Lessons learned on improving health and social care between PCTs and Local Authorities

1
Lessons learnedon improving health and social
care between PCTs and Local Authorities

• A short presentation by
• Keith Skerman

2
Agenda

• Background to discussion
• personal lessons
• recent national policy
• Cultural change workforce
• Developing health social care joint
  commissioning integrated provision
• Governance in the care sector
• Some technical issues

3
Personal Lessons

• Health Social Care career seamless service
• Joint approach LA/NHS as Director SS Swindon
• Interim in LAs PCTs since 2005 Lambeth,
  Aberdeen, Staffordshire, Milton Keynes, Luton
• NHS Workforce Review Team focus on integrated
  services

4
Recent Policy Background

• DH World Class Commissioning (WCC)
• PCT separation
• NHS market development
• DH Putting People First (PPF)
• Personal budget Personalisation agenda
• Choice control
• 9 NHS DH guidance documents Nov 08-Jan 09
• NHS Operating Framework (incl. collaboration
  competition)
• Transforming Community Services
• Safeguarding reviews
• Adult children
• Care Quality Commission (CQC) starts April 09

5
Cultural Change Workforce

• Focus on customers (patients, users, carers)
• Shift from professional gift to in control
• Care sector as key player in local economies
• Sustainable improvement quality dependent upon
  investment in workforce
• Stepped approach to change associated with
  consistent focus on outcomes not process
• Choice competition with joint commissioning

6
Developing Health Social Care

• 1)Commissioning (WCC) NHS focus upon market
  management PCT separation for VFM
• - Joint commissioning issues with LAs led by
  NHS? Care pathway reviews, Patient experience,
  Security of supply versus Competition/choice
• 2)Provision personalisation/choice impact upon
  health social care, versus integrated services?
• - Impact of mixed NHS economy/ WCC procurement
  on patient outcomes, workforce

7
Governance In The Care Sector

• Coherence in community political governance of
  care sector i.e. is there a thread from LSP/LAA
  to frontline services for health and social care?
• Joint Commissioning accountability officers
  with NEDs Members, with users/carers
• Ownership and involvement in models of provision
  innovation NHS FT, PBCs, Social Enterprises,
  Direct Services, ?customer focus
• Quality user/carer experience outcomes

8
Some Technical Issues

• Access to capital, developing assets (such as
  property, ICT) in credit crunch
• Shared services for integrated care providers
• ICT support to users carers for self
  assessment, brokerage, telecare/health
• Access to commercial expertise ( providers
  commissioners procurement) in care market
• Due diligence techniques support in new
  providers to support sustainable solutions