Inspection Wales partners begin joint work on support for young people

Young people in the UK today may become the first ever generation to record lower lifetime earnings than their parents and grandparents. The media is full of stories about young people struggling to get on the property and career ladders and the vote to leave the European Union has left some people questioning whether there is a generational divide between young and old [opens in new window]. Recently, the BBC reported that rises in life expectancy from birth are slowing down [opens in new window].

Austerity, fiscal policy, and the pressures of an ageing population have all been blamed so far, but the issues affecting the life chances of the younger generation are complex. There is some interesting work being done by the Intergenerational Commission to see whether young adults today are worse off [opens in new window] and if so – why? The Commission is a panel of experts hosted by the independent think tank the Resolution Foundation. The Commission will publish a final report in 2018 with a set of recommendations for the UK government to address imbalances between the generations.

Young people have distinct needs and some need extra support as they move from childhood into adulthood. Understanding and meeting the needs of young people at the same time as serving the wider population poses a challenge for policy makers. Some policy areas like compulsory education are designed around children and young people, but how do you make sure that things like housing, health and economic policy work for them? The challenge for government is to have a coherent strategy to improve young peoples’ lives which cuts across all policy areas that can make a difference. Government also needs effective ways of delivering services for young people that bring the right people together, at the right time, in the right way for young people.

Over the next 18 months or so, Inspection Wales partners will complete the first joint national thematic review, which will look at services for young people. The scope of the Wales Audit Office work has yet to be confirmed, but the study team are currently interested in how the Welsh Government is developing strategies to meet the needs of young people aged 11 to 25.  The team are also interested in understanding what the picture looks like for young people in Wales: Who are they? Where do they live? What are they doing? What do they need? What is the picture of their overall wellbeing and how is that changing over time?

In addition, Estyn has already started its first round of fieldwork looking at local authority and voluntary sector youth services. It will complete further fieldwork in the autumn. Its work looks particularly at the effectiveness of local partnerships, including the contribution of Public Services Boards, in securing adequate and high quality universal and targeted youth support services. Estyn’s work will also capture young people’s views of the youth services they use, and will include an assessment of how the Welsh language needs of young people are being met.

The transition between children’s and adults’ services can be extremely challenging for young people, their families and for professionals. Healthcare Inspectorate Wales (HIW) has decided to investigate the care provided to young people making the transition from paediatric to adult services. The work will investigate whether care is planned effectively, whether young people receive appropriate support and how the system works together to ensure young people receive the services they need. Care and Social Services Inspectorate Wales (CSSIW) plans to examine the decision making process for placing looked after children in care settings, although its plans are yet to be finalised.

This blog will provide updates on the thematic review of support for young people as it progresses.

About the author

Emma Giles, Inspection Wales Programme Board ManagerDr Emma Giles took over as Inspection Wales Programme Manager in March 2017. Prior to this, Emma was a performance audit lead with the Wales Audit Office.
Emma is an outdoor enthusiast who likes mountain biking and walking.

Her PhD in Criminology looked at how offenders and criminal justice staff understood fairness, and what these differing perceptions of fairness meant for relationships between staff and offenders.

Working together to deliver the joint review of governance arrangements at Betsi Cadwaladr UHB

The Wales Audit Office and Healthcare Inspectorate Wales (HIW) completed their fourth joint review of governance at Betsi Cadwaladr University Health Board on 29 June 2017.

Cover of the reportThey concluded that ‘while the direction of travel is positive, there is still much that needs to be done’. You can read the report on both the Wales Audit Office [opens in new window] website and on HIW’s website [opens in new window].

However, the purpose of this blog is not to focus on the conclusions reached. Rather, it is based on conversations I had with review team members. Its purpose is to reflect upon their experiences, and in so doing to highlight the benefits of collaboration and identify some factors which contributed  to successful joint working and some potential challenges. What follows might not be ‘rocket science’, but I hope you find this slightly different perspective on audit and inspection interesting.

Joint working added value in a number of ways, particularly communicating to the Health Board the seriousness of the challenges it faces

For the review team members, the very act of the Wales Audit Office and HIW coming together to undertake a joint review is important because it sends a strong message to the Health Board, its partners and stakeholders about the seriousness of the concerns about the governance arrangements at the Health Board.

The message is further strengthened as the 29 June 2017 review was the fourth in a series of joint pieces of work undertaken since 2012. Over that time, the joint HIW and Wales Audit Office reviews of Betsi Cadwaladr have established themselves as authoritative accounts of the progress made by the Health Board in meeting the challenges it faces.

The strength of the message and the authority of the report should increase the likelihood that the Health Board takes actions on the areas of remaining concern, which include that the Health Board has yet to develop a clear plan for how clinical services in North Wales should be reshaped to ensure that they are clinically and financially viable.

Drawing upon the relative skills and experiences of HIW and Wales Audit Office staff led to a more comprehensive and whole system perspective about how the Health Board’s processes are working from the experiences of the patient upwards. Broadly speaking, Wales Audit Office staff brought expertise and knowledge about financial matters and governance, and HIW staff brought knowledge about patient care and safety.

‘It sounds cheesy, but successful joint working starts with a willingness to work together and a recognition of the expertise and skills of others’

The absence of shared repository for storing information, which then required the information to be shared by email, was the only issue identified as a challenge.  So to what can the review team ascribe the success of the project? And what advice would they give to others embarking on such joint work? Certainly the success of this piece of joint work lies, to some extent, in the fact that this was the fourth joint piece of work, and so there was a well-established and well understood approach to working together.

