PROSPECT news update - First quarter 2023/24

In the last few months, we have made some great progress with the development of service user roles that will help to inform the work of PROSPECT LPC.

Based on feedback from service users, we have developed a Project Support Worker role that will be undertaken on sessional basis. This aims to give service users flexibility to choose the activities they would like to be involved in, and to work hours that suit their circumstances.

In November we held interviews and, subject to pre-employment checks, have given conditional offers to four service users. Once recruitment is complete, we hope our pool of sessional workers will support two key functions in PROSPECT LPC:

1. Project activity – firstly, this will focus on the co-production of PROPSECT LPC’s service user engagement strategy and then the group will help us to deliver it.
2. Quality activity –our Project Support Workers will accompany PROSPECT staff when visiting services to help bring service user voice and perspective to quality visits.

Starting activity will be dependent on the completion of pre-employment checks, which we will be supporting applicants with over the next few months.

The Lived Experience Charter is an award that providers of NHS England Health and Justice services and integrated systems can apply to complete and receive.  Having Lived Experience Charter ‘status’ will demonstrate that organisations have quality standards, best practices, and a commitment to improving the inclusive recruitment and retention practices of people with lived experience.  

The Lived Experience Charter breaks down barriers, challenges unconscious bias, and negative assumptions about the recruitment of people with lived experience and creates systemic change across organisations. 

The LPC would like to encourage its Providers to apply for Charter status, but in the first instance the PROSPECT LPC commissioning team has been accepted for completion of the process. It is believed that this will support the team’s reflection on the recruitment processes that have been tried and tested for the PROSPECT Internship and sessional Project Support Worker roles and look to formalise the approach to recruitment of people with lived experience going forwards.  

We have until January 2024 to complete our evidence submission.

An overview of the service developments that PROSPECT LPC have invested in has been described in the following video.

Prison Pathway Team

This team has been jointly commissioned as a 2-year pilot by PROSPECT LPC and NHS England North West Health and Justice Commissioners. The team aims to be a bridge between local prison services and secure mental health services, supporting staff, prisoners and patients with the transition and pathways between prisons and hospital.

Plans for implementation are being developed by Mersey Care, and recruitment is due to start imminently.

Cheshire and Merseyside LDA Specialist Community Forensic Team

We now have a multi-disciplinary team working across this area funded by PROSPECT and the Integrated Care Board. This jointly funded service will enhance the support available in the community for people with learning disabilities and/or autism and will aim to reduce the number of people that need to be admitted to hospital. 

Please see the dedicated drop down below to learn more about this service and meet the team leader.

PROSPECT Lead Provider Collaborative (LPC) and Cheshire and Merseyside Integrated Care Board (ICB) are jointly funding a new Learning Disability and Autism Specialist Community Forensic Team for the Cheshire and Merseyside population.

In line with PROPSECT LPC’s aims, the benefits realised from the LPC’s demand management activities has enabled the shifting of funding from secure bed provision to community provision. This jointly funded service will enhance the support available in the community for people with learning disabilities and/or autism and will aim to reduce the number of people that need to be admitted to hospital.

We caught up with Julia Anderson, Mersey Care’s Clinical Service Manager who is leading on this work, to find out more.  

Background

The Transforming Care programme aims to improve the lives of children, young people and adults with a learning disability and/or autism who display behaviours that challenge, including those with a mental health condition. The programme identified existing gaps in learning disability and/or autism (LD/A) services nationwide and provided a supporting framework for commissioners to develop local services that would help to meet this overarching aim.

In response to the Transforming Care programme, support teams have been developed across Cheshire and Merseyside to provide wrap around support for people when care packages are breaking down. These developments have been effective for reducing unnecessary admissions to hospital, and some excellent pockets of expertise and practice have formed. However, this is not standardised across the region and the teams do not have a focus on patients once they are admitted into secure mental health services. This can mean that there is not a shared view of how to support individuals who are currently in hospital, meaning they are more likely to have long lengths of stay with an unclear pathway to discharge.

Cheshire and Merseyside LDA Specialist Community Forensic Team

The new Cheshire and Merseyside Learning Disability and/or Autism Specialist Community Forensic Team (C&M LD/A SCFT) will work with people in our local area who have learning disabilities and/or autism that have come into contact with or are at risk of coming into contact with criminal justice agencies.

The team will have two main aims:

• Working with adults who have a formal diagnosis of a LD/A with a risk of offending behaviour in the community, providing support to prevent unnecessary hospital admission; and
• Working with patients who have a diagnosis of LD/A who are in secure mental health services to support their discharge planning and transition to the community.

