Title: Working Together
1Working Together
- Tim Crayford
- Maggie Atkinson
- John Dixon
2Dr. Tim Crayford
- President, ADPH
- Director of Public Health Medical Director,
Croydon NHS Primary Care Trust
3Central Government
- Our Health, Our Care, Our Say DH 2006
- To ensure there is more visible local leadership
on health and wellbeing, particularly on public
health issues such as childhood obesity, smoking
rates and health inequalities. It is important
that the local authority lead member for adult
social services is able to influence the
commissioning decisions of health and social care
bodies, and drive action to reduce health
inequalities - by engendering systematic partnership working
between NHS bodies, local authorities and other
partners, for example through greater use of
joint appointments, pooled budgets and joint
commissioning. We want to see health and social
care services delivered seamlessly around the
needs of patients, families and carers, and local
partners able to work together in tackling the
wider causes of social exclusion, worklessness,
and vulnerability
4Our Health, Our Care, Our Say
- New powers for Scrutiny (APHR)
- Jointly appointed DsPH
- LDPs to become more aligned with LAAs
5NHS view on commissioning
PPI
6Strong and prosperous communities
- by engendering systematic partnership working
between NHS bodies, local authorities and other
partners, for example through greater use of
joint appointments, pooled budgets and joint
commissioning. We want to see health and social
care services delivered seamlessly around the
needs of patients, families and carers, and local
partners able to work together in tackling the
wider causes of social exclusion, worklessness,
and vulnerability - local authorities will now be under a statutory
duty to (establish) Local Involvement Networks
(LINks) - formal arrangements for Directors of Public
Health to be jointly appointed and held jointly
accountable by the chief executives of local
authorities and PCTs
7Strong and prosperous communities
- statutory partnership for health and well-being
under the LSP - Strengthened role for LA Scrutiny esp. in
relation to the DPH and the APHR - A new Lead Member at local authority executive
level, whom we will expect to play a leading role
on local health and well-being partnerships - LAAs strengthened
8Pulling it all together
Annual Public Health Report (HEAs)
LSP LAA
6 Domains of Choosing Health
JSNA
9JSNA
DPH
JSNA
DASS
DCSS
10Care Services Ideal
Need
Demand
Want
11Efficient delivery
Need
Demand
Want
12Current Care Services
Need
Demand
Want
13Wellness needs?
Need
Demand
Want
14Challenges Joint DPH Appointments
- Variable interpretation
- Clearly the right direction
- Need to remain NHS-based
- ?account via the LSP
15Challenges JSNA Information
- Accessing it
- Pooling it
- Analysing it mapping it
- Presenting it in a JSNA
- Sharing our experiences with it
16Dr. Maggie Atkinson
- President, ADCS
- Director of childrens services, Gateshead
Metropolitan Borough Council
17Childrens Services integrated!
- We are charged with being outcome focused ......
- not process obsessed or stuck in old models
...... - Which means a focus on addressing and narrowing
gaps and taking out inequalities - We are REQUIRED to work together Health's NSFs,
Every Child Matters, Our Health Our Care Our Say - ...And my friend, Mrs Cannybody.
18Whos she?
- She lives on Ubiquity Street, Anytown,
Everyshire, in social housing, on the minimum
wage - She's a single parent and a busy woman
- She wants to ask one person for help, guidance,
advice on public services and get a straight
answer - where to go
- what to do
- how to get support
- She wants her family to be healthier and better
placed than she is - She is not interested in who pays your wage, or
mine - She's interested in ......
19- Good ante-natal, maternity and post-natal care
for herself - Advice on her baby, her older child, her teenage
stepchild's smoking, drinking and risk taking
lifechoices - Advice on lifestyles, when finances are tight
and diet, fitness, exercise - Advice on stress hers and others'... and on
stopping smoking - She wants us to .....
