Welcome to the 5th Co production Event from IMPACT Clinical Model Update of Secure Services in the East Midlands Thursday the 12th September 2019 Kegworth.

Welcome to the 5th Co production Event from IMPACT Clinical Model Update of Secure Services in the East Midlands Thursday the 12th September 2019 Kegworth Hotel & Conference Centre WiFi code FREEWIFI 12/09/2019 IMPACT Co-Production

WELCOME Dr Julie Repper Director, ImROC 12/09/2019
IMPACT Co-Production

Welcome to the IMPACT Coproduction forum
Julie Repper Director - ImROC

Introductions Who is here? The importance of knowing who you are working with and what experience/expertise they bring …..

ningup knowledge–action systems to a wider range of disciplinary and
What is co-production? The art and practice of people sharing risk and responsibility together to find solutions to shared challenges (modified from Mark Brown, 2019) A way of working that involves people who use health and social care services, carers and communities in equal partnership … at the earliest stages of service design, development and evaluation… Part of a range of approaches that includes citizen involvement, participation, engagement and consultation (Coalition for Collaborative Care, 2018) ningup knowledge–action systems to a wider range of disciplinary and “Opening up knowledge–action systems to a wider range of disciplinary and societal actors is a necessary step in achieving transformative change” (Miller and Wyborn 2018)

“Coproduction in its purest sense is like the secret lovechild of two different trends; people who design services and people who want better ones getting together to make something new happen that wouldn’t have happened in quite the same way if they hadn’t hooked up” (Brown, 2019)

“The reciprocal effect of co-production is people who regain hope, hope that together they can make a change that will last. Not as people with lived experience, advocates, peer workers or health workers but as a people and a community that is valued” (O’Reilly, 2019)

Traditional services recognise one set of experts
It is assumed that health workers are the experts Therefore it is health workers’ job to tell ‘them’ what is wrong with them and to ‘fix’ them Service design and development have traditionally been led by healthcare professionals who do not have experience and expertise of using services, caring for people who us services, providing housing, employment, social support, financial support ….. Coproduced services recognise multiple sets of expertise Expertise based on professional training, experience, research and theories Expertise based on personal experience of distress and personal journeys of Recovery Expertise based on different functions, funding streams, contexts of care, priorities and different skills sets Creating coproduced services requires us to recognise the expertise of all stakeholders on equal terms as professional expertise “In coproduction professional knowledge is valuable based on how it is used, as is lived experience: neither is a veto or an unfair advantage if you work out how to work together and not at odds with each other” (Brown, 2019)

Coproduction in IMPACT – still in development
Coproduction forum – all stakeholders invited to inform and guide plans and developments (statutory and third sector health and social care services, primary, secondary and specialist providers, housing, prison, probation, employment; different professional groups, different funding streams, different priorities … Multiple stakeholders on task and finish groups (now need to identify, engage with and represent views of more people who use services and family members) Lived Experience Facilitator post being established to facilitate and support greater engagement by collecting views of inpatients and supporting greater service user and carer membership of different forums. Peer support workers already started working in blended service pilot at St Andrews Peer support workers will be employed in Community Forensic Teams …

Aims of the Day Programme Update & Recap of Previous Events
Claire Holmes Dr Katina Anagnostakis Programme Lead Clinical Lead 12/09/2019 IMPACT Co-Production

Clinical Model Development Learning Disability & Autism
CO-PRODUCTION WORKSHOP 5 12th September Claire Holmes - Programme Lead Dr Katina Anagnostakis - Clinical Lead REDESIGN OF ADULT SECURE SERVICES Clinical Model Development Learning Disability & Autism

Aims for today… Ensure all stakeholder views included in ongoing process IMPACT Provider Collaborative update Stocktake: 8 months later what have we achieved? Topic focus: learning disability & autism NHS England- direction of travel and how can you influence developments in the East Midlands

NHSE/ National Picture
The plan is to change specialised mental health commissioning arrangements for the first phase of adult secure care; CAMHs tier 4 & eating disorder services by April 2020 through the development of provider collaboratives (PCs). A PC is a collective of mental health providers led by a Lead Provider working in partnership to provider specialised MH services for a given population; to improve and standardise services. A PC will be financially and clinically responsible for their patient population and accountable to NHSE for the decisions made and quality of care provided. IMPACT has now been awarded “fast track” status; we will go live in April 2020.

