Safeguarding Adults at Risk in the new commissioning landscape Stephan Brusch Professional Safeguarding Adult Advisor

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

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

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)

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

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

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.

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

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.

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

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

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

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.

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.

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)

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.

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