“Fit For Purpose” – measuring ‘clinical governance’ in Derbyshire’s Mental Health Voluntary Sector
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‘Fit For Purpose’ - background

The Fit For Purpose project has been established to measure the clinical governance in Derbyshire’s mental health voluntary sector.

Why measure ‘clinical’ governance?

The concept of ‘Clinical Governance’ is a method of ensuring that there are adequate systems in place in an organisation to deliver an effective and safe service, whilst implementing processes for monitoring and constantly improving the services to the benefit of those who use them.

In health services, clinical governance is an accepted and widely used tool. As voluntary organisations increasingly form partnerships with these services, there is a growing pressure on the sector to also show effective ‘clinical governance’.

The problem is that the term ‘clinical governance’ is not clearly defined in relation to the voluntary sector. The term “clinical” is perceived outside of health as a system relating to medically based services. The term “social” or “service” governance might therefore be more applicable to those service areas that the voluntary sector traditionally delivers.

In 2004 the National Institute for Mental Health in England (NIMHE) attempted to map clinical governance within the voluntary sector (1). This mapping focussed on thirteen large national voluntary sector providers of mental health services. The research concluded that “there are serious issues regarding the perception of governance within voluntary sector organisations on the part of Strategic Health Authorities, Commissioners, Clinical Governance Managers in NHS Trusts and from within the sector itself.” The report goes on to show evidence of sound clinical governance within the thirteen national organisations studied.

This report is very welcome, however, the majority of voluntary sector Service Level Agreements, and increasingly, Contracts that are commissioned in Derbyshire are with much smaller, locally run and managed organisations.

In working within the local voluntary sector, it is apparent that many aspects of good governance are present in even the smallest service provider, but there has been little work undertaken to test and evidence this. Thus local commissioners and statutory partners may worry that investment in the voluntary sector is a risky business and might decide not to invest in services.

Why prove we are ‘Fit For Purpose’ now?

Commissioning for mental health services is done locally by commissioners who work in Primary Care Trusts. If the voluntary sector is to engage with these bodies effectively, these are the people we need to convince and we need local evidence of our effectiveness.

Now, with the re-organisation of Primary Care Trusts and the move towards Practice-based commissioning led by GPs, is an opportune time to provide that local evidence.

We want the Fit For Purpose project to deliver a picture of the local voluntary sector to commissioners, to highlight its effectiveness, and also to show what actions are being taken to improve governance across the sector in Derbyshire.

Fit For Purpose will give the local mental health voluntary sector an opportunity to demonstrate that they can, and do, offer well governed, diverse and robust services to the mental health community. It is hoped that the research findings will provide organisations with the evidence needed to give the status and recognition that has to date been limited and that the voluntary sector will be considered as more equal partners with other mental health service providers.

It is hoped that many mental health voluntary sector agencies will take part in the research and we look forward to working with you. Please do Contact: Fit For Purpose Research Officer Sinead Dalton if you would like further details about the project.

(1) “Mapping Clinical Governance in Voluntary Sector Organisations”, Tracy Austin, NIMHE (2004)
July 2006
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What are the aims and objectives of ‘Fit For Purpose’

 What is the aim of ‘Fit For Purpose’?

 The principal aim of this research project is to measure and promote the effectiveness of “clinical governance” within the local mental health voluntary sector in Derbyshire.

Incorporated within this overall aim we also wish to:
  • Develop a clearer understanding of the term ‘clinical governance’ as it applies to voluntary sector service providers
  • Raise awareness of commissioners about the current standards of ‘clinical governance’ within Derbyshire’s mental health voluntary sector;
  • Develop a joint action plan with commissioners to maintain and if necessary improve standards of ‘clinical governance’ within the sector.

What are our objectives for ‘Fit For Purpose’?

