24 June 2019
The Department for Health and Community Services (HCS) has responded to the Comptroller and Auditor General's (C&AG) findings of Adult and Older Adult Services, which is part of what was previously Community and Social Services, run by the then Health and Social Services Department.
In April this year, the C&AG published a report called ‘Community and Social Services for Adults and Older Adults – follow-up’ – which followed an initial report by the C&AG in 2015 – and HCS have now responded to this.
The HCS response to the report, called 'Health and Community Services response to Comptroller and Auditor General follow-up report on Community & Social Services for Adults and Older Adults' seeks to address the concerns raised by the Comptroller and Auditor General in her April 2019 report.
In their response, published this week, the Health and Community Services (HCS) department (formerly known as HSSD) fully accepts the C&AG’s findings.
Group managing director for HCS, Rob Sainsbury, said: “The newly established Executive team for HCS are working at pace to address the issues outlined by the C&AG.
“We fully accept the findings of the C&AG. However, our report in response seeks to outline the fundamental reform that is currently underway across HCS that goes some way to addressing the issues raised in the C&AG report.”
He added: “The timing of this follow-up report coincides with the implementation of the recommendations from the response to the ‘Governance Arrangements for Health and Social Care’ report that HCS published in October 2018.
“As we outlined in that response, HCS are currently undertaking fundamental changes in our approach to governance which includes establishing a streamlined board and supporting committee structure. Alongside the governance work, substantial changes are being implemented within health and social care as part of the One Government reforms.”
As part of the new organisational arrangements being undertaken across Health and Community Services, the former Community and Social Services department is integrated as part of ‘One HCS’.
The roles and responsibilities of the new HCS senior leadership team also reflect this change with a wider remit of responsibility covers the whole of HCS.
Mr Sainsbury added: “The new model aims to ensure consistency across all of our care groups, which includes the services that were part of the former C&SS department. Implementation of the new target operation model in HCS will also seek to address many of the concerns raised in this C&AG follow-up report.”
In order to ensure that Community Services and those provided in the General Hospital are more closely linked, the organisational changes across HCS, with full oversight of both General Hospital and Community Services mean that there will be:
- increased service user involvement in the design of services;
- commitment to strengthening clinical and professional leadership so that more responsibility and increased accountability in decision making can be devolved to front line staff;
- better care co-ordination and integration across HCS;
- a clearer focus on safety and quality for all users;
- stronger performance management; and
- streamlined governance and more visible lines of accountable reporting in a leaner structure.
Mr Sainsbury said: “The HCS Management Executive team believe that, by significantly strengthening and streamlining our governance arrangements and implementing the new TOM, we will go a significant way to addressing a number of the fundamental issues that the C&AG raises. These improvements will ensure that there is regular assurance across all of our services, particularly in relation to management of budgets, quality, risk, resources and performance.”
The report published by the C&AG in April found that:
There were significant concerns highlighted in relation to the services provided to some of the island’s most vulnerable individuals across community, social care and mental health services. The collective findings also highlight the inequity between physical, mental health, community and social care services.
HCS respond that these findings are consistent with many health and care jurisdictions, and, further support the ‘Case for Change’ for HCS to ensure there is greater focus on health and care outside of the General Hospital remit.
In their response to the Comptroller and Auditor General, the HCS response states there are three linked pieces of work which are ongoing which will ensure that Community Services and General Hospital services are delivered with parity. These are:
- The development and implementation of the Government Plan, Common Strategic Policy 2; Improve islanders' well-being and mental and physical health.
- The Implementation of the ONEHCS vision through the new Target Operating Model for the department. This ambition clearly sets out the objective to fully integrate Health & Community services, ensuring that there is parity between functions and continuity in care for our islanders.
- Developing the Future Care model, which sees a greater focus on care closer to home, targeted at the most vulnerable groups within the island.