EM IMPACT Provider Collaborative

IMPACT Provider Collaborative Vision
Primacy of patient experience & patient outcomes

IMPACT Provider Collaborative Values
Our Co-produced Values PEOPLE FIRST & WORKING TOGETHER OPENNESS & HONESTY EMPOWERMENT & OPPORTUNITY SAFE & LEAST RESTRICTIVE

IMPACT Provider Collaborative Objectives
Primacy of Patient experience & patient outcomes Better Community Support Less reliance on inpatient bed based services Population needs based service provision Personalised, co-produced, outcome focused services Integration with health & social care systems Culture change across regional secure care system incentivizing collaboration for patient benefit Culture change across the regional secure care system incentivising collaborating for patient benefit eg shorter LOS, fewer admissions, streamlined processes

2019 Co-Production Events Date Topic Attendees January 2019 Leicester
Co-Production & Values How can secure services improve/ what works well 40 February 2019 Nottingham Improving admissions Improving admissions task & finish group Values for the programme- service user groups Name for the programme- service user groups 62 April 2019 Northampton Discharge & effective support in the community Community task & finish group: new Assertive Transitions Service as per the CFS bid. Recovery & Outcomes presentation: Ian Callaghan 80 June 2019 Nottingham Improving transitions through secure services Women’s Blended Pilot: presentation by the Expert by Experience team and St Andrew’s Healthcare Senior Leadership Panel- representation from each provider within the collaborative to demonstrate commitment to the programme. 80+ September 2019 Learning disability & autism Clinical model update

Feedback…. “Listening to peers and recovery stories. Very powerful”
“Positive group discussions, great connections and more opportunities for shared understanding of the challenges for forensic services” “Fantastic potential but worried that many decision makers, CEOs, leading staff not present and they are the key ones to win” “Listening to peers and recovery stories. Very powerful”

We Said…. We Did… New referral, assessment & admissions process
Approved assessment process Principles of consideration Development of new Assertive Transitions Service New service will work with people up to a Year pre-discharge and intensively in Community, heavy focus on support staff & peer support Development of a Lived Experience Facilitator job role within IMPACT, and a shared communication platform to update changes and outcomes to all Too many assessments; Not enough focus on Choice in the process You Said: There are too many assessments to get into secure services Individual choice as to where people are placed is often not taken into account. We did: We are introducing a single “approved assessment” process that negates the current practice of multiple assessments We have developed a “decision tree” ie a set of principles that are applied by all clinicians when people are placed in a secure bed or move between levels of security. Service user and family choice will be central . This will be introduced when the new referral form starts being used from 1 June. Decisions around bed allocation will be audited to ensure choice is consistently applied. There should be more support available to help people well before discharge from secure services and after discharge Peer support and support workers are needed in forensic services to provide practical advice and assistance including emotional support. We are developing a new service that will provide support to people up to a year before discharge and help transition in the community; a large part of the staff will be peer support and support workers. People are often “stuck” in secure services; they don’t know when their discharge date is or what is happening. We have set up a new task & finish group to look specifically at transitions and a system whereby there will be much more oversight of people when in secure care including a “single point of exit”. This group is also looking at how we can end repeated assessments when people move between levels of security. The Women’s blended pilot at St Andrew’s should reduce the times people transition; if successful this can be rolled out across other services. Not enough support to prepare for discharge/ support in community Co production not just in design, but delivery

Milestones since Nov 2018 Communication: staff info, organisations, CEO panel Network of clinicians & Clinical Lead Created a programme Name & Identity Transformative clinical model Piloting SPA and new clinical processes Built a provider collaborative inclusive of independent sector Built co-production infrastructure SCFT Bid & Blended Pilot Data sharing/ MCA agreement Service scoping, data analysis & reviewing best practice evidence Stakeholder engagement eg CCG survey, presentations

Assertive Transitions Service (Community Forensic Bid)
Dr Katina Anagnostakis

Context NHSE wave 2 specialist community forensic (SCFS) pilot
£1.735m per annum allocation for East Mids Pilot is for 2 years from Aug 2019 Provider collaborative bids by 24th June Aim: to test co-produced 12 core components as safe alternative to inpatient secure care Service is mobilising now; first phase due to start Jan 2020.