20- see the person, not the episode or the casework
- ask her to tell her story once,
- safely share and use what she tells us
- keep our promises that we can help
- think wellbeing and wellness, and
- plan services around helping her attain them
- join up to support her and her family, and MEAN
IT! - not make her second guess or be clever or
articulate to get what's needed
21Circle of exchange
Lead Practitioner(s)
Nurses
Advisers, mentors
Circle of participation
Teachers, tutors
Outreach workers
Places of worship
scouts brownies guides Cadets etc
Dinner supervisor
Circle of friendship
Police And support officers
grand father
grand mother
Social worker
People next door
Circle of intimacy
Fire fighters
Football or other sports clubs
best friend
Mum, Dad, carer, brothers sisters others at home
Aunt or uncle
Lollipop person
Nanny or childminder
People in the park
Godparent
Doctors, health workers
cousin
Community wardens
Class mates
Step sibling
Parents friends
Education Welfare Service
Community of neighbours
Learning support assistant
Other children in school
Shopkeepers
Librarian
Therapy services
Baby sitter, Child minder
Educational Psychologist
22John Dixon
- President, ADAS
- Director of Social Caring Services,West Sussex
County Council
23Inequalities and Well-being Working
TogetherJohn DixonExecutive Director of
Adults and Children, West Sussex County
Counciland President, ADASS
24Adults Services A Changing Role
- Life Chances of Disabled People Opportunity
Age - Independence, well-being and Choice Our
Health, Our Care, Our Say - Safe and Prosperous Communities
- Place Shaping and The rise of well-being
- Shift in relationship between state and
citizens - 100 of population and personalisation
- DASSs huge assimilation of roles
25DASS Joined Responsibilities
- 50 - Housing
- 40 - Crime Prevention
- Regeneration
- Safer Communities
- Neighbourhood Services
- 25 - Culture, Leisure, adult learning
- Most - Health
- 10 - Childrens as DCS
26All our Tomorrows - Revisited
Professional gift relationship
Specialised interventions
Resource Intensive
Targeted help to individuals
Support to Communities
Infrastructure for Community development and
self-help
Sustainability
Customer in control
27Infrastructure for citizens to support informed
safe choices to help providers
- Housing/Accommodation/Supporting People
- Public Health
- Community Health
- Transport
- Access to Employment/Workforce
- Social Inclusion
- Lifelong Learning
- Community Safety
- Regeneration
- Leisure Recreation opportunity
28 Effective Joint Commissioning
- All about patient/care pathways
- Best mix for patients of health/social care/3rd
sector input - From self-care to tertiary care
- Choice and control from professionals to
users/patients - Transferring activity finance within care
pathways the 5 plus test - Joining the two commissioning frameworks
- Achieving - user satisfaction
- - clinical outcomes
- - reconfiguration
- - financial sustainability
29Personalisation, Eligibility The Green Paper
on Care Support
- Its about Social Justice as much as funding
- Need to agree principles of new settlement first
- Rethink dependency and contribution
- The two groups those currently eligible for
state funding - those outside of the state net
- Those currently funded not much longer
affordable - to be
given control - Those not now funded more than half the
population - Transparency and eligibility
- Some help for everyone, and more for those who
need it most - Public knowledge and affection NHS vs. social
care - The weakest link in the welfare state assurance
for old age and disability? - Affordability and 1.1trillion insurance risk
capping?
30World Class Commissioning and Putting People First
- Comprehensive understanding of the needs of
everyone in the community - Planning in partnership with users and carers for
services to meet agreed outcomes through improved
choice and control - Work with providers and Third Sector to develop
services for independence and well-being - More intelligent and responsive procurement of
services to improve outcomes. - Ensure individual purchasing is as near to the
person as possible - Improving evaluation of service provision as a
return on investment - Need to join up governance, leadership, basic
skills and knowledge - Need for workforce development
- Practice based commissioning focus on needs of
communities - links with local government social care and
childrens services - with acknowledgements to Mark Britnell
31(No Transcript)
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