During the lifetime of Fit For Purpose the project will have a number of specific objectives and tasks. These will be:

  • To design and distribute a questionnaire regarding quality systems and clinical governance in voluntary sector mental health services
  • To complete three focus groups with a sample of voluntary sector service providers to examine a number of key issues around clinical governance in depth
  • To analyse the questionnaire and focus group findings and carry out a gap analysis of areas where improvement is needed
  • To conduct a telephone survey with funders/commissioners of a 10% sample of organisations, ensuring geographical, service area and cultural spread
  • To write up five case studies of areas of particular good practice
  • To compile a final written report on the findings of the project, highlighting examples of good practice and providing recommendations for further action
  • To circulate and present this report to a wide audience including: voluntary sector organisations, service users and carers, GP’s commissioners, statutory services and other interested parties.

To follow the progress of Fit For Purpose go to the Latest Project News section on this site. Regular updates will be given on the work and developments during the research.
July 2006
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Fit for Purpose Report

 The Fit for Purpose Project is now completed. You may download a copy of the executive summary and the full report. Please click on the links below.


Fit for Purpose - Executive Summary


Fit for Purpose - Full Report

July 2007
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Who is being Researched?

 All mental health voluntary sector organisations which provide and deliver services in Derbyshire.

The principal task of ‘Fit For Purpose’ is to measure the standards of and promote the effectiveness of ‘clinical governance’ within voluntary sector mental health services in Derbyshire. As such it is intended that all voluntary sector organisations which provide and deliver mental health services in Derbyshire will be invited to take part in the research.

Participation in the research will be done via a questionnaire, focus groups and through a number of case studies highlighting good practice.

In the first stages of the research a database will be compiled of all voluntary sector mental health service providers who deliver their services in Derbyshire. Groups will be identified from existing databases held by SDVSMHF and North Derbyshire Voluntary Action (NDVA) and from other information sources in the public domain.

Participation in the research is voluntary but all of these groups will be invited to take part and will be sent a questionnaire and information about the research. Involvement in subsequent focus groups and case studies will again be optional.

It is hoped that we will be able to discover and be made aware of all such groups. The more services involved in the research the better. A high level of involvement will increase our evidence base and give more credence to the findings.

If you feel that your service should be involved in the research and you are concerned that we may not have your details please contact Sinead Dalton, Research Officer as soon as possible by email: sinead.dalton@sdvsmhf.org.uk or tel:01773 763666

Service funders / commissioners

As part of the project the research officer will also conduct a telephone survey with a sample of funders/ commissioners across all the 8 localities in Derbyshire. They will be asked a range of questions about their perceptions and expectations of clinical governance in the voluntary sector, their awareness of systems and policies in place and their usage of monitoring information that is given to them.

July 2006
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Fit For Purposes Questionaire

 The main way in which we are hoping to gather information about standards across the mental health voluntary sector in Derbyshire is via a questionnaire.

The questionnaire has been sent out to all the organisations we are aware of. Information and guidance notes have been provided and organisations can contact Sinead Dalton, Research Officer for any queries or support they require in completing the questionnaire.

Questions have been formed around the following areas of governance:
    • Strategic planning
    • Policy development and review
    • Quality and care standards
    • Recovery principles and practices
    • Risk management
    • Incident reporting and resolution
    • Health and Safety
    • Monitoring and evaluation of services
    • User involvement in planning, delivering & measuring services
    • User experiences, complaints, suggestions, surveys
    • Equality of opportunity & cultural awareness in service design & delivery
    • Staff training and development
    • Volunteer deployment, training and support
    • Learning
    • Service improvement.


We will collect quantitative information on policies and systems, i.e. whether they are in place, how often they are reviewed, as well as qualitative information on methods of implementation, turning policies into practice, and seeking good practice case studies to illustrate effective governance.

If you feel your service should be sent a questionnaire and you have not received one please contact Sinead by email: sinead.dalton@sdvsmhf.org.uk or tel:01773 763666
September 2006
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Fit For Purpose project completed!