One of the team members told me that, while it sounds like a cliché, those embarking on joint working need to begin the journey with a willingness to work with others and a recognition of the skills and expertise which colleagues in other organisations can bring. Also, success was deemed to be about keeping the overall goal in mind, rather than becoming dogmatic about process. At the same time it was important to ensure that project management arrangements were clearly set out and the project was rigorously managed to complete it within agreed timelines.  Clear and frequent communication also seemed a key ingredient to the success of the project. Key elements of the process were jointly delivered, such as fieldwork and reporting to the Betsi Cadwaladr board. This links into an earlier comment about how joint working has helped to communicate to the Health Board the seriousness of the challenges it faces.

Finally, both project leads referred to a future piece of joint working, not between the Wales Audit Office and HIW, but between HIW and the Care and Social Services Inspectorate Wales (CSSIW) on community mental health teams. So watch out for that joint report which is due to be published early in 2018, and for another similar blog on the experiences of the HIW and CSSIW joint review team.

About the author

Emma Giles, Inspection Wales Programme Board ManagerDr Emma Giles took over as Inspection Wales Programme Manager in March 2017. Prior to this, Emma was a performance audit lead with the Wales Audit Office.
Emma is an outdoor enthusiast who likes mountain biking and walking.

Her PhD in Criminology looked at how offenders and criminal justice staff understood fairness, and what these differing perceptions of fairness meant for relationships between staff and offenders.

Why worry about collaboration?

Ruth StudleyOur guest blogger, Ruth Studley, Healthcare Inspectorate Wales, explains the importance of collaboration. 

You may ask why should we worry about collaboration? In the current times of wanting to increase our impact with often reducing resources, collaboration is vital.

We all need to know what we are doing and why. We need to know how our personal role fits into that of our organisation goals.

In the public sector we need to go a step further and consider how our personal and organisational roles fit into the broader goal of wanting to create a positive impact on the population. We can do this on our own but we have a greater impact if we do this with others. Do you agree?

Why don’t we collaborate more – do we all understand what collaboration means?

The Oxford University Press states that collaboration is ‘the action of working with someone to produce something‘.

I believe effective collaboration is more than this. It is more than a joint goal with agreed milestones and deliverables. It is enhanced by trust and respect, openness, honesty and transparency about conflicting views and opinions, working through difficult problems to achieve a consensus, an aims that suits everyone.

 How do we collaborate more – have you considered what collaboration looks like in your environment?

Collaboration is the driving force behind Inspection Wales. But what does that mean? How does it feel?

From a personal perspective, it is about trust, mutual respect, openness, honesty and reliability. Interestingly, this can be summarised mathematically:

trust-equation-image-english

Lets first consider those aspects of trust that have a positive impact on collaboration.

Credibility – Do you say what you know and is it right?
Reliability – Do you do what you said you were going to do?
Intimacy – Do you know your colleagues, staff, managers? Do you you value them and inspire them? Do your respect their values?

Like any mathematician, I know the power of the denominator! The reciprocal has the ability to undermine the numerator. Here it can do immense damage to the trust and rapport we build. In this example, we need to be aware of the trait of the self interest.

Are you making decisions or behaving in a particular way for your own benefit without consideration of the impact on others? Is it all about your brand? Your goal?

Inspection Wales is based on many of these principles. For example, the recent publication of the information sharing principles places a huge amount of trust in other organisations to use that intelligence appropriately and keep it safe. In many areas we identify our joint or overlapping goals and focus on delivering these together to achieve better outcomes for people.

Indeed, we could use the power of the reciprocal here and say – why would you not collaborate? Resistance rather than trust can develop by focussing on our self interests and those of our own organisations, but these will eventually be broken down by those who are credible and reliable and open and want to work together to achieve greater outcomes.

I’ll end with a quote from Helen Keller:

“Alone we do so little; together we can do so much”

 Ruth Studley is the Director of Strategy and Development at Healthcare Inspectorate Wales (HIW) Before joining HIW Ruth was the Head of Health Statistics at StatsWale

Views on report into independence of older people in Wales

The Auditor General for Wales, this week, released a report ‘Supporting the Independence of Older People: Are Councils Doing Enough?

The report examines whether councils are working effectively to support the independence of older people. While the Welsh public sector recognises the challenges of an ageing population, the report found that some key barriers are inhibiting the shift in focus that is needed to reduce demand for health and social care services and support older people to live independently.

This study was conducted by the Wales Audit Office and the Care and Social Services Inspectorate, who are part of Inspection Wales, along with the Older People’s Commissioner for Wales.

In this series of videos, the Auditor General for Wales, the Chief Inspector of Care and Social Services Inspectorate Wales and the Older People’s Commissioner for Wales answer the following questions on the report:
Clearly there are financial challenges to delivering these services, what can local government do to ensure that services are available for those who need it most?

Given the findings of today’s report what recommendations would you make to both councils and Welsh Government to help improve the services they offer to older people in Wales?

Huw Vaughan Thomas, Auditor General for Wales

Imelda Richardson, Chief Inspector of Care and Social Services Inspectorate Wales

Sarah Rochira, Older People’s Commissioner for Wales

If you would like to view a copy of the report you can do so via the Wales Audit Office website

Two (Heads) are better than one

Wales Audit Office

Here, our guest blogger Mark Campion, HMI Estyn, explains how Estyn and the Auditor General for Wales together examined school improvement services delivered through regional consortia in Wales and the benefits gained from working in collaboration.  

With a common interest in how the four regional education consortia were developing, Estyn inspectors and Wales Audit Office staff worked together to share hypotheses, draw on each others’ expertise, and work more efficiently by pooling resources.

How did Estyn and the Wales Audit Office work together on this report? Video transcription

We planned our fieldwork visits together, spending four days as a combined team in each of the four regions.  While each organisation had particular areas of interest, we were mutually concerned about the leadership and management of the consortia.  We therefore held joint interviews with senior staff and elected members during the visits.  During the week we held joint team meetings…

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