The Big Diversion Project North East

 

                           

The NEOHCU launched the Big Diversion Project on the 9^th November 2010.  The Big Diversion Project (BDP) is the north east's response to Governmental documents such as The Bradley Report (Bradley, 2009) and Improving Health Supporting Justice (DH, 2010), which coupled with more recent publications such as No Health Without Mental Health (DH, 2011) and Breaking the Cycle (MOJ, 2010) all describe better health outcomes for offenders through a multi-agency focus across the whole of the criminal justice pathway supporting key government initiatives around reducing health inequalities, reducing offending, health improvement and protecting the public. The launch event represented the first of a series of events that will continue to bring together the expertise needed to build on the momentum gathered since the project's inception.  

The BDP relates to the whole criminal justice pathway from pre-arrest to arrest to charge right through to courts, sentencing and finally community or custody disposal and adds a new objective to the North East Offender Health Commissioning Units remit:

• to improve the health and social functioning of adult offenders and reduce re-offending and its severity in the North East region by offering timely and appropriate interventions to meet their needs through effective Liaison and Diversion services.

In translating this vision into action the Big Diversion Project has been formulated as 3 distinct phases (Figure 1).

Figure 1 - The 3 Phases of the BDP

 

Phase 1: Initiation and Scoping

  This included:

1.    The launch Event  - 09 November 2010, Durham Centre, Belmont

Itinerary of the day: 

• Launch of the north east offender health diversion project - 12-Nov-2010 - 358K

Presentations:

• The Mental Health Trust Perspective - Martin Barkley, Chief Executive, Tees, Esk and Wear Valleys NHS Foundation Trust
• The Policing Perspective - Michael Barton, Deputy Chief Constable, Durham Constabulary
• Crown Prosecution Service Perspective - Kerry Bell, District Court Prosecutor
• HM Courts Perspective - Judge Bowers, North East Circuit Judge
• The Prison Perspective - Patrick Fox, Governor, HMP Castington
• Probation Trust Perspective - Dave Gardiner, Deputy Chief Executive, Northumbria Probation Trust

Presentation slides - 12-Nov-2010 - 365K

• Warrington Criminal Justice Liaison Team - Rebecca Norman

• warrington - 12-Nov-2010 - 1690K

• Developing Integrated Services in Manchester - Matt Paterson

• DEVELOPING INTEGRATED SERVICES IN MANCHESTER - 12-Nov-2010 - 271K

Notes from the day:

• Notes from the Big Project Conference - 09 Nov 2010 - 13-Dec-2010 - 55K

 

2. A literature review - carried out by Wendy Dyer an academic at Northumbria University which looked at best practise developments post the Bradley Report

Report 1 - Review of Health Care Delivery in Police Stations, North East Region

Report 2 - Review of Criminal justice and Liaison service, North East Region

Report 3 - Criminal Justice Diversion and Services, Post-Bradley Updates on 'Best Practice' Developments

3. Initial consultation with key stakeholders (e.g. police, probation, the courts) in order to understand the current state, future aspirations and what would be needed to achieve these and any barriers to development.

4. During this phase the NEOHCU supported by the North East Procurement Service (NEPS) began the process of taking a restricted procurement procedure to procure a project provider to complete phase 2: the development phase.

A Stakeholder Event was held on Friday 6 May 2011, 10am - 12pm at The Durham Centre, Belmont Industrial Estate, Durham, DH1 1TN.  This event provided an opportunity for prospective providers to hear about the intended service model, the procurement process, the key milestones for the procurement and to ask any questions.  Providers also had the opportunity to network with other providers in order to enable discussion around potential collaborative tender submissions.

Resources from the Stakeholder Event held on 6 May 2011:

The Big Diversion Project, Project Briefing

The Big Diversion Project Stakeholder Event Presentation

The Big Diversion Projct Stakeholder Delegate List

The Big Diversion Project Stakeholder Event Question & Answers

This phase has now been completed. **Please note any references to the Big Diversion Project north east (BDP) and the tender process have been subject to change and revision since the above referenced materials creation**.

