Service Level Agreement Independent Inspection and Review of Health and Social Services.

Information about the publication of Ministerial Decisions

A formal published “Ministerial Decision” is required as a record of the decision of a Minister (or an Assistant Minister where they have delegated authority) as they exercise their responsibilities and powers.

Ministers are elected by the States Assembly and have legal responsibilities and powers as “corporation sole” under the States of Jersey Law 2005 by virtue of their office and in their areas of responsibility, including entering into agreements, and under any legislation conferring on them powers.

An accurate record of “Ministerial Decisions” is vital to effective governance, including:

demonstrating that good governance, and clear lines of accountability and authority, are in place around decisions-making – including the reasons and basis on which a decision is made, and the action required to implement a decision
providing a record of decisions and actions that will be available for examination by States Members, and Panels and Committees of the States Assembly; the public, organisations, and the media; and as a historical record and point of reference for the conduct of public affairs

Ministers are individually accountable to the States Assembly, including for the actions of the departments and agencies which discharge their responsibilities.

The Freedom of Information Law (Jersey) Law 2011 is used as a guide when determining what information is be published. While there is a presumption toward publication to support of transparency and accountability, detailed information may not be published if, for example, it would constitute a breach of data protection, or disclosure would prejudice commercial interest.

A decision made (26/10/2007) regarding: Service Level Agreement Independent Inspection and Review of Health and Social Services.

Decision Reference: MD-H SS-2007-0072
Decision Summary Title :	Service Level Agreement for Independent Inspection and Review of H&SS		Date of Decision Summary:	24 October 2007
Decision Summary Author:	Richard Jouault		Decision Summary: Public or Exempt?	Public
Type of Report: Oral or Written?	Written		Person Giving Oral Report:
Written Report Title :	Independent Inspection and Review of H&SS		Date of Written Report:	24 October 2007
Written Report Author:	Richard Jouault, Director, Corporate Planning & Performance Management		Written Report : Public or Exempt?	Public
Subject: Service Level Agreement Independent Inspection and Review of H&SS.
Decision(s): The Minister approved the contract between Health and Social Services Department and the Commission for Healthcare Audit and Inspection for the provision of two independent reviews in 2007.
Reason(s) for Decision: The Governance Board met in September 2006 and agreed to participate in independent review by the Healthcare Commission of maternity services and inpatient mental health services in 2007. The reviews of substance misuse and racial equality were not pursued as the Board identified that the Health and Social Services Department may not be able to provide equivalent data to UK benchmarks. Furthermore the Board recognised that maternity and inpatient mental health represented high risk activities that would particularly benefit from independent review with regard to good governance and the management of risk.
Resource Implications: £4,000
Action required: Deputy CEO to sign, on behalf of the Minister, the Service Level Agreements between Health and Social Services Department and the Healthcare Commission.
Signature:		Position:
Date Signed:		Date of Decision (If different from Date Signed):

Service Level Agreement Independent Inspection and Review of Health and Social Services.

Item 4.3 12/12/06

Independent Inspection of Health & Social Services by the Healthcare Commission in 2007. Options for Governance Board

12th December 2007

Introduction

It is the intention of the HSS Department to be independently inspected by the Healthcare Commission (HC) in 2007 as identified in The States Strategic Plan 2006-2010:

2.3.1 The performance of the Health and Social Services Department in meeting “Standards for Better Health” will be independently inspected by the Healthcare Commission in April 2007 and the results of that inspection will be published (HSS)

A business case for independent inspection of HSSD services and provision of second stage complaints was sent to the Healthcare Commission (HC) on the 04/07/06. This was reviewed by the HC Strategy Committee on the 13/07/06. The Chief Executive of the HC wrote to the HSSD CEO on the 01/08/06. To summarise;

The HC declared that they were unable to provide HSSD with second stage complaints due to their own resource constraints.
The HC was unable to provide independent inspection to the States of Jersey Health and Social Services due to a lack of management capacity.

A response from the HSSD CEO was sent on 09/08/06 and a meeting arranged in London to identify a way forward. Those attending the meeting were as follows:

Dr Richard Lane Medical Director HSSD

Richard Jouault Director CPPM HSSD

Kate Lubley Head of Operations HC

David Bawden Head of Methods HC

At this meeting, the merger of the Healthcare Commission and the Commission for Social Care Inspection (CSCI), due in 2008, was discussed. The precise outcome of this merger and its effects upon the current approaches to inspection are not known at this time. With regard to inspection, the HC currently carry out a wide range of reviews of healthcare services and it was considered to be practicable for HSSD to be included in these reviews. This would enable HSSD to benchmark its’ services against UK provision by independent means.

The Minister for Health & Social Services has expressed his intention by Ministerial Decision for the Department to participate in a rolling program of independent review of healthcare services prescribed by the Healthcare Commission in 2007. The Programme Development Manager for the HC, Dr Amanda Squires wrote to the CEO of HSSD on the 29th November 2006 identifying a selection of reviews for consideration by HSSD. The Governance Board are asked to consider these options.

Service Reviews for Consideration

The reviews for consideration are divided into three sections:

Reviews that are "active but not yet started" as follows:

Maternity Services ( to commence May 2007)
Acute Inpatient Mental Health Services (to commence June 2007)
Race Equality. (Commence date tbc)

Reviews that have been completed by the HC (The Health & Social Services Department would be able to use the methodology from these reviews for which the HC could provide comparative data) as follows:

Children’s hospital services
Community mental health
Tobacco control
Heart failure
Substance misuse
Medicines management
Admissions management

Diagnostic services.

Future Reviews

Emergency Care (Acute Hospital Portfolio).

Way Forward

Maternity Services and Acute Inpatient Mental Health Services are recognised as high risk from both a medico-legal and SUI (Serious Untoward Incident) perspective. It would be appropriate to independently review these services as a means of managing these risks. It is possible that insufficient numbers of throughput and therefore sample size may exclude one or both of these services from comparative review. It is therefore necessary to consider other reviews that may be valuable at this time. Tobacco Control in light of impending legislation, heart failure, with regard to recent debate regarding cardiology services need to be considered on their merits with regard to Jersey’s unique context.

Recommendations

It is recommended that HSSD liaise with the HC regarding the feasibility and cost of inclusion in a review of Maternity Services and Acute Inpatient Mental Health Services. Furthermore, it is recommended that the Governance Board identify two other reviews to consider in reserve should either of the former be statistically inappropriate following feasibility study.

Richard Jouault, Director of Corporate Planning & Performance Management,

Dr Richard Lane, Medical Director,

Rose Naylor, Director of Nursing & Governance.

7th December 2006.