Development of the Service Model (1)
Service scoping: Variable regional coverage of 12 core components- mainly traditional functions e.g. assessment, case management Less developed psychosocial and rehabilitative components e.g. peer mentorship, carer support, substance misuse, employment etc. Most well developed CFS in Notts and Northampton

Development of the Service Model (2)
Co-production events feedback: Patients feeling “stuck” in services Not enough pre and post discharge support Need help with practical issues eg registering with a GP, housing support, benefits advice Added value of support workers & peer support workers alongside traditional qualified roles More support for carers Work in partnership with third sector

Service Model (1) Assertive Transitions Service (ATS)
With a multi-disciplinary team situated in the North (hosted by NHCFT) covering Nottingham City and Nottinghamshire And a multi-disciplinary team situated in South (hosted by St Andrews) covering Northamptonshire and Leicestershire Service Aims: Proactively work with in-patients (approximately 1 year prior to discharge) in order to expedite discharge Unblocking issues that could delay or prolong discharge from a low or medium secure setting Providing intensive support as patients transition out of secure services Support patients following transition to be independent and remain in the community setting Reduce length of in-patient stay Collaborative working with 3rd sector and independent specialists in the community

Service Model (2) Criteria for the Assertive Transitions Service:
Patient must be an East Mids patient residing in an East Mids bed Patient must have a forensic history Patient must be within a low or medium secure facility (NHS and Independent) This will include patients with a mental disorder (inc. Autism &ASD) Areas that will not be covered initially by the pilot are: Patients being discharged from a locked rehab provision or a prison

Service Model (3) Interventions offered during and through transition:
Individualised support plan, developed with and for the individual shared with all those involved in their care. Peer support workers: Providing 1:1 support and guidance, involvement in group development and potential drop in hubs in the community. Support workers: supporting access to community activities, using public transport, registering with GP and attending appointments. Psychological input to support transition and building relationships. Substance misuse work- provided by a regional wide 3rd sector provider Housing and benefit support/guidance Occupational and daily living activities Support/financial assistance to enable community living (e.g. purchase of bus passes, essential equipment for day to day living )

Service Model (4) Extended hours to support reintegration into community and accessing activities outside of core hours. (8am – 8pm) Mon-Fri and 10am-4pm weekends 7 day a week access to team via telephone and planned appointments. The ATS will be delivered by a newly recruited team in both the north (up to 20 WTE) and the south (up to 15 WTE). Key full and part time personnel some working enhanced hours to provide the 7 day service include: Pathway Navigators (qualified MH professionals e.g. CPN/RMN, HCPC registered staff), Clinical Team Leader Support workers (provided by a 3rd sector organisation e.g. Rethink) Peer Support Workers (trained & supervised by IMROC) A regional wide substance misuse service that supports both the North and South teams Specific carer support

Outcomes Improved patient experience of transition
Reduced lengths of stay in secure units Unblocking pathways from medium to low secure units Increased discharge rate Reduced use of out of area beds System savings (through less bed usage) Support for similar regional developments

Thank You Thank you for listening We hope you enjoy the workshop!

Passport Feedback Leigh Johnson & Dr Rachel Haughton – Elysium
Presentation: 12/09/2019 IMPACT Co-Production

Single Point of Access: Changes to Referral, Assessment & Admissions Processes
Debbie Stanton NHS England/Improvements Presentation: 12/09/2019 IMPACT Co-Production

#IMPACTcoproduction #securecare #providercollaboratives
BREAK #IMPACTcoproduction #securecare #providercollaboratives @cygnethealth @derbyshcft @elysiumcare @LPTnhs @LPFTNHS @NottsHealthcare @NHFTNHS @PrioryGroup @StAndrewsCare @ImROC_comms 12/09/2019 IMPACT Co-Production

Is Impact making a difference to the experience of people using forensic services?
The primary goal of the New Care Model programme in the East Midlands (IMPACT) is to change the experience of forensic service users and their families and friends We would like your help to decide how we find out if we are achieving this. We are already collecting a lot of information about length of stay, number of assessments, movement through levels of security, where people are discharged to, the satisfaction of family members etc. Today we are asking you how we should assess the differences these changes are making to the daily life of people using services and their families.

