Staying in Control

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Staying in Control

• What it is and how its developing
• November 08

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Staying in Control- What is it?

• Staying in Control is a learning community
  focussed on a specific task-
• Exploring how the personalisation model being
  applied in Social Care can be tested and amended
  in health care
• Acknowledged not to be appropriate for all
  aspects of health care
• 37 PCTs (including 3 Care Trusts) and their Local
  Authority partners- in 35 sites in many different
  parts of England, counties and cities

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Staying in Control- which places are members?

• PCT and Local Authority members of Staying in
  Control
• By Strategic Health Authority area
• London SHA
• Croydon PCT and Croydon Council
• East of England SHA
• Bedfordshire PCT and Bedfordshire County Council
• (will be splitting into two councils in April
  09 Bedford Borough Council and Central
  Bedfordshire) 
• NHS Norfolk and Norfolk County Council
•  
• South East Coast SHA 
• East Sussex Downs and Weald PCT and
• Hastings and Rother PCT- both partners of East
  Sussex County Council
• West Sussex PCT and West Sussex County Council
• Medway PCT and Kent County Council
• Surrey PCT and Surrey County Council
•  
• South Central SHA 
• Berkshire East PCT and Slough Borough Council

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Staying in Control- which places are members?

• PCT and Local Authority members of Staying in
  Control
• By Strategic Health Authority area
• Yorkshire and Humber SHA
•  
• Barnsley PCT and Barnsley Metropolitan Borough
  Council
• Doncaster PCT and Doncaster metropolitan Borough
  Council
• Hull PCT and Hull City Council
• Rotherham PCT and Rotherham Metropolitan Borough
  Council
• North East Lincolnshire Care Trust Plus
• North East SHA
• Redcar and Cleveland PCT and Redcar and Cleveland
  Borough Council
• North Tees PCT and Stockton on Tees Council
• Hartlepool PCT and Hartlepool Borough Council
•  
• North West SHA
• Stockport PCT and Stockport Council
• Cumbria PCT and Cumbria County Council

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Staying in Control- which places are members?

• PCT and Local Authority members of Staying in
  Control
• By Strategic Health Authority area
• East Midlands SHA
• Nottinghamshire County teaching PCT and
  Nottinghamshire County Council
• Bassetlaw PCT-both partners of Nottinghamshire
  County Council
• Northamptonshire Teaching PCT and
  Northamptonshire County Council
• Nottingham City PCT and Nottingham City Council
• Lincolnshire Teaching PCT and Lincolnshire County
  Council
•  
• West Midlands SHA
• Heart of Birmingham PCT and Birmingham City
  Council
• Stoke on Trent PCT and Stoke on Trent Council
• Solihull Care Trust
• Worcestershire PCT and Worcestershire County
  Council
• Dudley PCT and Dudley Metropolitan Borough
  Council
• Wolverhampton City PCT and Wolverhampton City
  Council
• Herefordshire PCT and Herefordshire Council
  with One Joint Chief Executive for the council
  and the PCT (only one in England)and a joint
  single management team.

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Staying in Control- for whom?

• Will be working collaboratively to create
  innovative ways of working across many different
  illnesses/conditions, including dementia,
  substance misuse, long term conditions such as
  diabetes and heart disease, mental health,
  neurological conditions, children with complex
  health needs, people with a learning disability
  and people funded by continuing health care
  money.

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Staying in Control- innovation not imposition

• Self Directed Support is a complex well-developed
  approach specifically designed to reform social
  care- it works well since it leads to better
  decision making.
• The nature of decision making in health care is
  different, as is the history, legislative context
  and number of professionals involved.

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Some reasons why health is different

• Our rationality in the face of death
• The existence of genuine professional expertise
  which cannot be easily be made transparent
• Health rationing is much more complex and
  multi-faceted
• There are many more professionals and care
  pathways than for social care

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Some Big Questions

• Will SDS replace the current social care system?
• Will SDS replace the current health care system?
• Would some things, currently funded by the NHS,
  be better delivered through SDS?

Probably
No
Possibly
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Staying in Control-budgets alone wont work

• Our experience suggests that while personal
  health budgets may be very useful- they will only
  work if there are also
• Opportunities to meaningfully plan and shape
  treatment and support- flexibly
• Effective systems of support, information and
  advice
• A range of effective options
• Appropriate systems for professional input and
  monitoring.
• A shift in the power between an individual and
  the NHS

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Staying in Control-some potential outcomes

• ? Strengthening citizenship and improving health
• ? Building more productive roles for
  professionals
• ? Increasing the focus on health outcomes
• ? Extending control to more people
  (nationalising choice)
• ? Clarifying entitlements and improving equity
• ? Increasing focus on healthy lifestyles and
  prevention
• ? Tilting the balance - giving more power to
  citizen
• ? Improving management through self-direction and
  self-care
• ? Creating a healthier, adult-to-adult, culture
  in health care
• ? Integrating services effectively - around the
  individual
• ? Increases innovation and experimentation
• ? Encouraging new services and forms of care
• ? Investing more effectively to promote health

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Staying in Control-what would be good?

• Any changes will need to be tested by the extent
  to
• which they
• Improve health outcomes
• Improve citizenship outcomes
• 3. Improving equity
• 4. Increasing efficiency
• Well designed system reforms will improve all of
  these variables

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Staying in Control-How we will influence the
Government pilots

• The recent Darzi report has said there will be
  personal health budget pilots next year.
• In Control and the Department of Health are
  working closely together.
• Staying in Control is well timed to inform the DH
  pilots which will start next Summer.
• The programme will highlight some of the key
  changes and developments needed to make
  personalisation in the NHS a success in practice.
  

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Staying in Control-next steps...

• During the next 8 months In Control will focus
  its efforts on
• ? Helping members to develop practical solutions
  for each aspect of Self-Directed Support,
  including creating outcome measures
• ? Publishing all interesting and positive
  innovations
• ? Supporting members to connect, share problems
  and solutions, and
• ? Helping draw out lessons for national policy -
  supporting members to influence the Health policy
  of the future.

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Staying in Control-keeping up to date

• In Controls new web site
• www.in-control.org.uk
• Go to the Membership button to find the Staying
  in Control section.
• Latest information is available, including
  peoples stories and useful resources documents
  and presentations. All new developments will be
  shared here.

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Mitchell at home with support through personal
health budget