CYP(3)-AS-06

Call for Evidence into Advocacy Services for Children and Young People

January 2008

Question 1

There seems to be widespread consensus that advocacy services should be independent. How do you think advocacy services should be commissioned to ensure a level of independence that gives children and young people confidence and builds trust in the system at the same time as providing services which are flexible and responsive?

A commissioned service should be a "one stop shop” so that advocacy services could be provided to any agency, by having one service it prevents confusion for children and young people and also professionals when seeking advocacy for them. One service also ensures that the advocacy provided is to a high standard, consistent and should be subject to audit and inspection. The Commissioner’s Office is an example of how to work with children to build their confidence and trust in a service and could be used as a template for an advocacy service.

Question 2

The Welsh Assembly Government has consulted on a New Service Model for Delivering Advocacy Services for Children and Young People

(i) Did you respond to the consultation?

Yes

(ii) Are you prepared to share your response with the committee?

Yes same attached

Response on Consultation on a New Service Model for Delivering Advocacy Services for Children and Young People

Name

Organisation Bro Morgannwg NHS Trust

Email/Tel Number

Address

Trust HQ
Quarella Road
Bridgend
CF31 1YE

Response on Consultation on a New Service Model for Delivering Advocacy Services for Children and Young People

Question No.-.General

General Are the areas covered by the draft Consultation on a new Service Model comprehensive and pertinent

General.Should any part of the Draft document be changed and, if so, how?

General.Are the key actions proposed appropriate and relevant? Are there other key actions that could be included?

.General.Do you have any practice examples

The above questions have been answered as a whole and not individually.

Advocacy is more than complaints and although this is mentioned the other components of advocacy are not explored as much as they could be.

Advocacy is an integral part of safeguarding children, there is no mention in the document of the Local Safeguarding Children Boards who should be consulted by partnerships on issues how children are safeguarded and have their welfare promoted. The partners for commissioning may also be members of Local Safeguarding Children Boards.

Background and Rationale for Change

Q1.Have we accurately summarised all the key national drivers for change and their findings or conclusions?

Q.2 Are there any that we should add or give more weight?

Q3.Do you agree with our vision and overall aims for advocacy services for children and young people in Wales?

Q4.Should the key aspects be strengthened or amended in any way?

Q5.Do these arrangements meet the requirements for accessibility and independence?

The key national drivers have been accurately summarised, however an omission is the NSF for children young people and maternity services which devotes a section to the participation of children young people and their families, agencies are currently action planning against this document.

The vision is admirable but a preferable option would be a totally independent service commissioned by WAG.

A one stop shop is recommended to prevent having complaints being dissected and each agency addressing its own area.

The document suggests children and young people will need to be Gillick competent to access advocacy, who would be assessing this? Children and young people should be assisted regardless of age and competency as in the case of children and young people with learning disabilities.

The New Service Model

Q6.-.Do you agree with the proposed staged approach to collaborative commissioning and have we correctly identified the areas which require priority attention within the new service model?

Q&.-.Do you agree with the principle of moving towards a more integrated model of provision?

Q8.-.In what circumstances do you consider advocacy services should be available to schools?

Q9.-.How can we define a serious complaint and in what circumstances do you feel advocacy support would be important?

Q10.-.Are there other groups of children and young people that should be included in service model 2?

The above questions are not answered individually

A staged approach appears to be the most suitable way to progress the new model however there are similarities in the categories of the 2 models so this requires further definition. As above advocacy should available to all children and young people whether they want to make a formal complaint or not as early access may solve the problem. Children and young people in the transition period between 16 and 18 years of age, who are children under the Children Act, but treated as adults if not in full time school, regardless of their competence, should be regarded as a separate category in the model.

The above point is very relevant to this age group that are admitted to adult acute mental health units. There is a significant risk that these young people will be missed so we need to be considered how their needs will be met.