I am pleased to be able to announce that the Fit For Purpose research project is now completed, the final written report has been put together and now has been printed.

The final written report is a culmination of what has been a tremendous year looking into the governance measures in place within Derbyshire mental health voluntary sector service providers. A wealth of information was gained through all stages of the research and the report outlines the key themes that emerged.

The research has provided evidence that the Derbyshire mental health voluntary sector service providers are aware of, are applying and are working to improve governance measures within their organisations and there is clear commitment to delivering services that are effective, of a high standard and which are delivered within quality frameworks.

It is hoped that organisations and partners in mental health care will be able to use the report to promote good practice and to continue to build upon exisiting standards to improve future service delivery.

Many organisations took part over the course of the year and thank you to all the voluntary sector service providers, commissioners and individuals who helped enable this research to be as successful as it has been.

The report will be launched as part of the SDVSMHF Annual General Meeting on the 17th July 2007 and presentations of the report will take place at a number of events and /or mental health forums over the year.

All organisations who took part in Fit For Purpose will receive a copy of the published report after the 17th July. You may now download a copy of the report by clicking on the links below.

Fit for Purpose - Executive Summary


Fit for Purpose - Full Report

Sinead Dalton
Fit for Purpose Research Officer

July 2007
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Fit For Purpose Groups are a great success!

 The Fit For Purpose Focus Groups took place in the first weeks of December and I am pleased to report that they were all extremely successful. All groups were very well attended and all of those who took part provided an enormous amount of information for the research project.


The first group was held at the Rosehill Business Centre in Normanton, Derby with the theme of ‘Equality and Diversity’, though it is fair to say that several themes were touched upon. It was a lively group and, had we not a set time to be out of the room, I think we would have been there well into the evening!






Above: Elaine Duro (CRUSE), Angela Simpson (DMN) Kuljit Tambur and Bon Ndlovu (Making Space) enjoying a well earned break

Left: Serious debate being held! Ross Leather (Edale House), Christine Lawrence (2Care) Den Phillips (Green Health Partnership and Wendy Beer (Derbyshire Mind)

In addition to gathering a wealth of information for the research it was evident that the focus group had provided an important chance for the mental health voluntary sector to network and foster future partnerships.

The second group was held at Links, CVS in Chesterfield and ran with the theme of Service Delivery. A smaller group than the first, but the subject was tackled with great passion and the examples of the professional ways in which the sector approaches the planning, monitoring and evaluation of its services were flowing.






Above: Keith Jones (Counselling and Psychotherapy Trust) Diane (Chesterfield Women’s Aid) continuing discussions over lunch


Right: Sinead Dalton (praying for the research to be a success??) and Kym Stallworthy (SAIL).

The final group was held at Amber Valley Association for Mental Health and the theme for this group was User Involvement. I was fortunate to have Graham Saxton, Derbyshire User Focused Monitoring Co-ordinator co-facilitate this group with me and provide his knowledge and experience of user involvement in governance.

Right: A festive feeling to the final Focus Group! A relaxed lunch allowing Graham Saxton to catch up on his calls; Anne Emberton (Making Space), Claire Winfield (AVAMH) Sara Haslem, Robert Allen (Federation Support Team) and Wendy Beer (Derbyshire Mind) wishing to food would stop tempting them any further.

This was another large group and the range of organisations represented was really diverse. The discussions were really thought provoking and groups looked at the mechanics of user involvement in the governance of their organisations, the difficulties they encountered and the different methods used to try and improve how people could have effective and meaningful involvement.

Over the course of the focus groups I welcomed representation from Amber Valley Association for Mental Health, Cruse Bereavement Care, Counselling and Psychotherapy Trust, Derby Depression Group, Derby Millennium Network, Derbyshire Friend, Derbyshire Mind, Derbyshire Rural Helpline, Federation Support Team, Green Health Project, Making Space, North Derbyshire Voluntary Action, P3, Relate, SAIL, 2Care, Walbrook Housing, Women’s Aid.

