National Service Framework (NSF) for Children, Young People and
Maternity Services in Wales
Implementation Working Group Meeting held on 26 September 2006,
Blue Room, Welsh Assembly Government, Cathays Park, Cardiff
Present
Ann Lloyd
Keith Ingham
Irene Allen
Nia Lewis
Dr Huw Jenkins
Joint Chair, Head of Health and Social Services, WAG
Head of Children’s Health & Social Services, WAG
Head of Children’s Health Policy Branch, WAG
Children’s NSF Implementation Support Manager
Director of Healthcare Services for Children & Young
People in Wales, WAG
Prof Richard Williams CAMHS Special Adviser, WAG
Dr Jane Ludlow
Senior Medical Officer, WAG
David Middleton
Children’s Framework Team, WAG
Joanne Absalom
Chief Executive, Blaenau Gwent Local Health Board
Dr Sarah Aitken
Consultant in Public Health Medicine, NPHS
Mike De Val
Head of Education, Torfaen County Borough Council
Charlotte Drury
Children & Young People’s Framework Partnership
Co-ordinator, Caerphilly CBC
Catriona Williams
Chief Executive, Children in Wales
Andrew Graham
Web Team, Health Solutions Wales, Velindre NHS
Trust
Beverlea Frowen
Director for Social Services and Health Improvement,
Welsh Local Government Association
Claire Bond
Children’s Health Policy Team, WAG
Rebecca Hawkins
Children’s Health Policy Team, WAG
Welcome, Introductions and Apologies for Absence
Ann Lloyd welcomed members to the third meeting of the Implementation
Working Group.
A warm welcome was extended to a new member of the group, Nia Lewis, the
newly appointed Children’s NSF Implementation Support Manager.
Apologies were received from Steve Thomas (represented by Beverlea
Frowen), Sally Ellis, Dr Andrea Thomas, Chris Burdett, Hugh Ross and Ann
Noyes.
Minutes of the last Meeting and Matters Arising
The minutes of the last meeting, held on 13 March 2006, were agreed without
amendment.
Children’s NSF Support Post
Nia Lewis, the NSF Implementation Support Manager briefed the group on her
career history prior to her appointment.
Steering Group
A Steering Group has been established to give day to day direction, advice
and support to Nia in her role as the NSF Implementation Support Manager.
Beverlea Frowen informed the group that additional representation had been
sought from the All Wales Trust Chief Executives Group. Katie Norton,
Director of Service Planning at Cardiff and Vale NHS Trust has been
nominated to represent NHS Trusts in Wales.
Catriona Williams asked the group to clarify how the Voluntary Sector would
be involved in the Implementation of the NSF and whether the Steering group
had considered Voluntary Sector representation. IWG members agreed that
Voluntary Sector involvement was imperative that they are engaged
throughout the implementation process, via their link with the Framework
Partnerships. While the group stressed that Steering Group membership
should not replicate the IWG, it was agreed that Catriona nominate a suitable
representative.
ACTION: CATRIONA WILLIAMS
Charlotte Drury raised a concern about how to engage with the Voluntary
Sector to become compliant with the NSF – as they are not able to input data
onto the SAAT. A discussion took place and it was agreed that as Voluntary
Sector bodies were commissioned to undertake various tasks, they need to be
aware of the standards and key actions within the NSF. Further consideration
on whether additional guidance is required will be undertaken.
ACTION: IRENE ALLEN
Beverlea Frowen informed the group that the WLGA were holding an “NSF
Day” on 2nd October in Mid Wales. The ethos of the day to establish what it is
that stakeholders want and need for the implementation of the NSF, and also
what they want from Nia in her role as Implementation Support Manager. At
the time of the meeting, around 68 delegates had confirmed their attendance
at the event, from across the board throughout Wales. All IWG members were
invited to attend.
2005/2006 Outcomes – SaFF Target and All Wales Partnership SAAT
Scores
The Balanced Scorecard - end of year summary and the All Wales
Partnership SAAT scores were considered by the group. Irene Allen informed
the group that Trusts and LHB’s reported progress against SaFF targets via
the balanced scorecard system – returns are submitted on a quarterly basis
and then an end of year summary is produced. The first three quarters
measures progress via red, amber or green while the final quarter illustrates
the target as being met or unmet via its green or red status.
The group noted that if organisations are failing in areas where they should be
compliant, such as clinical governance, where they have legal and statutory
responsibilities or are failing the vulnerable, such as at risk children, then
there should be stringent measures in place to monitor and remedy the
situation.
Ann Lloyd informed the group that Local Health Boards had met only 70% of
the SaFF targets during 2005/06, which was unacceptable, particularly as the
number of targets for that year had been significantly reduced. If organisations
are failing, troubleshooting measures are implemented, and for those
organisations that need to improve performance, modernisation teams are
would be sent in to assist.
