007 ■ Priorities 2007–2008

Valuing People Support Team
Lead Carol Robinson Development Consultant Key activities this year include:

• Supporting regional networks for employment,
communication, ethnicity, health and personcentred planning

• Facilitating a regional forum and
themed events

• Offering specialist advice and consultancy to
regional leads

• Launch a regional carers’ network • Support for day services modernisation • Review of transitions • Advocacy development work to support
campus closures


Annual Review 2006–2007 ■ Priorities 2007–2008

CSIP South West Staff Information
Name Jean Julie Diane SarahJoy Francine Richard Leeanne Sandy Simon Paddy Faye Lynne Lynn David Rebecca Nye Eve Alan Robert Surname Alger-Green Armstrong Bardsley Boldison Bradshaw Byng Caldwell Clarke Coombes Cooney Davison Dean Emslie Goodban Hardwick Harries Hawkins Howard Humphrey Job Title Business Manager Business Support Administrator Service User Participation Lead Development Consultant – Social Inclusion Development Consultant, Race Equality GP Advisor, Mental Health Administrator Physical Disability & Sensory Impairment Lead; Long Term Conditions Lead Prison Mental Health Primary Care Development Worker Regional Director CSIP SW Programme Support Officer HSCCJ Regional Change Agent, Social Care Lead, Health and Social Care in Criminal Justice CAMHS Lead Lead, Voluntary & Community Services Regional Change Agent, Older People Events Co-ordinator Development Consultant, Acute Inpatient Care Associate Development Consultant, Acute In-Patient care Work Mobile 07917 593450 N/A 07785 511807 07775 684776 07775 684785 07765 400752 N/A 07889 209083 07967 175315 07957 153139 N/A 07920 711018 07899 968190 07787 510232 07768 612736 07775 897428 07785 511722 07876 453497 01392 403474 Email


Annual Review 2006–2007 ■ Priorities 2007–2008

Name Caroline Jeanette Shoba Carrie Mark Steve Linda Mark David Carol Jackie Carol Kate Sue Alex Trish Sue CSIP SW Office

Surname Jones Longhurst Manro Morgan Norman Onyett Parker Patterson Pennington Prescott Prosser Robinson Schneider Staddon Stirzaker Stokoe Turner

Job Title Development Consultant CAMHS Regional Change Agent, Adult Social Care CAMHS Service Improvement Lead Senior Development Consultant and Commissioning Lead Service Improvement Lead Senior Development Consultant Regional Change Agent, Children and Families Race Equality Lead Mental Health Legislation Lead Information Co-ordinator Development Consultant, Primary and Community Mental Health Services Development Consultant, Learning Disabilities Deputy Regional Director, Mental Health Lead, Workforce Lead Project Manager – South West Court Mental Health Assessment and Advice Pilot Practice Development Lead Personality Disorder Services Development Consultant – Social Inclusion Regional Advisor, Valuing People Support Team Mallard Court, Express Park, Bridgwater, Somerset TA6 4RN

Work Mobile 07785 511678 07776 466087 07748 656939 07900 905487 07990 528836 07771 908812 07920 711007 07884 492741 07799 627244 N/A 07768 612673 07816 034463 07973 732766 07917 593470 07799 895012 07768 421669 07866 715742 01278 432002


Care Services Improvement Partnership

Mallard Court Express Park Bristol Road Bridgwater Somerset TA6 4RN Tel: 01278 432002 Fax: 01278 432003

We help to improve services and achieve better outcomes for children and families, adults and older people including those with mental health problems, physical or learning disabilities or people in the criminal justice system. We work with and are funded by