Julia Ross

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Julia Ross
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Personalised care and more self-care in an
integrated waymore services in local communities
that are closer to peoples homes and more
emphasis on prevention
Lord Warner June 2006
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The Peoples Choices

• NHS life check MOT 76
• Mental well-being
• Help for carers
• Trained nurse first
• Joined-up services
• Better access

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Context

• Rising expectations
• New technologies telecare
• Cost pressures Wanless x 2
• More choice and better access
• More efficiency tax payers

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New outcomes from commissioning

• Fewer block contracts for hospitals
• Shift of (health and social) care closer to as
  well as in - home
• More investment in community services
• Demonstrate value for money
• New models of care
• Plurality of providers

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New Models of Commissioning

• Strategic whole population
• Focus on locality
• Focus on individuals
• Supported by stronger PCTs
• 75 co-terminus with social services
• Cost effective
• Outcome focussed

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Three key principles that underpin the White
Paper, integration, empowerment and
preventionintegration and partnership are not
sideshows. They are the most likely way of
achieving our objectives
Ivan
Lewis June 2006
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Integrated health and social care

• Joint appointments and leadership
• Long Term Conditions - joint teams, care plans
  and single assessment process
• Local Area Agreements
• Joint commissioning
• Managing systems together
• Performance assessment
• Planning and budget cycles

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Integration via LAAs

• 90 LAAs public health outcome
• Phase 2 Green Paper
• Phase 3 White Paper
• Vehicle for partnerships
• Strengthen DH regional presence
• Role of CSIP

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Empowerment

• Act on peoples choices
• Local deliberative events and PPI
• Engage in design and commissioning
• Reconfiguration and decommissioning
• Expert patients community interest company
• Expanding self-directed support

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Prevention

• Peoples choice and independence
• Economic case
• National Reference Group for Health and
  Well-being
• Increased investment

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Delivery our approach

• A strategic shift not just a set of proposals
• Embed in all programmes and build through CSR
• Inclusive work with stakeholders on further
  development and implementation
• Service user engagement national and local
• Use system reform levers
• Support for innovation

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Phase 1 2006-8

• What people will see
• More services in under-doctored areas
• Improved information for service user
• Carers support
• New GMS contract
• Locally-driven improvements from changes (e.g.
  DASS appointments, roll out of PBC)
• PPI changes

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2006-8 Foundations for sustained shift

• Develop evidence base
• Align incentives and levers
• Local Area Agreements and new performance
  measures
• Strengthened commissioning
• Workforce development
• Support for innovation and new models
• Infrastructure

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Phase 2 - from 2008

• New planning cycle CSR outcome, funding and
  targets aligned with White Paper aims
• LDPs must show shift in resource into community
  services and prevention
• Roll out learning from pilots and demonstration
  sites
• Integration of services rolls out, with IT
  support starting
• new community hospitals on stream
• System changes bedding in

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Feedback so far

• Joined-up commissioning
• Making the shift closer to home
• Working together under financial pressure

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3 Final Questions

• Do people have more control?
• Are people finding access easier?
• Are people getting the outcomes they wanted?