Thanks to all of those who took part, for your time and the wealth of information that you provided.
January 2007
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Latest Project News

March 2007 Update

 The last month has been spent completing the final stages of the research, the case studies and telephone interviews with commissioners.

    • Thanks must go to the 6 organisations who have been kind enough to give up their time and talk with me so that I can highlight some areas of good practice in the mental health voluntary sector. I have worked with individuals representing Walbrook Housing, 2Care, Cruse Bereavement Care, Derby Depression Club, Derbyshire Mind and Derbyshire Friend. Thank you to you all and I hope that everyone will enjoy reading their case studies in the final report.
    • The telephone interviews, with a range of people who are involved in commissioning mental health services across Derbyshire, have provided a vital addition to the wealth of information already gathered. These are still continuing to date but thank you to all who have agreed to take part.
    • I will now be spending the next two months writing up the written report. It is hoped that it will be ready towards the end of May for distribution and we will be alerting you to that nearer the time.
January 2007 Update

    • After the success of the focus groups the new year has begun in earnest. I am now working with a number of groups on the case studies that will be used in the final written report to highlight areas of good / emerging practice within the mental health voluntary sector. I look forward to providing you with further news on this work in the next update.


December 2006

Fit For Purpose Groups are a great success!

 The Fit For Purpose Focus Groups took place in the first weeks of December and I am pleased to report that they were all extremely successful. All groups were very well attended and all of those who took part provided an enormous amount of information for the research project.


The first group was held at the Rosehill Business Centre in Normanton, Derby with the theme of ‘Equality and Diversity’, though it is fair to say that several themes were touched upon. It was a lively group and, had we not a set time to be out of the room, I think we would have been there well into the evening!






Above: Elaine Duro (CRUSE), Angela Simpson (DMN) Kuljit Tambur and Bon Ndlovu (Making Space) enjoying a well earned break

Left: Serious debate being held! Ross Leather (Edale House), Christine Lawrence (2Care) Den Phillips (Green Health Partnership and Wendy Beer (Derbyshire Mind)

In addition to gathering a wealth of information for the research it was evident that the focus group had provided an important chance for the mental health voluntary sector to network and foster future partnerships.

The second group was held at Links, CVS in Chesterfield and ran with the theme of Service Delivery. A smaller group than the first, but the subject was tackled with great passion and the examples of the professional ways in which the sector approaches the planning, monitoring and evaluation of its services were flowing.






Above: Keith Jones (Counselling and Psychotherapy Trust) Diane (Chesterfield Women’s Aid) continuing discussions over lunch


Right: Sinead Dalton (praying for the research to be a success??) and Kym Stallworthy (SAIL).

The final group was held at Amber Valley Association for Mental Health and the theme for this group was User Involvement. I was fortunate to have Graham Saxton, Derbyshire User Focused Monitoring Co-ordinator co-facilitate this group with me and provide his knowledge and experience of user involvement in governance.

Right: A festive feeling to the final Focus Group! A relaxed lunch allowing Graham Saxton to catch up on his calls; Anne Emberton (Making Space), Claire Winfield (AVAMH) Sara Haslem, Robert Allen (Federation Support Team) and Wendy Beer (Derbyshire Mind) wishing to food would stop tempting them any further.

This was another large group and the range of organisations represented was really diverse. The discussions were really thought provoking and groups looked at the mechanics of user involvement in the governance of their organisations, the difficulties they encountered and the different methods used to try and improve how people could have effective and meaningful involvement.

Over the course of the focus groups I welcomed representation from Amber Valley Association for Mental Health, Cruse Bereavement Care, Counselling and Psychotherapy Trust, Derby Depression Group, Derby Millennium Network, Derbyshire Friend, Derbyshire Mind, Derbyshire Rural Helpline, Federation Support Team, Green Health Project, Making Space, North Derbyshire Voluntary Action, P3, Relate, SAIL, 2Care, Walbrook Housing, Women’s Aid.

