Health Engagement in MASH Development Mary Mullix MASH Project Lead NHS London

Drivers and Evidence MASH Children’s Rights Munro Review of Child Protection UN Convention on the Rights of the Child 1989 Children Act 1989/2004 Duty to cooperate MASH Messages from Research Messages from Serious Case Reviews Poor communication and information sharing Poor assessment and risk assessment Prevention still not happening Silo working evident

NHS reforms 2010 Put patients (people) at the heart of all we do Improvement & better outcomes Empowered liberated clinicians New commissioning strategies Public Health in Local Authorities - Children’s public health 0-5 - Health Visitors to LA 2015 Children’s public health 5-19 – School Nurses to LA 2013 Health and Wellbeing Boards Established (local needs assessment) Health Visitor and Family Nurse Partnership numbers increased

Safeguarding Structures in Health NHS reforms – safeguarding structures Safeguarding statutory responsibilities sit in all the new structures – NHS CB, CCG’s and Providers NHS CB Nationally sits in NHS NCB Chief Nurse Directorate Direct commissioning Primary care Specialist commissioning Military health Offender health PH Screening Assurance, clinical leadership and oversee role of CCG Clinical Commissioning Groups Safeguarding children is part of CCG authorisation Designated Nurses sit in CCGs as clinical lead (Doctors by Service Level Agreements) CQC registration & regulation Registration Standard 7 & Joint inspections of child’s journey

Implementation processes Commissioning - against new NHS values Joint Strategic Needs Assessment - Health and Wellbeing Board Local Safeguarding Children Board Support Commissioning Intentions - safeguarding elements of NCB, CCG & PH Leadership and influence – the right people in the right place Expertise of Designated Professionals – for clinical & commissioning issues, performance & assurance Multi-agency MASH implementation Groups – Designated Professionals are key Tools & techniques to assist implementation – taking people with you MASH NHS implementation work plan – identifying stages risks and issues MASH information and slide pack Standard example MASH professional JD Involve IT / IG leads in planning Seminars to – Provider exec leads, CCGs, Caldicott Guardians, front line practitioners

Information Sharing Very real problem for some clinicians Is seen as problematic (GMC guidance) Meet current requirements for early help, innovation and integration MASH process is secure, incoming and outgoing Information ‘agreement’ is important also processing agreement is required IT compatibility is a challenge Moves towards using NHS number as unique identifier

Multi-Agency Safeguarding Hubs (MASH) Making MASH fit for London Florence Ogunyankin MASH and London Probation Trust (LPT)

London Probation Trust and Multi-Agency Safeguarding Hubs LPT National Offender Management Service Ministry of Justice Our Mission –Changing lives for a safer London

What we do We ---- Manage approximately 70,000 offenders a year Work with Courts Community Sentences Community Payback Work with Prisons Support Victims Approved Premises Work with partners from public, private and voluntary sectors

LPT - What we do

LPT – What we do Our Vision, Mission and Values Vision We will inspire public confidence in probation by reducing reoffending in London. Our staff will be proud to work for London Probation Trust and London will be a safer place because of the work we do. Mission - Changing lives for a safer London London Probation Trust works with offenders to help them lead responsible and law abiding lives.   Our over-riding aim is to reduce reoffending and protect the public.   We achieve this by:     Assessing offenders and making skilled judgements about how to reduce the risk they pose.   Influencing positive changes in offenders’ behaviour.   Working with other agencies to protect the public.   Liaising with victims. Values London Probation Trust has five core values which are at the heart of our responsibility to create a safer London Engaging with Communities – working together to improve public safety. Listening– seeking and responding to public and user feedback makes our work more effective. People– our staff are our greatest resource in our drive to achieve excellence. Change– we believe in the capacity of offenders to change Diversity– recognising and celebrating the richness of difference

Multi-agency (partnership) approach Local Authorities , LSCB – Local Safeguarding Children Boards, Social Services / Children Social Care and Adult Services: Social workers, key workers Prisons The Police Service Youth Offending Services (YOS) National Health Service- GP’s, Hospitals, Mental Health Services CPS Children and Young People Services The Learning Trust Cross Sector Providers

The multi-agency approach From 1 April 2010 Community Safety Partnerships (CSPs) have had a duty to formulate and implement a strategy to reduce reoffending by adults and young offenders and Probation has become the sixth statutory partner of CSPs. Partnerships give consideration to the following three key areas of activity: Strategic planning Operational activity Case management and intervention

The multi-agency approach Established pathways out of offending provide a useful framework for considering needs and service provision The pathways approach involves looking at offender need against the key areas of: Mental and Physical Health (including Learning Disabilities) Drugs and Alcohol Education, Training and Employment Accommodation/Housing Children and Families Finance, Benefits and Debt Attitudes, Thinking and Behaviour Tool Kits - Offender Assessment System (OASys), Risk Matrix, SARA

The Multi-agency approach Risk of harm and risk of re-offending Multi-agency offender- focussed programmes : Prolific and Priority Offenders (PPO) Diamond Project Integrated Offender Management (IOM) Drug Intervention Programme (DIP) Multi-Agency Risk Assessment Conference( MARAC) Multi-Agency Public Protection Arrangements ( MAPPA) Multi-Agency Lifer Risk Assessment Planning (MALRAP) and MARAP Multi-Agency Safeguarding Hubs (MASH)

LPT and MASH Safeguarding Children – Shared Responsibility Statutory organisations that work with children have a duty under Section 11 of the Children Act 2004 to ensure their functions are discharged with regard to the need to safeguard and promote the welfare of children. Safeguarding children: a shared responsibility will enable those whose work brings them into contact with children and families to: understand what to do when they have a concern about a child’s welfare know how to work as part of a multi-agency or multi-disciplinary team be clear about roles and responsibilities understand statutory requirements and how to apply them.

LPT and MASH Strategic Planning Objective in LPT’s Business Plan 2012/13 – includes Safeguard children and vulnerable adults HOW ? Deliver world-class Multi Agency Public Protection Arrangements In collaboration with partners provide leadership in the implementation of Multi-Agency Safeguarding Hub (MASH) arrangements LDU ACOs will review local Safeguarding arrangements in line with LPT Policy (for children and vulnerable adults) and make improvements to reflect changing needs

LPT and MASH OVERALL OUTCOMES ? 5% reduction in harm 5% increase in successful completion of community sentences 3% increase in successful completion of Licences Achieve standards as defined by Ofsted inspections Develop an approach to delivering services for Safeguarding Children and (Vulnerable) Adults Improve Stakeholder engagement and effective collaboration with relevant Partners

LPT and MASH Our Commitment Service Provision Staff training and professional development Increased profile Take learning forward from Serious Further Offences and Serious Case Reviews Integrated approach with relevant Partners

Member, London MASH Operational Delivery Group Jeanne King Member, London MASH Operational Delivery Group

MASH is a means to an end… not the end itself

Making MASH fit for….