The report of the Bradford District and Craven Health and Care Partnership & Bradford Metropolitan District Council (Document “L”) provides an update on the national governance arrangements for NHS host commissioning and what has been implemented in Bradford. This paper will also provide a summary of the outcomes of the National Safe and Wellbeing reviews which were conducted in Bradford during 2021/22.

Resolved –

(1)       Members are asked to consider and comment on the information provided within the report.

(2)       Members are asked to receive assurance against the Host Commissioning process in Bradford and Craven.

 (Contact: Jacqui McMahon - jacqui.mcmahon@bradford.nhs.uk)

The report of the Bradford District and Craven Health and Care Partnership & Bradford Metropolitan District Council (Document “L”) provided an update on the national governance arrangements for NHS host commissioning and what had been implemented in Bradford. This paper had also provided a summary of the outcomes of the National Safe and Wellbeing reviews which were conducted in Bradford during 2021/22.

At the invitation of the Chair, the representatives gave a synopsis of the report. It was explained that an update against arrangements in “place” in relation to the governance and assurance processes for Host Commissioning arrangements for the Bradford and Craven Health Care Partnership (HCP) and how intelligence was shared and triangulated at a West Yorkshire level, within the Integrated Care board (ICB). This Bradford District and Craven HCP report set out the arrangements established in Bradford; identifying roles, responsibilities, and mechanisms in place to support this, on behalf of the West Yorkshire ICB who now had the overall statutory function for host commissioning. Furthermore, the report described the Safe and Wellbeing review process that took place in 2021/22 in response to a national requirement in light of a report published by Norfolk Safeguarding Adults Board into the deaths of three young Adults: Joanna, Jon and Ben. They were all in their 30s and had learning disabilities and had been patients at Cawston Park hospital and they died within a 27 -month period (April 2018 to July 2020). Key learning from the outcomes and recommendations made from the independent panels were also provided.

Proceeding the presentation, a question and answer (Q&A) session ensued:

How would this framework be managed?

o   NHS Bradford District and Craven HCP as host commissioner on behalf of the WY ICB had a number of key roles. To be the main contact for local communication and quality oversight with the provider. To be the main point of contact for placing commissioners to triangulate intelligence, enhanced by the Safe and Wellbeing process undertaken in 2021/22. To develop and implement robust governance arrangements to triangulate and share intelligence with Integrated Care Board partners across West Yorkshire, including local authority safeguarding teams, CQC and local providers. To align to local, regional, and national Quality Surveillance Group (QSG) arrangements, with strong links with the local Bradford Safeguarding Adults Board (SAB);

·         How would the transition from children to adult services be managed?

o   There were differences, legally, for children’s services and this as based on education. There was a transition lead for children with a diagnosed learning disability or autism. A child would receive care in the community (which usually started at 14 years of age) to ensure a transfer to adult services was supported.

o   If a young person under the age of 18 was admitted into an adult inpatient service, they would be placed in a separate area of the adult inpatient ward, and a risk assessment would be undertaken to understand the risks to the individual in this environment. This was easier to do in a learning disability assessment and treatment unit as there were often areas for long term segregation that lend itself to supporting someone who may be at risk. Pressure would be then placed on the ‘placing’ commissioners to identify an appropriate CAMHS bed for the individual young person as soon as is practically possible.

o   If a young person over the age of 18 was placed into adults in patient services via the host commissioner route the following oversight would be in place; and,

·         What was a major contributor towards the significant wellbeing within the process?

o   As a direct result of the ‘Safe and Wellbeing’ review process at Bradford, the professional and working relationships between the quality and personalised care team had realigned and strengthened, resulting in greater intelligence sharing and wider oversight of individual care needs. Due to the resilient working relationships between host and placing commissioners at Bradford, the scrutiny panel was assured that due to early identification of any themes, trends or risks, the team were able to influence quality patient care and effective discharge planning. The scrutiny panels advised that due to the relationships established with providers, service users and families, they were assured that any risk indicators identified would be acted up on and addressed promptly. There was confidence that due to robust relationships forged with service users and families, that their voices were heard and therefore had greater influence in the care planning and delivery, in line with the individual’s needs. The established host commissioning oversight mechanisms in place at Bradford provided an opportunity to share good practice regionally and nationally; as well as the ability to influence strategic decision making regarding the host commissioning service.

Resolved:-

That officers be thanked for their informative report.

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