Thanks to all of those who took part, for your time and the wealth of information that you provided.

What Next?

As the new year begins I am moving into the 3rd stage of the research, which involves carrying out case studies with 5 organisations to highlight some areas of good / emerging practice in governance. As a result of the information gleaned via returned questionnaires, and from the views of those who attended the focus groups, I have now identified the organisations that I will be working with over the coming weeks. The case studies will be used within the final report.

If you would like any further information about the progress so far please do not hesitate to contact me.

sinead.dalton@sdvsmhf.org.uk or tel:01773 763666

November 2006

    • Focus Group dates have now been set. The second stage of the research has now been organised and we are pleased to be able to now advertise the three Fit For Purpose Focus Groups. The groups will give mental health voluntary sector service providers the opportunity to examine a number of clinical governance in more depth. Please click here for more information.

    • The questionnaires are still being returned, thank you. For those of you who have still not had the chance to fill them in there is still time and do keep sending them in.

October 2006

    • The deadline for return of the questionnaires is 6th October 2006 and thank you to those of you who have returned the questionnaires so far. If you have not had chance to fill in the questionnaire by the 6th please do not throw it in the bin! If you can find a little time fill in what you can and send it in, the information is really valuable to the research. I will continue to add the data into the main returns. The more information I have the stronger the evidence base will be.

    • We were pleased to welcome Dr.Rowan Myron, Grant Manager from the Mental Health Foundation, who took time out to visit us in September. The funding for the Fit For Purpose Project came via a new grants programme set up by the Mental Health Foundation and Dr.Myron was interested in finding out about what we were doing. In addition to learning more about the research and meeting some SDVSMHF committee members we were able to visit Freshstart in Ilkeston and Trevelyer in Derby. Dr.Myron has since contacted us to say that she really enjoyed meeting us, visiting the groups and felt the project was going well.

    • A presentation about the Fit For Purpose project was given to the Mental Health Strategic Commissioning Group on 28th September. Members were given an outline of its purpose, work schedule for the project and information about the way in which commissioners will be asked to be involved in the telephone survey, which forms part of the project. It was fortunate that the majority of commissioners were present and were able to have a full update on this research.

September 2006

    • The questionnaire for the project is now completed and has been mailed out to groups. Please click here for more information

August 2006

    • The draft questionnaire for the project is now completed. The questionnaire and guidance sheets are now being piloted with a number of groups before full distribution in September.

    • The Ethical Approval application process is now finished.

    • We are pleased to announce that Dr.Rowan Myron, Grant Manager from the Mental Health Foundation, is planning to visit the project next month. There has been regular communication with Dr.Myron about the progress of the Fit For Purpose project and we will shortly have a direct link to our project from the Mental Health Foundation website.
July 2006

    • SDVSMF website now set up to provide a specific section for the Fit For Purpose Project. Updates on the project will be posted on a regular basis.

    • Questionnaire development and compilation underway with a view to distribution in August/ September 2006.

June 2006
    • Sinead Dalton came into post as the Research Officer for the Fit For Purpose project.

    • Work began on compiling the database for the project. It is intended that the database covers all mental health voluntary sector service providers across Derbyshire. All groups are invited to contact the project if they are in any doubt about being included in the research.

    • SDVSMHF advised to submit the project application to the local Ethical Approval Committee. Application completed and filed. Awaiting news.

    • Mental Health Foundation announces the confirmation of successful applications for their new grants programme.

July 2006
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Contact Fit for Purpose Research Officer

 Sinead Dalton has been appointed as the Research Officer for the ‘Fit For Purpose’ project at SDVSMHF. Sinead took up post at the start of June 2006 and will carry out the research over the next year.

