Examination of Witnesses (Questions 320
- 328)
TUESDAY 28 OCTOBER 2008
SAVAS HADJIPAVLOU
Q320 Mrs James: Going on to commissioning
and planning, how much investment do you believe can be achieved
at a local level through better strategic planning, partnership
working and commissioning alone?
Savas Hadjipavlou: We could list
all the investments that are vertically oriented services. I do
think that if we look at for example community mental health services
and the integration of those services with mental health inreach
in prisons, achieving greater synergy between those through commissioning
and efficient connection; it is not always about money. It is
about making sure that we integrate and connect up from the perspective
of the individual. I think it would be important to try to see
in that context how better to connect up those sorts of service.
Q321 Mrs James: So more cross-departmental
resources being shared and sharing of practice?
Savas Hadjipavlou: Sharing of
practice and actually joint planning and joint commissioning,
which would include sharing information about outcomes and that
feeding into the planning cycles of the organisations involved.
Q322 Mrs James: If you were in charge
of the budgets where do you think it should be concentrated? How
do you think we should go forward?
Savas Hadjipavlou: I think there
are a couple of areas which would give us maximum impact. I mentioned
them both earlier in terms of the court and in terms of the transition
points really which would give us maximum impact, the point being
trying to get the right person in the right place as far as possible.
Q323 Chairman: Do you mean getting
medical attention to someone at the court stage?
Savas Hadjipavlou: Getting the
effective screening that is needed, so if somebody is better placed
back in psychiatric services for example if they have come into
the court system—
Q324 Mrs James: Would you link that
in with drug issues then?
Savas Hadjipavlou: I would. If
we accept the evidence that says a substantial amount of people
have all these issues to a greater or lesser extent it needs to
be rounded assessment but we need to make sure that there are
services for them to go to that are connected up. You have to
have somewhere to divert to.
Q325 Julie Morgan: We have already
looked at this in how you can measure the outcomes of cross-departmental
working. Is there any system that you have got in place to see
what the results are? Are there any research projects or anything
like that going on to measure the cross-departmental working and
its effectiveness?
Savas Hadjipavlou: Yes, the Care
Services Improvement Partnership carried out a survey about a
year ago through regional workshops precisely on the point you
are asking about—the extent to which the partnership arrangements
were effective. I have to say that the results were not very encouraging
partly because they demonstrated the weaknesses of partnership
working without effective governance to go along with it. That
informs some of my comments earlier on about the need to join
up services more effectively and to look for ways in which we
align commissioning.
Q326 Julie Morgan: So you are saying
that the partnership working that you had has not been very effective
so far?
Savas Hadjipavlou: I am saying
that it has been variable, that there is good practice and there
is poor practice, but if we are going to achieve a step change
in the access to services that we would like to see it needs to
be a good deal better.
Q327 Chairman: The National Audit
Office concluded that existing provision was actually under-used
in relation to mental health treatments and alcohol treatment
requirements at the stage when community orders were being made.
Has there been any improvement since they made that report?
Savas Hadjipavlou: I do not believe
there has. Their report was published a few months ago. The evidence
we have suggests that the point that they make is absolutely correct.
Q328 Chairman: What do we have to
do to change that situation?
Savas Hadjipavlou: I think we
need to go back to the point of maximum impact when the court
community order is being established. If we know for example that
somebody is already in contact with psychiatric services then
that should help inform the requirements of the community order,
but that will not happen unless that screening system is in place.
I think we need more effective screening at that point.
Chairman: Thank you very much indeed.
We are very grateful to you for your evidence. You made the odd
point that you might follow up on by letter because there were
one or two things we could not cover today. Thank you.
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