I was amongst many others i think who were fairly horrified to read the blog of Sir Stephen Bubb, CEO of ACEVO following being asked by Simon Stevens to head up another group – this time one to “co-commission between the voluntary sector and the NHS”. It says little for Simon Stevens that he thinks the ACEVO represent the voluntary sector – as the title says it’s the CEO’s it represents. Even worse it appears he draws in the great and good – CEOs indeed who over breakfast draw up a plan which seems purely to be for them to deliver potentially more of the same. So his trusty right hand man draws up a plan…. this is before anyone else is involved. It’s shocking as it would seem that not only he has no idea how to engage with the people who know, but neither do these CEOs if they think it is OK to draw up such a plan….. which talks about buildings and 10 years. I appreciate that for some there won’t be a quick fix and transitions need careful planning BUT it needs the skills – and housing shouldn’t be an issue if it is recognised that most of the problem relates to the lack of NHS specialist support in existing services. We have providers of all sorts who are supporting people who challenge – they will need the time to assess and plan for individuals, recruit and train at the right level. I never thought it was a quick fix but you don’t fix it this way!
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So I “commented” as below on his blog but it never got printed – so here I am doing it myself and I’d welcome others’ views – some of them have got onto his page! So I said:
Could you start by asking people who know – like Sarah mother of Sparrowhawk and others she’s in touch with; like ChangePeople (see Philipa’s comment above) who’ve been working with Europe on closing institutions and had a great conference recently “Our voices, our Choices, our Freedom” run by and for people with learning disabilities; like Housing and Support Alliance who produced “There is another way” showing how people who’ve challenged can be supported well in the community and develop good lives; like Respond who understand the damage that institutional abuses have done and what helps; like training organisations such as PRT who’ve been working for many years with Positive behaviour management; like looking at Jim Mansell’s publications; like learning from history – what about the King’s fund “Ordinary life” and the N/West Regional Health Authority’s Model District Service which successfully resettled people into ordinary housing in the community and put money and training into community services. (This included a “challenging behaviour service” which would go into a crisis and hold things to find solutions – before the multiple reorganisations of Health decimated the services so they don’t exist in many places if at all) Should we be surprised to find behind our backs the growth of the industry making profits too out of the poor commissioning that hasn’t ensured local services include people (such as mental health services – allowed to get away with not making reasonable adjustments)? And what about the unintended consequences of local authorities having to pay for community placements (which can be very expensive relatively to other placements but cheaper than assessment and treatment units ) whereas health (not commissioning much for learning disabilities) pay for “hospital services”. We need some structural change on funding to make a properly planned community service happen – and in the context of the huge cuts many LAs have had and are having, it’s a nonsense to expect them to pay for what should be funded by health – but commissioned with experience and understanding of what works. We do have experience in the community but there needs some reinvestment which will save money in the end. For goodness sake don’t start building yet more buildings – get the expertise in to help develop a properly thought out plan – not one regurgitating the same old building-based solutions. How could you develop a plan without looking at history, understanding where the expertise lies? And with respect it’s not in the top CEOs of large nationals. You should start with the families and people with learning disabilities who know and have the experience to help, and maybe see if you can talk with people who did it into ordinary housing (not models but a range of provision that changes with changing needs) and who have worked for years with people who challenge and have been through institutional abuses and experiences. As a starting place to a plan why not look at the model suggested by the CaFS released yesterday on their website – it’s informed by some providers who know but also closely drawing on service users and carers http://www.campaignforafairsociety.com/2014/07/call-to-action-on-winterbourne-3000-people-rising/ But please please don’t go off on another institutional route – show that you can listen and start differently and don’t allow a shuffling of the cards so we see a prolonged building and rise of yet more institutions.
They are not the answer
Rosemary Trustam – Community Living magazine
PS – I wonder how the NHS and ACEVO CEOs working together will ensure joined up local services with LAs? I wonder what they think about being left out too? It makes little sense when the structural problem is the NHS only thinking in terms of medical models and building-based services. People have got to stop being partisan and gather round the individuals and families, but also government has to look at how they can help this to join up. The situation is wasting people’s lives and damaging them. It is urgent to do this properly.
original story cited from http://rosemarytrustam.wordpress.com/
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