 

 

Phase 2: The Development Phase

Following completion of the restricted procurement process initiated in phase 1, the contract for phase 2: the development phase of the Big Diversion Project has been awarded to Northumberland Tyne and Wear NHS Foundation Trust (NTW) in partnership with Tees, Esk and Wear Valley NHS Foundation Trust (TEWV) and Revolving Doors Agency (RDA).

A stakeholder engagement event was held on 21 October 2011. The aims of the event were as follows:

• inform diversion stakeholders of the programme of Phase 2
• inform diversion stakeholders of the latest national Department of Health policy context of the BDP (and the region's pathfinder projects)
• engage the research and development community with the need for continuing re-search to inform the future development of diversion and liaison

Please see below the supporting materials from the event held on 21 October 2011:

BDP The Development Phase Flyer

BDP The Development Phase Evaluation Form

Liaison and Diversion, The National Approach, Richard Bradshaw Presentation

Catherine Hennesey Presentation

Maria Leonard Presentation

Mark Bradley Presentation

Andrew Gray Summary 

Please see below for the service specification for Phase 2:

Service Specification

Phase 2: the development phase is expected to provide commissioners with an instrument for self assessment and a toolkit to address any identified shortfalls in provision and increase the correlation between identified need and service provision for offenders.  Essentially commissioners require NTW TEWV & RDA to inform on the current state and what the future state should be, and the process for moving to the future state.

This will include the development of service specifications for diversion and liaison services that demonstrate value for money and the potential for service provision which is firmly grounded in reality and achievable within the available resources of the current economic environment. This will ensure the future commissioning of interventions that are strategic, effective, joined up and able to make the best use of available resources.

We are now in month 3 of Stage 1 the 6 month analysis which is being led by the Revolving Doors Agency on behalf of the consortium. The purpose of this analysis is to gain a comprehensive picture across the north east:

• Existing service provision
• Demand for service provision
• Cost benefit analyses of provision in specific settings (police station/court etc)
• Potential opportunities for future developments

To achieve this RDA are currently undertaking:

• Desk based literature reviews
• 1:1 interviews with key stakeholders
• Focus groups
• Financial modelling
• Service user engagement
• And are planning of stakeholder events in February to begin to disseminate their initial findings

We are currently managing RDA on a project plan to achieve those tasks and the outcome of this stage 1 6 month analysis will be an options appraisal due in April recommending a series of development projects to be taken forward into stage 2 service development.

 

Big Diversion Project, Current State Analysis of Diversion Services in the North East Region Final Report

Final Report - Revolving Doors Agency

Big Diversion Project Next Steps 

 

The Big Diversion Project Advisory Group

The NEOHCU is designated PCT lead for all north east diversion and liaison work. In light of this, the NEOHCU has formed the Big Diversion project advisory (BDP AG) group which brings together key representatives from agencies working across the criminal justice system in the north east. The BDP AG is collectively responsible to the north east offender health commissioning board/equivalent boards of advisory group members for advising on the Big Diversion Project, overseeing the north east's work as part of the national diversion programme and police early adopter programme and all associated implementation, resource and communications issues.

The advisory group provides a vehicle for its members to:

• Provide expert opinion and advice on all matters related to the diversion of offenders with mental ill health/learning disability/dual diagnosis needs
• Advise on the best ways to communicate with key stakeholders; and
• Act as a conduit to networks and connections across the health service, local authority and criminal justice system.

This established forum is evidence of the commitment, interest and strategic buy-in from all relevant partners involved in the commissioning, planning and delivery of criminal justice and associated offender health services within the north east region.

BDP AG Terms of reference and a list of Member Organisations:

BDP Terms of reference

BDP Member Organisations 

All agendas and minutes from the BDP AG will be uploaded to this page and accessed below:

09 September 2011:

Agenda: BDP Steering Group Agenda - 09 September 2011

Minutes: BDP Notes - 09 September 2011

10 June 2011:

Agenda: BDP Steering Group Agenda - 10 June 2011

Minutes: BDP Notes - 10 June 2011

11 February 2011:

Agenda: BDP Steering Group Agenda - 11 February 2011

Minutes: BDP Notes - 11 February 2011

 

The National Diversion Programme

Criminal justice mental health diversion liaison services can be effective in facilitating the transition across the interface of the criminal justice system and mental health and social care sector.  