It will be a multi-disciplinary team made up of Nursing, Social Work, Occupational Therapy, Speech and Language Therapy, Psychology, Support Work, and Psychiatry disciplines. The team will ensure there is equity of provision across the C&M ICB region for anybody requiring this specialist support, and will work flexibly, depending on the needs of the patient. For example, the team may be the lead health role providing treatment for a patient with LD/A in the community and in other cases it may work alongside existing services and provide consultation or specialist support.

Cheshire and Merseyside is a large geographical area, with lots of different services that the C&M LD/A SCFT will interact with and support. This will include NHS Trusts, Local Authorities, Criminal Justice agencies such as links with Liaison and Diversion services and custody suites, community LDA teams and partners in mental health pathways and services as autistic patients are often in mainstream services requiring reasonable adjustments or additional support.

Implementation

We’re at an exciting point in the development of the C&M LD/A SCFT. A service specification has been agreed which sets the scope, remit and outcomes of the team. Julia and colleagues are now working to recruit team members and have so far been successful at appointing an Operational Team Manager and Clinical Lead who will lead the outstanding recruitment and set up of the team.

Julia described that “we understand the needs of our local population, so it is exciting to be building a new service from scratch that has been designed to meet these needs and will provide additional support to pre-existing provision.”

Access

People must be registered with a GP within C&M to be eligible to access this service.

The service is for people who are aged 18 years and above who have been, or are at risk of being, in the criminal justice system and have a formal diagnosis of LD/A.

We want the service to be as seamless as possible to access.

People in Cheshire and Merseyside with LD/A in hospital or known to the criminal justice system will be identified through the Dynamic Support Database, and the C&M LD/A SCFT will proactively become part of their Multi-disciplinary Team.

The referral pathway for people in the community will be more formal, but referrals will be considered from any agency that is interacting with people in the community that have learning disabilities and/or autism and have offended or are at risk of offending.

The team is expected to be live and taking referrals by April 2024. Updates will be provided via the PROSPECT LPC webpages.

Our usual quality oversight activities will continue as normal, but we have a number of projects and key workstreams that will also be progressing in the next few months.

NHSE bid monies

PROSPECT LPC and our partners have been successful in bidding for NHSE funding for initiatives which focused on improving patient care, pathways, services or environments. The initiatives that will be led by the LPC include projects to:

• Develop peer support to enhance physical health improvements;
• Improve provision for patients with Autism Spectrum Condition in secure services;
• Improve the quality and standardisation of approach to undertaking external long term segregation reviews.

The projects will be initiated by early 2024, with progress reported into the PROSPECT governance structure.

Patient Safety Incident Response Framework (PSIRF) Implementation The PSIRF will replace the current Serious Incident Framework and represents a significant shift in the way the NHS responds to patient safety incidents.

PROSPECT LPC’s three Providers are at different stages in their implementation of the new PSIRF, and as Commissioners we’re working with our Providers to understand their

implementation plans and how assurance will be received. Over the next few months, we will continue to work closely with Providers, adapting to challenges that arise, to ensure that we have oversight of patients’ safety.

Start date: September 2023

Remmy is the newest member of the PROSPECT Commissioning Team and is undertaking an Internship role which aims to give a local young person with lived experience of the care system experience of the NHS and an opportunity to develop work-based skills.

We spoke to Remmy about his role and what parts of the opportunity interested him most.

What is your role with PROSPECT Provider Collaborative?

I started my Internship in mid-September and since then I have been completing induction learning, and supporting the team with the development of a newsletter and updating data sets such as tracking the discharge trajectories of patients.

The role will be varied so I have the chance to see different parts of working in the NHS and Mersey Care.

Why did you apply for the Intern position?

I applied for this role to get hands on experience of working in a role in the NHS and to learn more about the NHS generally. I want to help people so I thought it was a good chance to get an overview of different services and roles which will help me to decide what I’d like to do for my future career. Earning a salary whilst gaining this experience has also really boosted my confidence.  

What have you been enjoying about your new role?

I have really enjoyed lots of elements of my new role. I love the flexibility of working from different bases, and have liked getting to know my new colleagues, seeing where I can help and learning new skills. It has been good to challenge myself and get used to a new routine.

What are the challenges in your new role?

It has been a huge learning experience coming into a new role. English is my second language so there has been a language gap, but my understanding and confidence is growing all of the time. Getting used to terminology and understanding the services was the biggest challenge over the first few weeks.

What do you hope to achieve in your new role?

My main aim is to develop my skills, experience and confidence. I am looking forward to supporting the service user engagement work that the team is setting up. I also really want to see how I can help and inspire other young people with lived experience like mine.  

What’s one thing that people may not know about you?

Outside of work I like to play football. I am a huge Manchester United and Saint George FC fan. I started supporting United when I was 7 after my Uncle gave me a United shirt as a present and I have loved them ever since.

In the next update, we’ll introduce the new Prison Pathway Team and meet other members of the PROSPECT team.