It was agreed that the qualitative data needed to be looked at, as well as
scores, to identify areas of concern.
ACTION: IRENE ALLEN & NIA LEWIS
2006/2007 Action and Updates
Andrew Graham of Health Solutions Wales delivered a presentation, on the
Self-Assessment Audit Tool.
In the discussion that followed, the group agreed on the importance of
receiving feedback from responsible organisations using the SAAT in order to
refine and improve the tool. It was agreed to set up a user group.
ACTION: NIA LEWIS & ANDREW GRAHAM
2006/2007 SaFF Target
Irene Allen informed the group that a number of responsible organisations had
expressed concern with the deadline for completing the 2006/2007 SaFF
target. Officials had contacted the Regional Offices and the Framework
Partnerships to establish whether they would welcome an element of flexibility
for the completion of the SaFF.
The IWG agreed that an addendum to the SaFF target WHC be issued to
clarify the following timetable:


Completion of the SAAT by March 31st 2007
Prioritise and complete the 2-year local priorities and Implementation Plan by
May 30th 2007
The group also endorsed the timetable as it fitted well with the development of
the children and young people’s single plan.
ACTION: IRENE ALLEN
It was agreed that the Children and Young People’s Framework Partnerships
would be advised immediately of this decision, at their meeting the following
day.
ACTION: DR HUW JENKINS & CHARLOTTE DRURY
Charlotte Drury informed the group of the problems responsible organisations
were experiencing in interpreting key actions differently and as result scoring
themselves differently on the SAAT – there is concern that SAAT data is not
accurate due a lack of consistency across organisations. It was suggested
that a Task and Finish Group be set up to look at these issues – guidance
would then issue as a result of their findings.
It was agreed to float the idea of a Task and Finish Group at the WLGA NSF
Day – on 2 October 2006. Dr Huw Jenkins and Charlotte Drury also agreed to
do the same at the Children & Young People’s Framework Partnership Coordinators meeting the following day.
ACTION: BEVERLEA FROWEN, HUW JENKINS & CHARLOTTE DRURY
2007/2008 Proposed SaFF Targets
The proposed SaFF Targets for the Children’s NSF and CAMHS were tabled
at the meeting (IWG 3 (7)).
Professor Richard Williams spoke to the group regarding the CAMHS SaFF
Target. Generally it was agreed that CAMHS must have a SaFF target. The
proposed target for 07/08 and 08/09 covers Tiers 1&2 and 3&4 and is
consistent with the Children’s NSF. This target is about the assessment for
admission, not the admission itself. The target won’t solve all problems but is
focussed on commissioning, for which the responsibility has to lie with HCW.
Ministers are also determined to have the CAMHS Commissioning Networks
working effectively. It was also agreed that the target needs to mention the
Children’s NSF and also to link in with the SO31 consultation.
The group discussed the proposed Children’s NSF target options (IWG 3 (7)).
It was agreed that it should be option B:
‘Set a NSF target for the Partnerships to implement the top 2 priorities within their
partnership which will be monitored and measured via the SAAT and reported to the
IWG’
In taking this forward, there would need to be further work done on the
rationale to make the purpose, process and outcomes clear. It was also
agreed that the organisations’ choices should be fed back to WAG.
Forthcoming Inspections and Reviews
Child and Adolescent Mental Health Services
Professor Richard Williams informed the group of the number of upcoming
CAMHS reviews - The Wales Audit Office (WAO) and Social Services
Inspectorate Wales are planning a review. Hilary Peplar, Chief Executive,
North East Wales NHS Trust is undertaking an internal review of transitions,
which covers CAMHS. Ted Unsworth is undertaking a review of Secure
Mental Health Services and looking at transitions through the Mental Health
NSF and NOMS are doing a CAMHS and Youth Justice Review.
While internal reviews will be harmonised, we have much less input and
control on the reviews undertaken by external organisations (although WAO
has been in contact for views and input from us.)
There are concerns that CAMHS would be over reviewed and differing
opinions may arrive at different conclusions. It was agreed that they should be
done in conjunction with the CAMHS element of the Children’s NSF as we do
not want to change the policy. It was also agreed that negotiation is needed
with the external organisations to ensure that they all have the same
information.
ACTION: IRENE ALLEN & PROFESSOR RICHARD WILLIAMS
Maternity Services
The group was asked to note the paper on the Maternity Services Review
(IWG 3 (8)). It was generally agrees that this was a good way forward in the
use of the SAAT.
Communication Issues – Proposed Future Activities
Ann Lloyd suggested that the group needs to discuss the Beecham Report
material and how it could be taken forward in the context of the NSF. It was
agreed that it would be included as an agenda item for the next meeting.
ACTION: IRENE ALLEN
Date of Next Meeting
The next meeting is being held on Tuesday 19 December, 1.30 – 4.00 at the
Welsh Assembly Government, Cathays Park, Cardiff.