The national diversion programme has been established following the Government's commitment in the 2010 Spending Review to make liaison and diversion services available on a national basis by 2014, and will work over the coming period to understand and evaluate the best model for commissioning these services and implementing them across the country in the future.

As part of this, the Liaison and Diversion Development Network has been formed to bring together the elements of the liaison and diversion programme of work, with the overall objective of informing full implementation of diversion services across the country, pending ministerial approval. The membership of the network has been drawn from the most advanced 54 adult diversion schemes in the country, alongside the first tranche of Youth Justice Liaison and Diversion sites and police transfer early adopter sites. Of the 54 adult schemes, 27 form 20 evaluation pathfinders' sites who will take part in a research study for adult offenders to develop the financial and social business case for implementing diversion services, and alongside the remaining schemes take forward the best of local learning and pilot options for making these schemes available on a national basis by 2014.

The following north east services had been successful in receiving invitations to join the network:

This network is tasked with establishing the economic case for roll out of liaison and diversion services and to help understand and evaluate the best model for commissioning these services in the future.

There are a number of specific projects that will be taken forward by identified cohorts of development network members.

1.    Evaluation 

Working with a selected cohort of 20 Evaluation Pathfinders from the network, this project will collect data and information to inform the development of a business case and impact assessment for DH/MOJ/HO Ministers on the financial, health and reducing re-offending impact of liaison and diversion services. This will inform a ministerial decision regarding wider roll-out, by January 2013. The Evaluation Study will also track individuals for a further 2 year period to provide information on longer-term outcomes. The following north east services are evaluation pathfinders:

2.    Development

Working with a selected cohort of Development Pathfinders this project will test different models of commissioning and provision for diversion services, including developing capacity of health treatment services (including primary care) to meet the needs of those diverted and looking at possible alternative forms of treatment-based accommodation for mentally ill and drug dependent offenders. Data from these pathfinder sites will also be collected and analysed alongside the evaluation study.

In September 2011, the Department of Health invited all network members to bid for funding to become development pathfinders. The following service proposals put forward by network members from the north east have been successful in obtaining development pathfinder status: 

A North Sector Liaison and Diversion workshop was held by Offender Health, Department of Health on 24^th February 2012.  This workshop was arranged to share programme developments in regards to the National Diversion programme following the Minister for Care Service's announcement of £19.4m funding for the second year of the liaison and diversion development.

The following was shared at the network:

• Pending approval of the business case, the level of investment is expected to rise over the next two years of the programme.
• £6,266,589 has been committed nationally for 51 development projects during 2012/13. £2,117,546 for 19 North sector projects. Offender Health (DH) hope to offer a further targeted opportunity to bid for development funds in Autumn 2012.
• Offender Health (DH) are exploring options to work towards an all age service, the entrance point to which will be contact with the police under suspicion of committing a crime. The service will aim to support offenders of all types and at all levels and cover a wide range of health issues and vulnerabilities relevant to all ages. Consequently, the youth and adult liaison and diversion work streams are being more closely aligned and a single business case will be developed to support implementation of liaison and diversion services for all ages.
• Liaison and diversion services will be commissioned using the police foot print.
• Commissioning liaison and diversion services for each police force area will be co-ordinated by an identified lead commissioner. From April 2013 (subject to the passage of the Health and Social Care Bill) the NHS Commissioning Board will have responsibility for commissioning services. Funding will be provided directly to lead commissioners who will have the ability to determine local levels and configurations of services.
• Offender Health (DH) will be working with Offender Health Leads and SHA Children's Leads to identify new sites in 2012.
• Offender Health (DH) are in the process of appointing a contractor to run and develop the liaison and diversion network. The contractor is expected to be in place by April 2012.

