The London and South East CYP-IAPT Learning Collaborative, Executive & Programme Boards, & Implementation Networks Terms of reference and collaborative structures Version 1.6 Updated 19 th Dec 2016 1
Contents Background 3 Section 1 Goals of the collaborative Core principles Vision and Values 5 6 7 Section 2 Collaborative Partnership Members 8 Section 3 What will the new structures look like? The Collaborative Programme Board The Collaborative Executive The Collaborative Implementation Groups The Shadow Board Local Partnership Structures 11 25 Appendix 1 Executive Group Expression of Interest form 26 2
Background Children and Young People s Improving Access to Psychological Therapies (CYP- IAPT) is an initiative supported by Health Education England (HEE) and NHS England (NHSE) to improve quality of Children and Young People s Mental Health Services through a range of interventions including: the introduction of better evidence based practice, authentic service user participation and the rigorous outcomes monitoring. Central funding from HEE and NHSE for the programme is agreed until at least the end of 2018. Nationally the programme includes services that reach 80% of children and young people 0-19 years of age. There is a Department of Health commitment to extend the programme to achieve a 100% reach by 2018 and there is further commitment and funding through Future in Mind, and Five Year Forward View for mental health to achieve this.. CYP IAPT is a core component of the transformation of children and young people s mental health services through Local Transformation Plans, and is one of the 57 indicators in the CCG Improvement and Assessment Framework. (Indicator 123c Children and young people s mental health services transformation) CYP IAPT is also one of the deliverables in the Planning Guidance 16-17 - 20-21, which defines the Sustainability and Transformation Plans, into which the Local Transformation Plans are being subsumed. The London and South East CYP-IAPT Learning Collaborative (called the Collaborative for the remainder of the document) is a collaborative venture between Children and Young Peoples Mental Health (CYPMH) provider partnerships across: Local Authority, Voluntary Sector and, NHS Child and Adolescent Mental Health Services (CAMHS), along with University College London, Kings College London, Tavistock & Portman NHS Foundation Trust, and the Anna Freud National Centre for Children and Families. The Collaborative works with partnerships from across London, Eastern and, South East, Regions of England. These regions are coterminus with the geographies of the three Clinical Networks (Healthy London Partnership, East of England, and South East of England), with which the collaborative works closely. There are currently 31 partnership members of the collaborative; the majority of partnerships are made up of more than one provider organisation; currently the Collaborative has 31 NHS Child and Adolescent mental Health Services (CAMHS), across 16 NHS Trusts, 25 Local Authorities, 23 organisations from the Voluntary Sector, and 5 Clinical Commissioning Groups (CCGs). By 2017 there will be 36 partnerships. The Collaborative has had substantial impact providing the resources and structures to facilitate quality improvement and best practice across partnerships. However, 3
given the limited time central funding to sustain the Collaborative, this period up until the end of 2018 will require consolidation of existing activities and assets, alongside the development of business planning that will enable the work of the Collaborative to continue in the most effective way. The options include the Collaboratives transformative mechanisms being transposed into existing partner organisations, or remaining an initiative hosted by the Anna Freud National Centre for Children & Families, which delivers support to services at a cost. These decisions will be influenced heavily by the needs and feedback of the existing partnerships, and the various partner organisations. This Document During the last few months of 2014, the collaborative partnerships were invited to express their views on proposed structures for the collaborative. At that time this document captured the proposed new collaborative governance structures taking into account the views of partnerships and wider stakeholders. Between January 2015 and early 2016 it codified the interim collaborative structures to be maintained whilst the future funding for the CYP IAPT programme was confirmed. Now that funding has been confirmed up until the end of 2018, this document will clarify what the Collaboratives functions are up until that time, and what plans and intentions there are for its life beyond that time. 4