The purpose of Sinead’s role is to run the research project, which will look at the ‘clinical governance’ standards of Derbyshire’s mental health voluntary sector service providers. Sinead will work under the guidance of Angela Kerry, Voluntary Sector Liaison Officer and the SDVSMHF Executive Committee. It is intended that a final written document will report on the findings and make recommendations for actions to support organisations to improve and build upon existing standards of service delivery.

Sinead will provide regular updates on the progress of the research through voluntary sector mental health forums and via the SDVSMHF website.

If you would like to find out more about Fit For Purpose or if you have any questions or queries about the project please contact Sinead at the SDVSMHF office.

Email: sinead.dalton@sdvsmhf.org.uk

Telephone: 01773 763666

Sinead Dalton
Fit For Purpose
SDVSMHF
The Bridge Centre
43 Cromford Road
Langley Mill
Derbyshire
NG16 4EF
July 2006
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Mental Health Foundation Grants Programme

 In 2005 the Mental Health Foundation launched a new grants programme to fund ‘innovative research into the care and treatment of mental illness, and mental health promotion’.

Applications for grants under this scheme were invited from individuals and non-profit making organisations within the mental health field. The SDVSMHF was one of ten successful applicants to be awarded a grant from this new programme for its ‘Fit For Purpose’ research proposal. The public announcement of the awards was made by the Mental Health Foundation in May 2006.

The Fit For Purpose research will meet the Mental Health Foundation's strategic objective of developing and promoting better mental health services for people of all ages - especially for neglected or excluded groups of people, as the intention of the research is to increase the confidence of commissioners to invest in all voluntary sector mental health services in Derbyshire. These services cover all age ranges and often work with the most excluded who do not engage with traditional mainstream or statutory services.

All successful applicants will liaise with the Mental Health Foundation throughout the length of their research, keeping them up to date with progress and findings.

The Mental Health Foundation press release in June detailed the exciting research that will take place as a result of their programme and as the announcements were released to the press, the Mental Health Foundation’s Chief Executive, Andrew McCulloch, said:

“We’re very excited to be starting the grants programme. We have chosen to prioritise innovative research, as we believe that this will provide a much needed boost to the mental health field. When it comes to the treatment and care of people with mental health problems, the field needs new ideas and fresh perspectives. Through giving grants to organisations and individuals, we’ll gain new perspectives from those on ground level.”

For more information about the Mental Health Foundation and the grants programme visit www.mentalhealth.org.uk or call 020 7803 1100
July 2006
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Press Releases

April 19th 2006

“FIT FOR PURPOSE” - MEASURING CLINICAL GOVERNANCE IN DERBYSHIRE’S MENTAL HEALTH VOLUNTARY SECTOR









Southern Derbyshire Voluntary Sector Mental Health Forum has been awarded a grant of £19,000 by the Mental Health Foundation to measure the clinical governance in Derbyshire’s mental health voluntary sector organisations.

The project, which will be called “Fit For Purpose” will examine a range of diverse measures that make up the profile of governance in voluntary sector service providers.

“Although it is often described in different ways to governance in Health, the local voluntary sector has traditionally had a strong track record when it comes to organisational and service quality” says Angela Kerry, Voluntary Sector Liaison Officer for The Forum.

“The research project comes at an opportune time for us with moves towards practice based commissioning, and greater involvement of voluntary sector providers in service delivery.

“We hope that it will provide strong evidence to users and funders of that quality, and will also help us to address areas for service improvement.”

The research will take place over the next twelve months, and progress reports will be posted on the organisation’s website at www.sdvsmhf.org.uk . If you would like further information please contact Angela Kerry on 01773 763666 or by E-mail to angela.kerry@sdvsmhf.org.uk

Through the grants programme, the Mental Health Foundation is funding innovative research into the care and treatment of mental illness, and mental health promotion. Visit www.mentalhealth.org.uk or call 020 7803 1100 for more information.
May 2006
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