Goal – to develop a new care model for adult secure services that is:
Quantitative measurement (numbers) Qualitative Measurement (views, experiences, examples) Person centred, recovery-focused support focusing on empowerment and resilience CPA audit Standardised outcome measures – Recovery, social functioning, mental and physical health, personalisation , quality of life What shall we ask? (eg communication, support with personal goals…) Who shall we ask? (eg inpatients, family members….) How shall we ask? (eg individual interviews, written questionnaires, online questions, focus groups…) Who will ask? (eg trained service user researchers, staff members, independent researchers?) Least restrictive environment – shorter length of stay Length of stay at different levels of security Better support in community alternatives to inpatient care that are closer to home Where are people discharged to? Support in the community? Readmissions and reason for admission Use of criminal justice services Inclusion of families and carers Family satisfaction with services More effective and efficient movement through levels, inc faster admission when required Number of assessments, speed of assessments, use of assessment information

Would anyone using forensic services, or their family members be interested in getting involved in the evaluation of IMPACT? If so, please let Vicki know your name and contact details and we will be in contact with you ….

Table Top Discussion & Feedback
How will we know whether peoples experience of care is positively changing including families/ social networks 12/09/2019 IMPACT Co-Production

#IMPACTcoproduction #securecare #providercollaboratives
LUNCH #IMPACTcoproduction #securecare #providercollaboratives @cygnethealth @derbyshcft @elysiumcare @LPTnhs @LPFTNHS @NottsHealthcare @NHFTNHS @PrioryGroup @StAndrewsCare @ImROC_comms 12/09/2019 IMPACT Co-Production

WELCOME BACK 12/09/2019 IMPACT Co-Production

Learning Disability & Autism: Adult Secure NHSE Update
Mark Hall NHS England/Improvement Regional Case Manager Presentation: 12/09/2019 IMPACT Co-Production

IMPACT Workshop Learning Disability and Autism (Transforming Care)
12 September 2019

The Long Term Plan Over 1.2 million people in England have a learning disability and face significant health inequalities compared with the rest of the population. Autism is a lifelong condition and a part of daily life for around 600,000 people in England. It is estimated that 20-30% of people with a learning disability also have autism Despite suffering greater ill-health, people with a learning disability, autism or both often experience poorer access to healthcare. In 2017, the Learning Disabilities Mortality Review Programme (LeDeR) found that 31% of deaths in people with a learning disability were due to respiratory conditions and 18% were due to diseases of the circulatory system. Across the NHS, we will do more to ensure that all people with a learning disability, autism, or both can live happier, healthier, longer lives This means that we will provide timely support to children and young people and their families. We will do more to keep people well with proactive care in the community. We will ensure that reasonable adjustments are made so that wider NHS services can support, listen to, and help improve the health and wellbeing of people with learning disabilities and autism, and their families. For people with the most complex needs, we will continue to improve access to care in the community, so that more people can live in or near to their own homes and families.

Presentation title

Provider Collaborative Responsibilities
Pathways of care Clear descriptions of the different pathways of care and treatment within the Provider Collaborative from the point of someone being at risk of admission to secure care/CYP Tier 4, to post-discharge. This should include details of what this means for different patients e.g. including those admitted through the Criminal Justice System, those with autism only, those with a co-morbid mental health problem. This should include reference to interface and joint-working with available community services, as well as highlighting any gaps and how you would seek to address these. You must be able to describe how you will ensure that care and treatment is personalised and person-centred, and least restrictive, throughout the pathway. The strategy for making reasonable adjustments across all service lines should be described, including use of digital flags. LTP commitments The business case should describe how the Provider Collaborative will reduce reliance upon inpatient care, reduce length of stay, and deliver care closer to home in the least restrictive environment possible for people with learning disability and autistic people. Specific reference made to the applicable inpatient targets and proportion of patients out of area for your collaborative. Detail of how C(E)TRs be delivered in an independent, challenging and effective way, with actions followed up and detail of how the collaborative will support the pre-admission C(E)TR and dynamic risk process, to reduce the number of avoidable admissions. Detail of how the collaborative will ensure the uptake of annual health checks, screening provision and flu vaccinations Detail of how the collaborative will ensure access to independent advocacy and make sure people are aware of their rights to access this (bearing in mind the need for reasonable adjustments) Detail of how the collaborative will contribute towards the LeDeR programme Governance The collaborative has links with relevant TCPs / ICSs / STPs and can articulate emerging governance for use of resources for people with a learning disability and autistic people. This must include CCGs, Local Authorities and those with lived experience, as well as local voluntary sector groups. The collaborative can describe how it will co-produce its pathway of care and plan for out of hospital care with people with lived experience and voluntary sector groups.

