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Building the Right Support (Transforming Care) peer reviews

The peer review methodology is based on the established sector-led improvement approach the local authorities in England have been using as an improvement tool for some time. Sector-led improvement, and peer review as the cornerstone of that, is an established, researched, and evidenced approach that is recognised as working.

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For further information, or if you would like to express an interest in undertaking a peer review in your Transforming Care Partnership or council area, please email [email protected]

Guidance and process information for peer reviews

Peer review summary

The peer review is voluntary in nature; aimed at supporting Learning Disability & Autism Partnerships thinking on how to develop and improve service delivery. Peer reviews are not inspections or about assurance and should be seen as ‘critical friends’.

Through peer reviews, the partnership and partner organisations are taking responsibility for their own improvement. As such, the feedback provided by the peer review team will be ‘owned’ by the Senior Leadership Team across the system.

The peer review is designed to support systems and services to develop and improve service delivery of the Transforming Care vision. This includes focusing on specialist community-based services that are needed to support people with a Learning Disability and Autistic People. In particular, the focus is on

  • Enhanced and Intensive Support Services
  • Community Based Forensic Services
  • Preventative Support to avoid hospital admission
  • Personalised Support that enables people to return to or remain in their community
  • Support to families, children, and young people to enable them to remain at or close to home
  • Co-produced solutions developed with people with lived experience and families to meet local needs

Focus of the peer review

The peer team will explore the following core components:

  • Local context and whole system working: Does the service work in a joined-up way with other services and systems that are also supporting the group of people your service supports?
  • Sustainability: Does the service have a plan in place to ensure its long-term viability and is there evidence that this plan is being implemented successfully?
  • Capacity to deliver: Is service capacity aligned to the priorities of the Transforming Care Partnership, and able to deliver on agreed outcomes set out within local TCP/transformation plans?
  • Service design: Is there a shared approach to designing innovative services to meet the identified needs of people in their community, developed in co-production with people with lived experience and families. Is this seen within neighbourhood networks, resilient social care workforce and in the delivery of key functions set out in the model service specification e.g. Intensive Support and Community Forensic Service

The peer review team

A peer team is established for each peer review. People are sought from across the country who all have a fundamental knowledge or experience of the programme. The LGA try to source people to make up the team from outside the systems region in recognition that the borders of some services may reach into other areas.

The team will always have a family carer, a person with lived experience, a social care provider alongside social workers, commissioners, and others from children’s services, housing, data to ensure a broad and knowledgeable perspective but all will have a working understanding of the programme. The team is then led by a clinical lead and a peer review manager from the LGA who upholds the methodology and keeps everyone focussed.

The area is provided with a Photo Team sheet and bio prior to the team coming into the local area.

Peer activity

The peer review will take three to four days to complete, during this time the Peer Team will be able to undertake

  • Facilitated Discussion Groups (60-90 minutes)
  • Meetings with small groups (three people) and individuals (45 minutes)
  • Visits to sites and services (when onsite)
  • Online Meetings with small groups
  • Attendance at meetings
  • Reading and review of documents provided to them

The local partnership will be responsible for arranging the timetable of activity organised in advance of the visit by the peer team. The timetable will include:

  • An initial ‘scene setting’ and ‘checking the brief’ discussion at the start of the first day, between the peer team and the Partnerships Senior Responsible Officers (SRO), Deputy SRO and relevant other system leaders e.g. Director of Adult Social Services, Director of Provider Trust, SRO Provider Collaborative .
  • Meetings and discussion sessions with a range of stakeholders enabling the peer team to explore the issues relevant to the purpose and scope of the peer review. Some suggestions (neither a prescriptive nor exhaustive list) of who the peer team could meet with whilst onsite are:
    • TCP members
    • Clinicians
    • Commissioners & Procurement leads
    • Finance leads
    • Providers of services: health, social care, community sector & housing
    • Inpatient service representatives
    • Individuals with lived experience
    • Family carers with lived experience
    • Education
    • Children’s teams
    • Front line staff in services including community teams
    • Police liaison officer
    • Mainstream mental health service representation/crisis teams
    • CAMHS
    • Liaison and diversion teams
    • Regional NHSE
  • The peer team will feedback to the leadership team every evening as part of the ‘no-surprises’ approach to peer reviews. 
  • The team will then provide a presentation and feedback in person at the end of their time on site. The audience of that feedback and presentation is decided by the local partnership. Some areas receive the final presentation and feedback and a facilitated action planning session to the Learning Disability & Autism Board or TCP, others choose to invite everyone who has contributed to the review and spoken with the team.