Section 1 Goals of the Collaborative The overarching goal of the collaborative is: To - Facilitate continuous quality improvement in children and young people s mental health and well-being provision, across London & the South East of England. Through - The application of CYP IAPT quality improvement principles and to support the implementation of Future in Mind (FiM) and the Five Year Foreword View (FYFV) for Mental Health By various means including - Facilitating close collaboration between partners including NHSE, HEE, Clinical Networks, commissioners, providers, other stakeholders Developing relationships with key strategic organisations that will embed CYP IAPT transformation principles into business as usual Deepening the penetration of CAMHS transformation through CYP IAPT in partnership areas, through the addition of new partner services to existing partnerships, and the continued training of staff Facilitating the sharing of learning and best practice between partnerships Expanding the scope of CAMHS Transformation locally to ensure new opportunities for innovation, e.g. digital, are harnessed. The offer of training, consultation and expertise in quality improvement Developing new training and aligning existing training closely with the needs in services, and with continuous quality improvement in partnerships Encouraging and supporting research and the development of evidencebased practice and practice-based evidence Lobby for, identify and securing funding to support the collaborative goals Lobbying to build capacity across services 5
Liaison and influence of key local and national stakeholders Influencing local and national policy to support quality improvement across CYPMH services Support the implementation of policy that improves quality across CYPMH services Monitor and support partnerships in the delivery of CYP-IAPT principles and practices Core Principles The core principles of CYP-IAPT are presented below in Fig. 1.0; they are to provide services that: Value and facilitate authentic participation of young people, parents, carers and communities at all levels of the service Provide evidence-based practice and are flexible and adaptive to changes in evidence Are committed to raising awareness of mental health issues in children and young people, and are active in decreasing stigma around mental ill-health Demonstrate that they are accountable by adopting the rigorous monitoring of the clinical outcomes of the service, and Actively work to improve access and engagement with services These principles are co-dependent and are applied within a culture of collaboration and shared decision-making. 6
Fig. 1.0 The Core Principles of CYP-IAPT Participation Evidence -based Awareness Accountable Accessible Vision and Values The collaborative vision is to improve services for the benefit of Children and Young People - the overarching values behind any collaborative decision must be guided by the core value: In what way does this change benefit children and young people with mental health problems? The comprehensive vision and values of the collaborative are set out in the document: Delivering With, Delivering Well (see appendix 1.) 7
Section 2. Collaborative Partnership Members Who can join the collaborative? As the programme has a KPI to achieve 100% geographical coverage of the country by 2018, it is necessary to both broaden the reach of the Collaborative into areas not yet covered, and deepen reach in existing areas by expanding partnerships to include other services. The process through which this happens has been almost entirely delegated to the local collaboratives by NHSE. Much of the programme has transferred to HEE, which has the final decision on new partnerships, made on the basis of the Collaboratives recommendations, and completed self-assessment and CEO signed-off commitment to transformation. It is also now possible for partnerships to move between Collaboratives, if they wish, and with agreement between the releasing and receiving Collaborative. Responsibility of the partnership members Partnership members commit to the implementation of CYP-IAPT principles across the organisations. At the point of joining the collaborative Partnerships undertook to: Ensure access and waiting times to treatment do not deteriorate during the training period as a result of this project Ensure that the transformation takes account of the cultural needs of the community they support Commit to all Tier 3 CAMHS, and Tier 2 CAMHS who are part of the project, undertaking session by session/frequent outcome monitoring using the CYP IAPT dataset - now a component of the Mental Health Services Data Set (MHSDS) managed by NHS Digital (formally HSCIC) which is used to guide therapeutic interventions and supervision Move to accept self referrals Create a local steering group to steer the project locally to include health and local authority commissioners, NHS and voluntary sector providers 8
Support new partnerships working with their collaboratives as they come on line in future years Work with the HEIs to select appropriately skilled trainees and supervisors Ensure that trainees, supervisors and service managers selected to undergo the training can attend training and can undertake the assignments necessary to pass the training Ensure that the infrastructure and data systems are sufficiently robust to allow data collection of the IAPT data set and ensure data is sent as required Agree that data sent to the programme office becomes the property of the Children and Young People's IAPT Programme Performance Management of the Partnerships The performance management roles of the collaborative and full performance indicators are set out in the document Local Management of the CYP IAPT Programme by Local Collaboratives (see appendix 2.) Benefits to Partnership members Member Partnerships will have access to a range of benefits to help them implement CYP IAPT these could include: training to therapists, supervisors, and leaders and mangers, and teams consultation and guidance, including direct work using a range of Quality Improvement approaches. participation in conferences, workshops and other collaborative events intensive consultation and front line service input (dependant on need and demonstrated commitment to the programme) access to publications including: implementation guidance, and newsletters the opportunity to join and contribute to Collaborative Implementation Groups 9