          This contractor will be responsible for:

• Running and developing the network, providing support and advice to members
• Advising and supporting Offender Health Leads in the preparation of regional development plans to implement liaison and diversion services
• Producing a suite of good practise guidance and documents to support commissioners and providers in the implementation of liaison and diversion services
• To manage liaison and diversion development activity and alternatives activity to ensure that activity is undertaken in accordance with their respective delivery plans

Key milestones for the National Diversion Programme are as follows:

February 2012	Business case contractor in place
March 2012	Data collection in place for all sites
March 2012	Publication of youth justice evaluation
April 2012	Network management contractor in place
April 2012	Development/alternatives work starts
March 2013	Business case completed and ministerial decision on roll out
April 2013	Commence roll out
April 2014	Commissioners in receipt of full funding allocation
April 2015	Programme completed

The NEOHCU are also sponsoring the pilot of a diversion and liaison service into Newcastle Crown Court building on the successful Old bailey pilot at the central criminal court in London.

Please follow the following link to find the membership of National Liaison and Diversion Development Network June 2011:

http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_127796.pdf

The NHS Trusts currently providing these diversion services within the north east (NTW and TEWV), have also been awarded the contract for the big diversion project. All service developments made through the national diversion programme will also be aligned to and supported by the Big Diversion Project. The north east's input into the national development network will support the objectives set out within the Big Diversion Project and visa versa. Such a co-ordinated and aligned regional approach will be mutually beneficial both in terms of capacity building and in enhancing the impact of this work by making the best use of available resources, avoiding duplication of effort and conflict of direction within the region.

 

Police Early Adopter Programme

A further work stream of the national diversion programme is the transfer of commissioning and budgetary responsibility of police detainee healthcare to the NHS. In March 2011, Home Office and Department of Health Ministers agreed to establish a voluntary framework to enable Police Authorities to opt into local commissioning partnerships with the NHS.

The transfer of the commissioning of health provision in custody to the NHS will have the following benefits:

• Supports the delivery of other national strategies, including support vulnerable groups reducing health inequalities, promoting positive mental health and well-being.
• Innovation in terms of new service models, new skill mixes and technologies.
• The development of improved care pathways for detainees in need of immediate access to Accident and Emergency (A and E).
• Improved integration with community services
• Improved engagement with health colleagues to signpost and manage the healthcare of offenders upon their return to the community to reduce their re-offending.
• A reduction in re-offending based upon better engagement with health services particularly around drug alcohol and mental health provision.
• Improved quality of service delivery e.g. through the incorporation of NHS expectations in this service
• Increased efficiency resulting from more streamlined processes

The NEOHCU are currently working with Northumbria Police, who are one of 10 police force early adopters nationally, on the shadow transfer of the commissioning of their detainee healthcare to the NEOHCU as the lead NHS Commissioner. The shadow transfer period, which will commence 25^th October 2011 until April 2014 has been established to enable the commissioner and police to assess the environment, undertake due diligence and establish working relationships before the NEOHCU takes over the commissioning and budgetary responsibility in 2014.

It is proposed that the process over the two year shadow transfer period will include:

• Setting up a local Partnership Board, agreeing terms of reference and setting up a partnership agreement (currently being drafted).
• NEOHCU and Northumbria police to undertake a needs assessment of the local offender population through police custody suites.
• Setting up clinical governance framework, plans and clinical protocols for the service.
• Review existing healthcare provider against clinical and forensic standards.
• Review healthcare processes within the police custody suite
• To ascertain the optimal provider model with options appraisal of potential solutions.
• Financial review of existing contract
• Agree financial and contractual arrangements of a proposed transfer.
• Set up performance monitoring arrangements to collect and measure health outcomes.
• Recommendations to delivery of optimal service model as a statement of readiness

Although the police will retain legal responsibility throughout the transfer shadow period, the scope of the shadow transfer and associated finances will be managed through the partnership board under a signed memorandum of understanding in a true partnership approach.

The output from this process will be a joint police/NHS statement of readiness to transfer locally, where upon the NEOHCU would take on the responsibility for healthcare commissioning.

 

Further Information 

Please see below quick reference guides to:

• Current and future commissioning of offender health in the north east
• Police early adopters
• Diversion and liaison in the north east

Quick Reference Guide Document  

These printable quick reference guides can be used to communicate key messages to those who want to get an overview of the different work streams/projects in relation to diversion and police custody currently underway in the North East.

For further information on the Big Project, please contact us using the details below:

The Big Project North East mailbox: cd-pct.thebigprojectne@nhs.net

The NEOHCU website: /access-to-services/offender-health/improving-health-supporting-justice,-the-big-project-north-east