Safeguarding Adults at Risk in the new commissioning landscape
Stephan Brusch Professional Safeguarding Adult Advisor
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Common Purpose Ensure that CCGs work with local authorities to
ensure that vulnerable people, particularly those with learning
disabilities and autism, receive safe, appropriate, high quality
care Delivery of 100% of actions set out in the Winterbourne View
Concordat and Francis response Ensure that there is a capable
system of safeguarding that is resilient to the transition and
linked to quality assurance NHS and Social Care Outcome
Frameworks
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NHS Commissioning Board Providers Funding Accountability Other
Parliament Patients and Public Local HealthWatch contract
Accountability for results Health & Wellbeing Boards (HWBs )
Public Health England Clinical Commissioning Groups (CCGs) contract
Monitor (economic regulator) contract Local Authorities (incl.
Public Health) Commissioning Support Services NHS Trust Development
Authority NHS Trusts Version 0.4 Joint licensing between Monitor
and CQC CQC National Regional Footprint / Local Health Education
England DH NHS CB Regional x 4 NHS TDA Regional x 4 FTs London
Health Education Work together to ensure commissioner support for
aspirant FTs Clinical Senates The NHS landscape from April 2013
Local Education and Training Boards
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NHS England Improve the quality of NHS care and health
outcomes. Held to account through NHS Outcome Framework and Mandate
Reduce health inequalities and empower patients and the public (NHS
Constitution) Directly commission or primary care, specialist
health services, prison health care. Develop and sustain
partnership working (DH, Local Authority, Metropolitan Police,
ADASS, Monitor and CQC)
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NHS England Ensure directly commissioned services meet specific
safeguarding requirements: primary care, specialist services,
prison healthcare. Policy Lead for the NHS around Safeguarding
Leadership role for NHS Leading and defining improvement in
safeguarding practice and outcomes. Lead on assurance and peer
review process CCG Assurance around Safeguarding and ongoing
development Lead on joint work with CQC and Monitor on joint
sharing protocol. Local Area Teams will have day to day
responsibilities
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Clinical Commissioning Groups Statutory NHS bodies Membership
organisations bringing together local GP practices. Allocated
60Billion to commission health services for local population.
Improve quality of primary care
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Clinical Commissioning Authorisation Statutory responsibility
for commissioning safe services that safeguards children and adults
at risk. Having in place effective system for responding to abuse
and neglect of adults in vulnerable situation. Statutory Partner on
Local Safeguarding Children and Adults Boards. Effective
interagency working Assurance that Commissioning support
organisations procure safe care.
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Clinical Commissioning Authorisation Appropriate systems for
safeguarding Adults at Risk Securing expertise for safeguarding
children. CCG plans to train staff in recognising and reporting
safeguarding issues. Clear line of accountability for safeguarding
is reflected in CCG governance arrangements. CCG has arrangements
in place to co- operate with LA in the operation of LSCB and LSAB.
CCG has safeguarding adult and MCA lead supported by relevant
policies and training
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Mental Capacity Act Retains responsibility for assuring through
the commissioning process compliance with the MCA 2005 and DoLS
legislation of all providers of health care Work with health
providers and local authorities to ensure appropriate capacity in
the system of professionals qualified to carry out best interest
assessments Support the training and education of health
professionals and best interest assessors to deliver effective safe
quality patient services.
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Provider All NHS trust will become Foundation Trusts and will
be licensed by Monitor. License will depend on CQC registration Non
NHS Trust will be accountable to NHS Trust Development
Authority
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Provider Required to demonstrate Safeguarding leadership and
commitment at all levels. Need to be fully engaged in local
safeguarding assurance structure via Boards and commissioners. Need
to have effective arrangements in place that support good
safeguarding practice: strategy, systems, workforce,
partnerships
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Public Health Public Health England will provide national
leadership, held accountable through the PH Outcome Framework
National Policy on tackling health inequalities, health improvement
and protection. Local leadership on Health and Wellbeing Boards,
leading JSNA and commissioning range of services
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Public Health Statutory responsibility for commissioning safe
services that safeguards children and adults at risk. Locally
through the Local Authority Structure. Nationally through 15 area
teams. Specific safeguarding duty relates to Health Protection
Duty.
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Health Education England England Will work in conjunction with
Local Education and Training Boards (LETBs) Has responsibility of
all professional education and training. Will provide strategic
leadership and workforce intelligence to support NHS CB LETBs will
be responsible for local workforce development and educational
commissioning. This needs to include provision of general and
specialist training on safeguarding.
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Local whole system Safeguarding Boards continue to provide
local leadership for safeguarding with Statutory membership Local
Safeguarding Forums Local Authority as lead statutory organisation
for safeguarding Boards have a role in making it clear where
safeguarding improvement are needed. Health and Wellbeing Board:
Strategic Responsibility for assessing local needs, including
vulnerable people (JSNA)
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Draft Care and Support Bill Duty to establish Safeguarding
Adult Board Duty to undertake Safeguarding adults reviews A SAB
must publish for each financial year a plan (its strategic plan)As
soon as is feasible after the end of each financial year. A SAB
must publish an annual report and distribute this widely.
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Wider System Regulators: Monitor will ensure that boards of NHS
FT focus on good leadership and governance. CQC continue to
regulate the safety and quality of patient care. Joint Inspection
with Ofsted. Professional regulators will need to play their
part