Mick Burns
Secure Services Commissioning Team
Yorkshire and the Humber Specialised
Commissioning Group

5.17m population
(NoS
2007 PCT population estimates)
14 PCTs (North,
West, East and South
Yorkshire and North and North East Lincs)

Overseen by Specialised Commissioning Group
Specialised Commissioning Team
Secure Services (plus a bit of Specialist Mental
Health) Commissioning Team
All high, medium and low secure services
PCT consortium arrangements including financial risk share
All activity managed via NHS standard MH contract budget for 201011 circa £130m

Current Secure in-patient population (month 5 2010 -11)
Placement
High Secure
Medium Secure
Low Secure
Total
No of in-patients No of providers
97 3
290
378
765 38
11
24

Secure Services Commissioning Team –
Team Structure
Associate Director – 1 WTE
Assistant Director (Finance 0.6 WTE)
Senior Commissioning Manager -2 WTE
Regional Forensic Case Manager – 5 WTE
Involvement Leads 1.6 WTE
Information Staff 2 WTE
Admin Staff 2.6 WTE
Activity managed across 25 contracts

‘Democratisation’ of mental health services since NSF
Two posts partly funded by PCTs partly funded by providers
Involvement Strategy ‘Reaching Joint
Solutions’
“Involvement is a bit like spinach: no one is against it in principle because it is good for you, but not everyone eats it”

RJS sets framework for involvement at 3 levels
– Individual Level
– Ward/Unit Level
– Strategic Level
Involvement monitored through
Involvement network ‘ i4i ’ (Improvement through Involvement)

Background to CQUIN development in Yorkshire and the Humber
Commissioning for outcomes
– Improved mental wellbeing
– Reduced Risk
– Therapeutic Use of Environment
– Social Inclusion
– Quality of Life
User Defined initiatives for improvement
– Advanced Directives
– CPA Standards
– Complete Dining Experience

CQUINS 2009-2010
Introduction of system for recording and monitoring outcomes
Demonstration of 25 hours meaningful activity (DH best practice)
Introduction of ‘My Future Plan’ advanced directive developed by Y&H i4i network
Introduction of CPA standards developed by Y&H i4i network
CQUIN value 0.5% of contract value as part of 2.2% uplift

CQUINS 2010-2011
90% target for use of HONOS secure and HCR-20
Introduction of tool to measure therapeutic use of environment (Essen CES)
Services to develop involvement and personalisation strategy in partnership with service users
Year 2 of CPA standard implementation, introduction of dining standards from user audit ‘complete dining experience’
Build on 25 hours structured activity plan through i4i network
Service implementation of recognised recovery planning tool
CQUIN equivalent to 1.5% of contract value with no uplift

CQUINS 2011-2012
Still under development, suggested themes
– Linking outcomes to model pathway
– Project re ‘choice and responsibility’ user defined
– Staff development programme (in support of increased involvement agenda), user led audits
– Primary Health
– Involvement for carers
– Standardisation of drug and alcohol interventions
Essen CES, Dining Experience and Recovery
Tool will roll over from previous year
Unclear as to value of CQUIN

Users see real benefit of involvement through inclusion within contract
Programme of involvement energises service users improves engagement with staff in services
Real change in culture within services, collaborative working becoming more of a reality
Services are starting to innovate
CQUIN development has helped to consolidate service network
Unclear as yet whether outcomes have improved but process has been helpful in itself