A Framework to Implement the New Service Model

Q11.-.Is the proposal for collaborative commissioning across local areas the most realistic and beat way forward to achieve improved access to, independence and quality of advocacy services to children and young people?

Q12.-.How might collaborative partnerships be defined across Wales? Are there any existing partnerships relevant to your area and /or to advocacy services that could be used or further developed for this purpose?

Q13.-.What other influences on commissioning or commissioning drivers relevant to children and young people’s services do we need to make to take into account?

Q14.-.How might the lead Children and Young Peoples Partnership for collaborative commissioning be selected?

Q15.-.What are the barriers to establishing a lead CYPP and lead commissioner for advocacy services and how might this be overcome?

Q16.-.Which structural model do you prefer and why?

Q17.-.Are there any other models that you think we should also consider and what are the key characteristics?

Q18.-.Are the roles and responsibilities of key commissioning partners sufficiently clear and robust?

Q19.-.Are the commissioning principles sufficiently clear and robust?

Q20.-.Are the proposals for governance and performance management sufficiently robust? Are there any that we have missed?

Collaborative commissioning would be beneficial in some areas for example where Trusts cover more than 1 local authority, however the logistics in achieving the suggestion of reducing commissioning to 3 or 7 areas appears would be almost impossible. As the different partnerships and LHB’s all work differently. The lead would need to be for discussion when the collaborative partnerships are developed, This may be difficult to select due to the workload of the leads of the different agencies and may even be seen as a separate role if the partnerships covered a number of areas. The lead would need to be committed and dynamic.

At present the CYPP does not have the infrastructure to commission and would likely use the local authority commissioning department which may have implications for the independence of the commissioning.

The favoured model would be model 2 as this allows all commissioning partnerships to be involved and take ownership for the service.

The suggested role and responsibilities are clear.

Could WAG examine the existing advocacy services that are in place (South Wales Advocacy for adult mental health service) and considering developing these services to encompass children service with appropriate training and funding. As these services are established and cover all trust boundaries across South Wales it would make sense to consider these.

The service model of allowing each area to commission its own service could lead to a lack of standardisation and variation in the service that children may receive in each area. It may be more appropriate to commission one service to cover all areas.

Role of Children’s Advocacy Unit

Q21.-.Do you agree that we have identified the support and development needs to ensure the delivery of the service model proposed?

Q22.-.What additional forms of support might be necessary?

Q23.-.Are the timescales for implementation of commissioning service achievable? Are there any constraints?

Q24.-.What will the impact and cost implications on your business in introducing the new model?

Q25.-.Do you consider we should set up an advocacy unit as suggested above?

Q26.-.Would it be advantageous to set up a board i.e. to monitor progress and advise assembly Government Ministers?

Q27.-.What do you feel would be the minimum representation members in terms of the ship on C&YP Advocacy Advisory Board?

Support and development needs if WAG currently holds any national data then this needs to be shared with the commissioning partnerships to provide a baseline, prevent duplication of work.

The timescale of 2008 could be Jan 2008 or Dec 2008 12 months difference this needs to be clarified, Jan 2008 is too soon.

Following agency assessment against the NSF only then will the resource implications for individual agencies be identified. As agencies will need to introduce advocacy in its broadest sense in order to be effective.

A reporting mechanism to WAG is essential and could consist of all the leads meeting as a board with WAG representation to identify good practice and themes of issues and complaints.

Workforce

Q28.-.Should advocacy services/providers be regulated?

Q29.-.Should advocates be a recognised profession?

Q30.-.What are the implications to your service in requiring registration and regulation of advocacy providers?

Advocacy services should be regulated in order to ensure consistency and allow for inspections.

Advocate should hold a professional qualification whether from the background of health local authority or police and agreed nationally, and in the future this may be a qualification in itself.

All staff within health are monitored in terms of professional registration.

Consideration will also need to be given to audit the work of the service provided to ensure that we are meeting the needs of the children and the services that they access.