membership on the Programme Board opportunity to put a candidate forward for election to the Collaborative Executive to inform and influence policy and wider CYPMH strategy locally and nationally be informed of key policy, strategy and other developments, form local and national stakeholders Access to competition-relevant information 10
Section 3 What the CYP IAPT structures look like National Structures 11
London and South East Structures 1. Strategy and planning group 2. The Collaborative Programme Board 3. The Collaborative Executive 4. Course Leadership Team (CLT) 5. The Collaborative Implementation Groups 6. Shadow Board 12
1. Strategy and planning group Function To provide strategic leadership to the Collaborative To attend and represent the Collaborative at the the Collaborative of Collaborative National Meeting To organise agenda for CLT and identify key issues for consideration by the CLT. To liaise with Health Education England around all aspects of commissioning of training Membership Joint Administrative coordinators Clinical Lead for Collaborative Programme Lead for Collaborative Joint leads from two universities (UCL and KCL) Structure To meet monthly prior to the CLT for one hour. To liaise between members about strategic issues by email. 13
2. The Collaborative Programme Board What is the Collaborative Programme Board? The Collaborative Programme Board oversees and steers the work and progress of the collaborative, and provides expert advice, information and comment. The role of the Programme Board is to: Oversee and support the work of the collaborative Monitor progress of the collaborative and its partnership members, including monitoring the risk register for partnership progress and initiating relevant responses. Provides expert advice and comment on the strategic direction of the collaborative Offer expert advice and information to the executive on the needs of the collaborative partners to implement CYP-IAPT Offer information and expert advice on the focus of the Implementation Groups Oversee and approve proposals for Partnership funding, e.g. Service Transformation Acceleration fund allocation Advise executive on allocation of training places. Oversee the work of the Implementation Groups To offer recommendations and advice on the training needs of the collaborative Provide advice and comment to the Collaborative Executive Oversee the work of the Collaborative Implementation Group Provide advice and information to NHS England, Health Education England, Clinical Networks, and other stakeholders as appropriate Elect members to the Collaborative Executive Contribute to a collaborative training needs analysis to feed into the LETBs 14
Who does it report to? The Programme Board reports to HEE/NHS England CYP IAPT Central Programme Team and the Collaborative Exec How often will it meet? The Programme Board will meet for half a day, four times a year (with the option of extraordinary meetings to be called by the chair as required) meeting dates for the year will be supplied by the project lead no later then the last meeting of the calendar year Who will make up the Collaborative Programme Board? The Programme Board will be made up of: Independent chair Partnership Member representatives (31 in total) this includes the provider lead and local commissioner Young people and parent rep (from the shadow board) Clinical Lead Programme manager Project Officer HEI reps Quorum The board will be deemed quorate for decisions that require a vote if 9 or more partnerships are represented 15
Partnership Member Representatives on the Programme Board The Programme Board will be made up of the provider lead AND the local commissioner from each of the existing partnerships in the collaborative. Individual partnerships will decide whom they put forward to this group but the representative must have authority from the partnerships to make decisions and representations on the behalf of the partnership. It is assumed that the representative will be the existing partnership lead and commissioner unless otherwise stated. Leads can send proxies to the meeting on their behalf. Proxies can represent more than one partnership at a meeting and have votes for all partnerships they represent. (i.e. if a person is representing three partnerships they get three votes) Should a person leave their organisation, it becomes that partnerships responsibility to find a replacement to sit on the Programme Board. Co-opted members At the invitation of the Chair, observers and individuals with specific expertise may be co-opted onto the Programme Board or invited to attend all or part of the meetings. The responsibilities of all members of the Programme Board To attend (or send proxies to) a minimum of 3 of the 4 meetings held each year. To promote the work of the Collaborative positively and appropriately in public forums. To agree to the goals, vision and values of Collaborative. To report to local steering groups about issues discussed at the Programme Board meetings and to report to the Programme Board issues raised at local steering group meetings as appropriate. 16
