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Section 6 Summary of Afternoon Discussions
Introduction
The afternoon discussions focussed on the main barriers to implementing the standards, identified by workshop participants, and how these could be minimised or removed.
The barriers were selected for discussion on the basis of the number of time they arose in the second participant based exercise. Although the topics selected were different in each workshop, there was substantial overlap between workshops and in the solutions offered.
This section presents the major issues raised followed by the solutions suggested by participants.
The need for stakeholder engagement and service user involvement
In order for the standards to achieve their aims and be successful it is necessary to have all stakeholders actively involved in the process and "signed up" to the principles and implementation of the standards.
Solutions offered
- Encourage a cultural change to develop a customer care approach and allow staff and services to become more flexible.
- Foster positive attitudes with the emphasis on the benefits of having standards and assisting the capacity building of services.
- Build understanding amongst personnel at all levels in providing or commissioning services on why the standards are necessary.
- Promote how the standards will enhance service delivery and produce better outcomes for the service users.
- Illustrate the benefits of using the standards ( i.e. that it would enable the service to accurately measure what it does therefore be better able to improve practice, this in turn would lead to better outcomes for service users and increased skill levels of staff and this improvement could be used to attract funding).
- Identify "champions" as a mechanism for promoting and encouraging the use of the standards, who could also communicate information about where the standards are already working and the benefits they have achieved to reinforce implementation.
- Involve service users in all areas regarding the standards, including ongoing development and monitoring and regularly seek their views to inform service improvements.
- To encourage service users involvement ensure that information about the standards is available in a variety of written and audio formats and involve them in the production of this information.
Lack of clarity over standards and expectations
The benefits of the framework may not be realised if there is a lack of clarity over the standards, the services they apply to and the expectations of what is required.
Solutions offered
- Ensure the standards are clearly defined.
- Provide additional guidance to help support the consistent implementation of the standards.
- Develop local performance targets which directly feed into national targets and strategies.
Lack of additional resources or joint working
Additional resource implications, such as the administration cost or training cost of introducing and maintaining the standards and collecting performance information, might mean that standards are not put into practice. This was identified as a particular issue in using monitoring tools (covered later).
In addition, the overall effectiveness of the standards may be restricted if services and other partners did not work closely together. This was identified as a particular issue in relation to information sharing.
Solutions offered
- Encourage services to use existing resources more effectively.
- Encourage greater partnership working and sharing of resources.
- Encourage the development of systems for more effective sharing of information and resources across partner services This would include developing standardised assessment and monitoring tools.
- Support the streamlining and enhancement of ITC systems to enable greater coordination and more effective and efficient data collection.
- Provide training in the use and implementation of all aspects of the standards.
- Provide support both internally and externally on the implementation of the standards, for example through the establishment of a national support officer to work with the services during their implementation.
- Form local and national forums dedicated to discussing the standards and their implementation, sharing examples of best practice throughout the sector.
- Encourage agencies to work together to provide economies of scale.
- Commissioners should ensure adequate additional funding is available for services to implement the standards.
- Scottish Executive should ensure consistency of funding streams so that the implementation of the standards will continue over time.
Need for a defined monitoring and measuring framework
In order to be useful the standards need to be measurable. At present there is no information on how to measure delivery of the standards with no clarity over monitoring tools, measurement targets or inspection processes. Combined with the view that the introduction of additional monitoring requirements could add an additional layer of inspections and increase workload the scale of implementation of the standards might be limited.
Solutions offered
- Ensure that implementing the standards did not add to the present situation regarding monitoring and inspection by making sure existing systems were able to include measurement against the standards and by making the national framework flexible enough to allow for variations in local environment.
- Provide additional definition to assist the development of any monitoring tool(s).
- Encourage guidelines for self evaluation to be developed by service management teams along with internal "quality groups" which could be used to enhance implementation of the standards.
- Develop a monitoring tool centrally, by the Scottish Executive along with the local DAATs which focuses on outcomes identified by the treatment goals.
- Combine existing inspections into one overall inspection.
- Agree shared inspection protocols between existing inspection agencies (Care Commission, SWIA et), and form Inspection teams comprised of a variety of members with different backgrounds and experience. including peers, service users, practitioners and commissioners.
- Ensure the data acquired by this process reflects information that various funding sources require.
- Consider whether inspections should eventually be linked to service level agreements / performance contracts as this would ensure implementation.
Addressing service user expectations
There was a feeling that service user's responsibilities and the impact of standards on their expectations may not be addressed sufficiently. If the standards enhanced the view that treatment was something that was done to the client, this may lead to loss of empowerment by service users. There was also a perception that the standards may raise clients' expectation of what the service could achieve which may lead to disappointment and disillusionment.
Solutions offered
- Focus on the partnership between the service user and the service.
- Encourage services to be open, direct and honest.
- Encourage services to be clear to clients from outset to ensure that service users have realistic expectations.
- Encourage all partners to address and overcome any professional assumptions about service users.
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