Robin Lorimer Robin Lorimer Associate Integrated Care Network January, 2005 lorimerbtconnect'com

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Robin LorimerRobin Lorimer
AssociateIntegrated Care NetworkJanuary,
2005lorimer_at_btconnect.com
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Models of Partnership

• Joint working
• Joint Planning
• Care Trusts
• S31 Health Act
• S28

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A Puzzle!Which is the well known phrase?

• No Because..
• Yes if..

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Care Trusts

• Applications
• Commissioner Model
• Commissioner and Provision Model
• Provider Model
• Governance
• Agreement

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S31 Flexibilities

• Pooled budgets
• Lead commissioning
• Integrated provision
• and- - Section 28A
• - Section 28BB
• combinations but not hybrids
• Pools not alignment

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Understand the flexibilities
Lead Comm.
Pooled
Integrated Provision
Lead Pool
Pooled Provision
Integrated Pooled
Lead Funds Pool/s
Integrated Small Pool
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Pooled Funds

• Flexible use of available revenue resources
• Money in fund able to be spent on any of the
  services
• Enabling innovation / undefined service
• One agency to host pooled fund
• Identified means of access

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S28A and S28BB

• How the transfer will secure more health gain
  than an equivalent expenditure?
• Description and relationship to HImP
• Total amount of money to be transferred
• Year(s) Capital Revenue
• Evidence you will use to indicate that the
  purposes described have been secured
• Annual Voucher of expenditure

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A Clear Agreementor a Legally Compliant
Agreement?

• Aims and Objectives
• Contributions and resource
• Service and Operation,
• Pooled Fund Management
• Risk
• Variation and governance
• S28?

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Experience of S31

• S31 process transparency
• Trust improves Transactions are reduced
• Services improved
• Efficiency and gain
• User Interface simplified
• Enablement of scope and of expertise
• Clear Resources focussed upon Strategy
• Marginalised? Complacent
• Pace of change/ facing the future

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Technical barriers to progress?
Contributions and Finance Input Content of
agreement Confusion eg VAT, Charging ,
Accounts Objectives or Expectation Partnership
Milestones Control, Management or Partnership
Gain
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Risk and Accountability

• Risk Rating
• Surplus
• Deficit
• LDP and HA
• Risk for the Pool
• Risk for the Organisation
• Audit Requirement

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Partnership

• Territorialism, traditionalism, timidity,
  tribalism, hidden attack, UNITY?
• Time consuming - to begin and to maintain FOCUS
  ON SERVICE?
• Potential for bureaucracy SIMPLICITY OF
  TRANSACTION
• Perceived unclear accountabilities SOUND
  GOVERNANCE

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Where to begin and return

• Put the customer first, not the service or
  service provider
• Think outside the box
• Establish good joint working structure
• Ask the right questions for the right problem in
  the right place
• Agree principles and values
• Clarity purpose, direction not destination