Regional Programme Boards Regional programme boards that provide a similar function to the full programme board will be considered and supported as long as they are fully supported by local Clinical Networks, commissioners and local partnerships, maintain links with the whole Collaborative, and can be seen to better support the local implementation of CYP IAPT. Agreement to set up Regional programme boards will be granted by the Collaborative Exec 17
3. The Collaborative Executive What is the Collaborative Executive? The Collaborative Executive is responsible for delivering the work of the collaborative. Its key functions are: To make recommendations on the strategic direction of the collaborative for the Programme Board to make comment and offer expert advice To develop a business model for the continuation of the collaborative and its aims for the Programme Board to make comment and offer expert advice To develop a five year strategic plan to ensure the continuation of the collaborative and the implementation of its aims beyond the life of the CYP IAPT programme To liaise and advise with key policy makers and stakeholders on behalf of the collaborative to benefit the collaborative aims To oversee the work of the paid officers of the collaborative particularly the clinical lead and programme/project lead for the collaborative To oversee and make recommendations on the best use of the support officer roles within the collaborative Oversee the work of the HEIs in delivering training Oversee the Collaborative budget Produce reports to relevant stakeholders, e.g. HEE and NHSE in respect of training commission, NHSE in respect of transformation funding and partnership performance. Consider and where appropriate agree the set-up of regional programme boards Who does it Report to? The Executive reports to NHS England and the Collaborative Programme Board. 18
Who will make up the Collaborative Executive? The Collaborative Executive is made up of: The Collaborative Clinical Lead (chair) Young Person co-chair (from the Young Advisors, or shadow board) The Programme/Project Lead The HEI Lead for UCL and Kings College London Three elected partnership members: o One representative from each of the stakeholder groups: Voluntary sector Local Authority NHS CAMHS Commissioning representatives Health Local Authority Clinical Network reps Co-opted members Young Person Representative (from the Young Advisors, or shadow board) Parent Carer Representative (from the shadow board) How often will it meet? The Executive will meet for 2.5 hours bi-monthly meeting dates for the year will be supplied by the chair no later than the last meeting of the calendar year. 19
Partnership Member Representatives on the Executive There are places for three Partnership members on the Executive each post representing the three main sectors of the collaborative: Voluntary Sector, Local Authority and, NHS CAMHS providers. Candidates should put themselves forward for election in writing stating which sector they wish to represent and why. (See appendix 1. for expression of interest form.) Candidates are automatically elected if they are the only one from their sector. If there is more than one candidate for a sector, the respective Expression of Interest forms will be circulated to the Programme Board for their decision. Members will be elected by the Programme Board to serve a two-year term in the first instance (this will be reviewed by the Board when the strategic plan is produced). Co-opted members At the invitation of the Chair, observers and individuals with specific expertise may be co-opted onto the Executive or invited to attend all or part of the meetings. This will is likely to include partners and/or people with particular expertise or experience include such, as major training partners, as appropriate. The responsibilities of all members of the Executive To attend a minimum of 4 of the 6 meetings held each year. To promote the work of the Collaborative positively and appropriately in public forums. To agree to the goals, vision and values of Collaborative. To act in the interests of the Collaborative To contribute to the development of products for the Collaborative, agreed between Programme Board and Executive To contribute to implementers group where expertise exists To represent the Collaborative at national programme meetings, i.e. task and finish groups, Collaborative of Collaboratives, as necessary. 20
