Our recent achievements and on-going joint working

I wanted to write about what we’ve been busy doing in the past year and reflect on all the hard work we’ve done as Inspection Wales.

Where were we a year ago?

A year ago, we published a stocktake of our progress, which showcased our progress in meeting four key themes over the previous 18 months or so.

These themes include being able to identify areas of collaborative working; support different approaches of working together to respond to legislation and policy change in Wales; coordinate the development of a forward programme; and continue to promote the work of Inspection Wales and increase public knowledge of what we do.

Some of the joint working projects showcased in the stocktake were:

  • Care Inspectorate Wales (CIW) and Healthcare Inspectorate Wales (HIW) worked together to monitor and review mental health services;
  • CIW and HIW worked together on learning disability services; and
  • Estyn and the Wales Audit Office worked together on the inspection of regional consortia for school improvement.

Our work during the past 12 months

Our collaborative project work continues in many areas.   child iconServices for children and young people:

  • The Wales Audit Office, CIW and Estyn have worked together on a joint local Safeguarding Children Review at Monmouthshire County Council.
  • Estyn and CIW are to work jointly to inspect early years’ settings that provide both care and education. Further information on the joint childcare and play framework is available on CIW’s website.
  • Joint teams of Estyn and WAO staff deliver Estyn’s local government education services inspections, which report on outcomes for learners, quality of services and leadership, including how well local authorities use their resources to deliver their strategic priorities.
  • Estyn and CIW routinely work together to inspect secure children’s homes and schools and colleges that have residential provision. During 2018-2019, Estyn will work with CIW to explore how to develop joint inspection activity for independent schools and residential special schools.
  • All Inspection Wales partners are currently completing various pieces of work on the theme of support for young people. Each organisation has a different role and remit in relation to the topic of youth and are working together to deliver a series of reports and other outputs. Estyn’s report on Youth Support Services In Wales was published first on 27 July and the WAO is due to report next, with a planned publication date of November 2018.

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Health and social care services for adults:

  • CIW and HIW jointly reviewed Community Mental Health Teams across Wales. A national overview report will be published before the end of 2018, and all individual inspection reports have been published.
  • CIW and HIW have recently (July 2018) published a joint thematic review of substance misuse services in Wales.
  • The Wales Audit Office collaborated with CIW in its inspection of Adult Social Services in Powys County Council and the report was published in May 2018.
  • CIW and HIW jointly reviewed the healthcare support provided to older people living in care homes in north Wales. A report of this work will be published shortly.

On reflection

These examples of collaborative work show that Inspection Wales partners are working together across a broad range of services, but particularly in the areas of healthcare and education. Our joint work is often about using audit, inspection and regulation as a way to improve services for the most vulnerable. For example, children detained in secure settings, individuals experiencing mental health and substance misuse problems and those using children and adult social services.

What next?

We will continue to prioritise joint work which can improve services for vulnerable people. For instance, CIW and Estyn, together with Her Majesties Inspectorates of Probation and Constabulary, are in the early stages of planning a review of safeguarding children in Wales, with fieldwork to begin in the latter part of 2019. There will also be a continued focus on joint work to improve health and social care.

The NHS celebrated its 70th birthday on the 5 July 2018, and the next day the Welsh Government published its long term plan for health and social care in Wales – Healthier Wales. Under the plan, the Welsh Government will ask two of Inspection Wales’ partners, HIW and CIW, to jointly review the effectiveness of Regional Partnership Boards and the progress of the Welsh public services in delivering integrated health and social care services. (Regional Partnership Boards are tasked with driving the strategic regional delivery of social care services in collaboration with health bodies.)

In upcoming blogs, I will report more on the joint safeguarding work and the joint response of HIW and CIW to Healthier Wales.

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.

Collaboration in Action – Working Together on Health Governance

We talk about collaboration a lot on this blog, and that’s because it important to make sure our partners work adds value to public services. It would be a waste of resources if we all looked at the same things in the same way. It’s important for other reasons too, if we looked at services through the same lens we might miss important issues.

Talking about it is one thing, but we thought it would be nice to show you how collaboration actually works for health services in Wales. Two of our partners both have roles in the external review of health service governance. Now you might think governance is somewhat dry subject for a blog, I would beg to differ!

Governance in it true sense is an enabler for effective organisations, it determines the big, important questions, like how do we do things around here? Is it acceptable to do this? How is an organisation structured? How do the leaders know if we are doing the right things? In health- are our patients safe?

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Healthcare Inspectorate Wales and the Auditor General for Wales both have specific remits which include governance of health services in Wales. Our partners could both just go out and review governance independently of each other, and report through their channels. But they decided that working collaboratively was better [opens in new window]. The paper [opens in new window]accompanying this blog explains how they do this in a clear way, but my summary is that we made a strategic decision to come at governance from two directions.

HIW approaches it from frontline services in individual wards and service areas, whereas WAO approaches it from the organisational top-down perspective. This means that our work complements each other. That is not enough on its own to get maximum value from our work, so we also work collaboratively in many ways, we use various formal and informal liaison mechanisms to make sure we make connections from what our work is telling us, and are able to spot many problems and draw attention to them before something awful happens.

We do this through our Healthcare Summit process, regular meetings between senior and operational staff from both partners, and engagement with Welsh Government through the NHS Escalation and Intervention process [opens in new window].

So what?

We have evolved our collaborative working since devolution, this is not something new, and this has helped us to produce a number of joint pieces of work from CAMS, to the Betsi Joint review of governance in 2013.

This is a good example of collaboration in action, and I hope you will read our partners paper.