Provider Collaborative Responsibilities
Focus on quality What is the strategy for reducing and continuing to reduce restrictive practice, including the over use of medication – with reference to the STOMP-STAMP programme? What will your quality assurance process look like, including escalation and triangulation of soft intelligence and the voice of those with lived experience? How will you proactively use the learning disability improvement standards to drive up practice across the collaborative? What is your strategy for reducing the number of temporary / agency staff and reducing staff sickness absence across the collaborative, for staff working with those with a learning disability and autistic people? What will be your approach to training to ensure all staff are able to make reasonable adjustments, irrespective of the service in which they work? How will you continue to ensure that you listen to and act on the voice of patients and families, on both service delivery and development, including specific reference to the Ask Listen Do model? Clinical leadership Clear description of how the collaborative will secure strong clinical leadership that is specific to learning disability and autism, and enshrine the principle of ‘board-to-ward’ How will population health data be visible across service lines, to prevent silo working between pathways? How will clinical leadership be joined up with that within STPs / ICSs, and with other collaboratives? What support / guidance would provider collaborative teams find helpful when developing their model to deliver these responsibilities?

Regional progress overview
Midlands Summary of Progress vs Plan Priority Area Regional progress overview Reasons for variance Inpatient Trajectories On plan Top 3 reasons for variance Gaps in autism only pathways leading to high admissions for autistic people High number of inpatients identified as non-dischargeable by March 2020 Transition pathways for 16 to 25 year olds not robust leading to over 18s admissions into inpatient services. 5 year plus N/A Commissioned Beds Top reasons for variance Identifying providers of care and support with the skills and expertise to deliver robust personalised community-based care Housing and care and support market shortages to enable discharge. Culture and practice of reliance on in-patient beds amongst commissioners and providers Community Services Intensive support services Community forensic services Immaturity of some TCP community services impacting crisis support. Care & Support market & housing options limited some areas Clinical practice and pathways immature

Regional progress overview
Midlands Summary of Progress vs Plan continued Priority Area Regional progress overview Reasons for variance Care and Treatment Reviews (CTR/CETR) Off plan - CETRs Only Community CETRs not being carried out prior to admission Post-admission CETRS not being conducted within policy timescales Late diagnosis of CYP post-admission into inpatient care Number of CYP with LoS over 12 months Children and Young People (CAHMS) Admissions without a pre admission or post admission CETR – increase in CETR compliance to 90% TCPs with high inpatient numbers CYP with length of stay beyond 12 months Housing All 12 TCPs are now rated green for having housing plans in place. Separate discussions with TCPs around new housing metric 'schemes on site or delivered' to be reviewed from Q2 onwards. Financial Circa £20m transferred from NHSE to (TCPs via the Funding Transfer Agreement (FTA) process to support discharges Based on an average of £180,000 per patient TCPs must meet the inpatient trajectory to access the FTA payment

Midlands Current Inpatients

Admissions and Discharges Apr-17 to June-19
Between April 2018 and April 2019 the overall number of discharges was 212 Over the same period there were 119 actual admissions

Patient Category There are very few adult and CAHMS admissions of patients with a Learning Disability Almost all CAHMS admission to the cohort, including into MH, PICU and Eating Disorder Services, have ASD An increasing number of young people are receiving a post admission diagnosis of ASD 34% of the total inpatient cohort have ASD 72% of CAMHS inpatients have ASD The lack of locally commissioned post diagnosis provision for patients with ASD has a significant impact on our ability to discharge patients into the community in a timely way.

Delayed Discharges August 2019

CTR/CETR Performance and Compliance
August CTR /CETR performance Target 75% August performance above target for all the KPIs Continue to experience challenges around the number of young people admitted with no Pre Admission CETR or via the LAEP process. Work is ongoing to address challenges in arranging post admissions CETRs within 2 week policy timescales Challenges are mainly: being informed late of the admission, providers unable to accommodate dates that falls within timescale, availability of panel members. Under 18 post admission (90%): 100% Under 18 repeat (75%): 78% Adult post admission (75%): Adult repeat (75%): 88% Midlands Region CTR Compliance Current Adult in date 86% CAMHS in date 78% We aim to achieve 100% improvement by the reduction of LAEPS and admissions with no Pre- Admission CTR/CETRs across the system

