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Rosehill, Derby: proposal for a Connected Care Audit

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Title: Rosehill, Derby: proposal for a Connected Care Audit


1
Nerys Anthony, Assistant Director, Centre
ofExcellence in Connected Care
Beyond Traditional Integration Developing
Connected Care
2
Why are we here?
3
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4
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5
Connected Care what is it and who does it
benefit?
6
Connected Care
  • Integrates health, housing and social care
    services
  • Is done with the community, not to it
  • Provides a detailed assessment of breadth and
    depth of needs
  • Leads to community designed services
  • Fits with current and emerging government and
    commissioner agenda

7
The community a unique model of community
engagement
  • Begins with the community and puts them at the
    centre of commissioning
  • Enables the community to design and deliver their
    own services
  • Engages hard to reach groups who are rarely
    consulted and often marginalised
  • Fosters the development of a local skilled and
    innovative health and social care workforce

8
Commissioners offering solutions
  • Commissioners need to demonstrate how communities
    are at the centre of commissioning
  • Market moving towards a joined-up approach to the
    provision of care
  • Renewed focus on reaching people with complex
    needs, and long term savings by meeting these
    needs
  • A bigger role for the voluntary sector

9
Government informing government thinking
connected care centres have the potential to
meet the needs of those who have complex needs
and live in deprived communities.Page 56
a recently completed audit is giving the
Connected Care partners insights into how better
connected services could improve the lives of
those in the greatest need. Page 169
Individual agencies sometimes miss those who
have multiple needs, and may fail to look
holistically at the individual Page 11
Connected Care is cited as an example of
effective partnership working, where services
meet local needs and are provided in a
streamlined and accessible way. Page 16
10
Connected Care in action
11
Connected Care the process
Service design
Service delivery
Community audit
Cost benefit analysis
Evaluation
12
Stages of a Connected Care audit
Identify priority areas
Desk research
Recruit and train
Design audit
Establish governance
Produce report service spec
Cost benefit analysis
Conduct audit
Evaluation
13
The Connected Care audit
  • Enables the community to have a direct say in
    what health and social care services need to be
    commissioned in their area
  • Assesses how the community perceives existing
    services and what they want in the future
  • Uses a variety of participative methods to engage
    with the community
  • Capacity-builds the community who are trained and
    supported to carry out the audit

14
Training on Connected Care and research methods
  • Recruitment of local researchers in the community
  • Local audit team provided with training in design
    and delivery of research methods, specifically
    working with difficult to engage groups

15
Owton, Hartlepool
16
Case Study One Connected Care and Hartlepool
  • The Concept
  • Turning Point/IPPR report on Meeting Complex
    Needs 2004
  • The Place
  • Owton Manor, a post-war housing estate on the
    edge of Hartlepool
  • The Partnership
  • Local community and services, Turning Point,
    Department of Health

17
About Owton, Hartlepool
  • Owton is in the 5 most deprived neighbourhoods
    in the country
  • More than 10 of Owton residents have either
    never worked or are long-term unemployed
  • Over half of Owtons residents aged 16-74 left
    school with no formal qualifications
  • 50 of residents have health problems
  • 27 of working age residents have a limiting long
    term illness

18
Local strengths of Owton
  • Good housing stock and physical environment (SRB)
  • Open space and countryside
  • Local shops and community facilities
  • Strong local identity
  • Social capital community leaders and
    associations

19
Key themes of the audit  
  • Information
  • Choice
  • Access to services
  • Continuity and coordination
  • Workforce and quality provision
  • Connecting involvement with change
  •      were surveyed to death 

20
Putting Connected Care into practice
  • Service redesign design bespoke Connected Care
    services alongside commissioners and the
    community
  • Service delivery work with multiple agencies to
    provide whole systems' funding and support
  • Social enterprise involving the community in
    delivering Connected Care
  • Individual budgets giving choice and control to
    the community

21
From audit to service specification  
  • Range of services how do services currently
    work?
  • What will the Connected Care service provide
    (gaps in provision)
  • Location
  • Access and referral
  • Assessment
  • Links between services
  • Intervention to be offered
  • Staffing model
  • Monitoring
  • Outcomes and evaluation

22
What it looks like now  
  • A team of navigators.
  • A complex care team integrating specialist
    health, social care and housing support.
  • A transformational co-ordinator to manage the
    service and promote change in the wider service
    system.
  • The development of a range of low level support
    services that focus on maintaining independence
  • Delivered through a social enterprise managed by
    residents and local community organisations.
  • Promoting individual budgets for people with
    mental health needs

23
Evaluating Connected Care
  • Audit Evaluation
  • Community researchers have a greater reach than
    professional researchers.
  • Training for communities is seen to be critical
    in fulfilling this function.
  • Improved the skills and confidence of individuals
  • It shaped the perception of how the community saw
    itself
  • Process is building relationships as well as
    gathering information
  • Strong emphasis on system, process outcomes e.g.
    access, navigation and co-ordination

24
Case Study Two Bolton
  • Farnworth. White working class area, high rates
    of unemployment and heart problems. In the 3
    most deprived neighbourhood in the country.
  • Derby and Deane. High BME population with over 40
    different spoken languages and many asylum
    seekers.
  • Halliwell. Majority white population although
    large asian population. Large rented housing
    market.
  • Building on the Bolton Urban Care Centre Model

25
Taking forward learning
  • Training module revised and supported by SCIE
  • Community researchers versus volunteers
  • Evaluation
  • Cost benefit analysis
  • Approach and outcome will vary locally

26
Cost-benefit analysis
  • Our cost-benefit model is a bespoke tool
    designed for commissioners that
  • Tests the cost-benefit impact of Connected Care
    on the provision of health and social care
    services.
  • Maps the current flow of resources across health
    and social care
  • Models the consequences of new decisions made by
    commissioners within a Connected Care environment

27
Cost-benefit analysis
  • It achieves this by understanding
  • How service users flow through different parts of
    the system and the resources used
  • How demand for health and social care and costs
    will be affected by different connected care
    assumptions
  • The long-term effects on the system caused by
    different approaches to strategy
  • The knock-on effects on other services

28
Connected Care evaluation
Commitment to development of clear and credible
evidence base to establish
  • Whether the Connected Care audit has effectively
    engaged the community
  • Whether the Connected Care services work for
    individuals, communities and commissioners
  • A Connected Care outcome framework adapted to
    reflect the different priorities of local areas

29
Key learning points
  • Community-led commissioning has the potential to
    deliver a range of positive benefits including
    service changes, improved health and social care
    benefits reduction in inequalities and increase
    in satisfaction with services
  • A range of different approaches to community
    engagement should be used by commissioners
  • Community-led commissioning needs to build on
    existing initiatives locally not duplicate them
  • Commissioners also should think long term and
    look at ways of ensuring community engagement
    activities are sustainable and linked to
    organisational decision-making and planning
  • The third sector can play a critical role in
    facilitating community-led commissioning and
    engaging with different service user groups and
    communities
  • Evaluation needs to be built in from the start

30
Any questions?
31
Turning Point Centre of Excellence in Connected
CareStandon House21 Mansell StreetLondonE1
8AA 020 7481 7650centreofexcellence_at_turning-point
.co.ukwww.turning-point.co.uk/centreofexcellence
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