Background information and reading

The peer team anticipate receiving the background information approximately two weeks before their visit. The information below will provide a guide to the Position Statement and additional documents the partnership may wish to share.

Position Statement

The Partnership will need to prepare a written Position Statement prior to the peer review. This is a key background document for the peer team, essentially a self-assessment. This provides a brief and a steer to the peer team in terms of what the partnership would like them to focus on.

It can usefully summarise the key drivers, issues, enablers, challenges, context, and current thinking and should be structured around the four core components of the peer review.

The Position Statement is an opportunity to undertake an honest self-assessment and provide the peer team with a summary of the most pertinent issues and reviews.

The peer review process works best if peers are clear at the outset of the areas where the TCP would most welcome and benefit from their observations. You may wish to include some specific questions within the document for peers to consider.

Background documents

In addition to a Position Statement the Partnership should provide a selection of background documentation to the peer review team, comprising of documents that will support and inform the peer team’s consideration of both the areas of focus and the core components. Documents can be linked or embedded in the Position Statement to help guide the peer team.

This should include information about the Partnership and its vision, plans, oversight etc. This should also include minutes and key papers from the previous two meetings of the Board alongside information on any subgroups or workstreams.

In addition, the Partnership may want to include some of the following:

  • Service structure charts and maps of the partnership areas
  • Housing strategy
  • Transition strategy
  • Information shared with people about the work (including Easy Read)
  • Local Area Autism Plan
  • Finance/budget plan/commissioning plans
  • Operational plan
  • Numbers accessing the service, including case management details
  • Joint Strategic Needs Assessment
  • SAF (for both people with a learning disability and Autistic people)
  • Market Position Statement
  • Local learning disability strategy
  • TCP plan
  • Local Transforming Care information and data including Dynamic Support Register and CTR/CETR/Pre-admission (Blue Light) data and processes
  • Patient experience reports
  • Pathways that have been developed to prevent admission or expediate discharge
  • Quality checking information
  • Workforce information
  • Whole system plans designed to create a seamless support to people with a learning disability, Autistic people, or families
  • Project information – proposals, evaluations etc
  • Information about Building the Right Support work with local general hospitals especially A&E

We can discuss additional information that will be useful to share with the peer team however, it is anticipated that most of the information required should already be in circulation.

It is likely that the peer team will require further information when onsite, so the Partnership will need to be prepared to respond to requests.

Communication about the peer review   

In addition to the Partnerships and system leaders buy-in to the peer review, it is essential that key stakeholders and those who will be participating in the peer review understand the process and their role in it.

We suggest you consider appropriate communications to ensure the organisation and relevant external stakeholders, including people and families are aware of the peer review, why you have is requested it and what you hope to get out of the process.

Onsite or remote peer review

During COVID-19 we moved the delivery of the Building the Right Support peer reviews to an online format. Whilst this has some benefits feedback from peers indicated that some of the richness of the experience was missed by not directly being in the area. Our first preference is to undertake an on-site or hybrid peer review but if circumstances don’t allow this remote reviews remain an feasible option.

Follow on support

Following the feedback from the Peer Team, the team can offer to facilitate an action planning session or schedule one for a later time.

The LGA are currently able to offer bespoke support to each partnership to address some of the actions identified in the planning session.  Examples of support have included capacity building, leadership support, specialist finance support, market development support, independent facilitation of events, housing related support, development of plans to embed co-production, commissioning plans, personalisation etc

We can also arrange attendance at the Partnerships meetings to both support delivery of the plan and observe whether the review is leading to change, Sue Gale will also routinely be in touch to ask how progress is going and see if there is any additional support the LGA or national partners can offer. 

Due to the nature of the LGAs role in the Building the Right Support programme we are able to support the Partnership to connect with other areas who may have worked through some of the challenges they are facing. In addition, we may also ask to highlight the areas of the Partnerships success with other areas.