CTR/CETR Post-Admission Performance
Midlands Region 2019/20 Apr May June July August 19 % & RAG Rating for post admission CTRs/CETRs carried out within timescale 100% 63% 0% 20% August achieved 100% post-admission performance The performance for May to July was affected mainly by C(E)TR not be arranged within timescales due to challenges in fixing dates with the providers which largely depend on RC availability. 1

Bed Reductions Midlands – NHSE Beds** Apr-19 May-19 Jun-19 Jul-19 Aug-19 Sep-19 Oct-19 Nov-19 Dec-19 Jan-20 Feb-20 Mar-20 NHSE - Plan 238 239 217 199 189 NHSE - current 209 207 204 Variance 29 32 35 - As at June the Midlands bed position was 204 which is 35 below plan. This includes 59 Out of Area patients occupying Midlands commissioned beds. 1

Community Services Investment
Enhanced Community LD Team Crisis Support Team/ Intensive Support Intermediate Care/ Alternative Accommodation Forensic Support Team Children & YP Pathway Commissioned Autism Pathway Commissioned Dynamic Register Provider Commissioning model Positive Behavioural Support Arden BSOL Black Country Derbyshire Herefordshire Leicestershire Lincolnshire Northampton Nottinghamshire Shropshire Staffordshire Worcester In Place On Track In Development Not in Place

Wider Community Services Landscape
Liaison and Diversion services FCAMHS

Liaison and Diversion Services
Birmingham and Solihull Birmingham and Solihull Mental Health NHS Foundation Trust Service Manager: Stephen Jenkins, Black Country Black Country Partnership NHS Foundation Trust and Dudley & Walsall Mental Health Partnership NHS Trust Service Manager: Dawn Homer, Coventry Coventry and Warwickshire Partnership NHS Trust Service Manager: Fiona Rose, Derbyshire Derbyshire Healthcare NHS Foundation Trust Service Manager: Dominic Pitter, Leicestershire Leicestershire Partnership NHS Trust Service Manager: Matthew Wakely, Northamptonshire Northamptonshire Healthcare NHS Foundation Trust Service Manager: Kate Woodfield & Rachael Blundred, Secure box: Nottinghamshire Nottinghamshire Healthcare NHS Foundation Trust Service Manager: Yvonne Bird, Stoke Service Coordinator: Simon Wilson,

FCAMS National Provision

Financial risk A new proposal for the FTA is being developed and will go to the national Oversight Group on the 19th September for approval As part of this paper, we have calculated the indicative financial risk on a provider collaborative footprint, based on the principles within the proposed FTA, and the current distance to travel towards the LTP inpatient targets, per provider collaborative footprint. Current data sharing agreement means that we can only currently share ‘suppressed’ data – this means data will be rounded up or down to the nearest 5. It will however give an indicative level of risk. We have also calculated the dowry commitment per provider collaborative footprint (this is the transfer associated with long-stay patients), which again will give an indication of maximum financial risk exposure. We will share this information following the 19th September.

Thank You Yasmin Surti Regional Specialised Commissioning Head of Transforming Care Mark Hall Regional Specialised Commissioning Service Specialist Christine Bakewell National Specialised Commissioning LD and ASD Lead

What improvements would you like to see in the care, treatment and support that people with LD and autism are receiving? Although we have begun to think about the changes we need to see in these services, we need your help to determine the priorities.

Are these services fit for purpose?
What are your priorities for improving services for people with learning disabilities and autism? Are these services fit for purpose? What is working well? What needs improvement and how? What is missing to support transition into the community? What is the biggest barrier to staying in the community?

Table Top Discussion & Feedback
In relation to people with a Learning Disability and/or Autism in secure care: Q1 Are our current inpatient services fit for purpose? What is working well? What needs to change? Q2 What is missing to support transition into the community? Q3 What is the biggest barrier to staying in the 12/09/2019 IMPACT Co-Production

FEEDBACK & QUESTIONS 12/09/2019 IMPACT Co-Production

Summary & Next Steps 12/09/2019 IMPACT Co-Production

Thank you for joining us today
For more information on future workshops and how you can get involved, please 12/09/2019 IMPACT Co-Production

Welcome to the 5th Co production Event from IMPACT Clinical Model Update of Secure Services in the East Midlands Thursday the 12th September 2019 Kegworth.

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Welcome to the 5th Co production Event from IMPACT Clinical Model Update of Secure Services in the East Midlands Thursday the 12th September 2019 Kegworth.

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