4. Course Leadership Team (CLT) Function To provide an opportunity for coordination across courses and programmes about areas of the delivery of courses. To decide together on shared challenges around the programme including student experience, shared teaching, participation of young people and other matters. To provide a forum though which the University Leads and the Clinical Lead for the Collaborative can seek views about the strategic development of the programme. Facilitate better strategic links between the training and wider transformation elements of the programme including outreach To advise the University leads on all matters to do with the current and future planning of the programme. To delegate responsibility for specific tasks within each university where needed. Membership Administrative Coordinators, Administrative staff, Course Leads, Module Leads, Collaborative Clinical Lead, Collaborative Programme Lead, Collaborative Project Coordinator, Assistant Psychologist (Collaborative), Joint University (HEI) Leads. Structure To meet monthly on the last Wednesday of the month at the Waterloo Campus of KCL with a rotating chair for 2 hours with a pre-circulated agenda 21
5. Collaborative Implementation Groups What are the Collaborative Implementation Groups? The Collaborative Implementation Groups are working groups, essentially the working group component of the Steering Group, taking on specific aspects of implementation of CYP IAPT. These groups might include: Participation group Data and outcomes group Evidence-based practice group Specialist clinical groups e.g. LD group, LAC, perinatal Other task and finish groups directed by the Programme Board Processes could include: sharing best practice across the Collaborative, problem solving specific implementation difficulties facilitated group discussions and workshops Outputs might include: written best practice guidance, presentation at conference and other events auditing training events Who do they report to? The implementation groups report to the Programme Board and Exec via the clinical and project leads How often will they meet? The groups will meet as required to complete the specific task they have been set and/or as on-going groups develop best practice in particular aspects of the CYP IAPT programme. 22
Who will make up the Implementation Groups? The Implementation groups will be made up from within the partnership organisations. They could include: clinicians, data managers, young people, parents and carers, service leads and others appropriate to the tasks. Each group will be appointed a chair who will be expected to report back either in a brief written report and in person where appropriate - to Programme Board at their request and no less than twice a year with updates on the progress and outputs from the group. The responsibilities of all members of the Implementation Groups To attend meetings regularly to complete the task To promote the work of the Collaborative positively and appropriately in public forums. To agree to the goals, vision and values of Collaborative. Attend the annual whole collaborative meeting 23
6. Shadow Board What is the Collaborative Shadow Board? The shadow board has the role of bringing together young people and parents/carers to inform and steer, both the work of the Programme Board and Executive. The ToRs of this group are to be drafted by the current participation group and decide how best this Shadow Board should meet and provide appropriate representation to the Programme Board and Executive. The role of the Shadow Board is to: Input into the Programme Board and Executive Ensure that the voices of young people and parents/carers voice are best heard in the Programme Board and Executive To guide the collaborative in a direction that ensures the work of the collaborative improves the lives of children and young people with mental health problems and sticks to the CYP-IAPT principles Who does it report to? The Programme Board and Executive How often will it meet? This will be decided by this group Who will make up the Collaborative Shadow Board? Young people who have direct experience of mental health difficulties Parents/carers who have direct experience of parenting/careing for a young person with mental health problems 24
Local Partnership Structures Local partnership are expected to have a local CYP IAPT steering group made up of reps form all the partnership organisations and local commissioners. This group should link to the Local Future in Mind/Local Transformation Plan implementation group, which in turn should link to local Clinical Networks London and South East Collaborative Clinical Network FiM/LTP Imp Group Local CYP IAPT Steering group Partnership Partnership Partnership 25
Appendix 1: Expression of interest form for partnership membership of the Collaborative Executive NOMINATION I (your name) want to represent (state which sector: Voluntary, Local Authority, NHS) on the Collaborative Executive. My organisation has agreed that I can stand for election. EXPRESSION OF INTEREST STATEMENT Below are three questions for you to answer. Please make your answers accessible. For example, use simple statements and don t use acronyms or jargon. What skills and experience can you bring to the Collaborative Executive (500 words)? 26
What do you hope to get out of being a Collaborative Executive Member (500 words)? Do you have any further comments (500 words)? 27
With Thanks to the Council for Disabled Children for their helpful advice on the initial draft of this document 28