Local Involvement Networks (Duty of Services-Providers to Allow Entry) Regulations 2008

rose to move, That the Grand Committee do report to the House that it has considered the Local Involvement Networks (Duty of Services-Providers to Allow Entry) Regulations 2008. The noble Baroness said: It is my pleasure to introduce the regulations to be debated today which set out the duty on health and social care services providers to allow authorised representatives of local involvement networks—LINks—to enter and view their premises to assess whether appropriate health and social care services are being provided. I begin by informing the Committee that a policy statement relating to LINks was passed to the Bill Committee and Health Select Committee back in March of last year. Further, these regulations were subject to a full public consultation process, which began before Report and Third Reading in the House of Lords of the Local Government and Public Involvement in Health Bill, which received Royal Assent in October last year. I thank the noble Earl, Lord Howe, and the noble Baroness, Lady Neuberger, both of whom contributed greatly to the Bill in the debates relating to LINks. We believe it is of great importance for authorised representatives to be able to enter and assess certain health and social care services. Without this ability, there is a significant gap in their role of seeking the views of people using health and social care services. It would mean that they would only be able to do this before or after they use the services rather than at the time they are most concerned and engaged; in other words, when they are actually using the services. Currently, a patient forum is established for every NHS trust, foundation trust and PCT in England. Each patient forum has on average eight members, meaning that there are a total of 4,000 forum members. It is necessary to change the patient and public involvement system because of the significant changes that are taking place in the nature of the health and social care system; for example, the changes to the configuration of primary care trusts, moving towards greater co-terminosity—a terrible word—with local authorities; PCTs’ changing role to focus on the commissioning of services; the move towards greater choice of service delivery; and increased joint commissioning across health and social care. For those reasons, it is no longer appropriate to have a patient and public involvement system which is based on scrutiny of individual services. Therefore, we decided to undertake a strategic review of patient, user and public involvement in October 2005 to ensure that the arrangements for future involvement and engagement were as suitable as possible. We wish this new system to be able to consider both health and social care, so that PPI can be joined up across the entire user journey, and encourage the involvement of a far greater number of people in the health and social care systems. Entering premises to observe the provision of health and social care services is just one of the activities a LINk can do to help it form an opinion about local care services and involve local people in the scrutiny and monitoring of those services. A LINk may well use a range of other mechanisms to involve people in a variety of aspects of commissioning and the provision of services. To enable LINks to gather the information they need about the services, there will be times when it is right for them to see and hear for themselves how those services are being provided. The draft regulations therefore impose a duty on health and social care services providers to allow authorised representatives of LINks to enter premises that they own or control to observe the services that are being provided. However, we believe that some exemptions to this duty are essential to protect patient safety and dignity. Therefore, under the draft regulations, a services provider does not have to allow a LINk representative entry if that would compromise either the effective provision of a service or the privacy or dignity of a person. The draft regulations further stipulate that while an authorised LINk representative is on premises owned or controlled by a service provider, they must not compromise the provision of care services of any person, and if provision is compromised, the duty on the services provider then ceases. There are also some types of premises that it would be inappropriate for a LINk to have the right to enter and, therefore, the duty to allow entry does not apply. This is particularly important when it concerns the provision of care in non-communal areas of a care home; for example, people’s private bedrooms. This does not mean that LINks cannot enter when invited by residents; it just means that services providers are not under a duty to allow them entry. The duty would also not apply in respect of premises used as accommodation for employees of services providers. LINks will not have the right to enter premises or parts of premises at any time when health and social care services are not being provided. LINks will also not have the right to enter premises if, in the opinion of the services provider, the authorised representative, in seeking to enter and view premises, is not acting reasonably and proportionately. This safeguard has been put in place to ensure that the LINk’s ability to enter and view premises is in line with the principles of good regulation and the general intention that LINks should use their rights with discretion and judgment. The duty does not apply to the observing of any activities which relate to the provision of social care services to children. There are already robust arrangements in place for the local delivery of children’s services. I must make clear that LINks will have an important role in listening to children and young people, taking account of their views, giving them a chance to influence the planning and running of health services, and giving services feedback on what children and young people think. This role applies to health services for children and young people and not to social care services. That is because there is a statutory duty on local authorities, through children’s trust arrangements, to take full account of the needs and views of children and young people. We do not believe that all those involved in LINks should undertake the role of viewing services. That is why we will encourage LINks to make sure that those able to exercise the power to enter services should, first, have the right skills; secondly, have received the right training; thirdly, have had criminal records checks carried out and be cleared against the LINks’ own policy administered by the host organisation; and, fourthly, be able to demonstrate an understanding of patient confidentiality and the right level of sensitivity towards the role. Members of the LINk will determine who their authorised representatives will be to perform this role. The draft regulations set out the additional persons who are to be services providers and who will, therefore, have to comply with the duty to allow authorised representatives of a LINk to enter and view the health and social care services delivered on the premises that they own or control, and to view activities carried out on those premises. These additional persons are: all those providing primary medical services, including GPs; all those providing primary dental services, including dentists; all those providing primary ophthalmic services, including opticians; all those providing primary pharmaceutical services, including pharmacists; and people who own or control premises where primary ophthalmic services or pharmaceutical services are provided. In conclusion, I remind the Grand Committee that LINks will enable genuine involvement of a far greater number of people than is currently available. This will ensure that local communities have a stronger voice in the process of commissioning health and social care and enabling them to influence key decisions about the services that they use and pay for. The responses that we received from the public consultation on these regulations showed broad support for our proposals, which represent just one part of a wider set of arrangements that are designed to create a stronger voice for service users and members of the public at every level of the health and social care system. This involves developing systems that are led by what people want and that learn from experience, resulting in real improvements to people’s perceptions of services and their experience of care. I beg to move. Moved, That the Grand Committee do report to the House that it has considered the Local Involvement Networks (Duty of Services-Providers to Allow Entry) Regulations 2008. 11th Report from the Joint Committee on Statutory Instruments.—(Baroness Thornton.)