Bexley Care Service Development Presentation Patient Council 8 September 2018 1
Integration 2
Formation of Bexley Care • The ‘Integrated Care Programme Board’ commissioned a review by IPC (2016) of existing services to create a vision for the future for Bexley integrated care for adults • Bexley Care launched April 2017 • £85 million pound gross budget - 35% from Oxleas - 65% from LBB • Budgets treated as one – looking for best outcomes for people and value for money • The new model is our contribution towards supporting the Bexley Local Care Partnership approach 3
Oxleas NHS Foundation Trust Adult Social Care Team/Service Team/Service Adult Mental Health Wards (Lesney Central Access Team Triage and Millbrook) Barefoot Lodge District Nursing Shared Lives Home Treatment Team (HTT) Wound Care Complex Care teams Working Age Day Treatment Continence Rapid Response Team Primary Care Plus (PCP) Cardiac Rehab/Heart Failure Safeguarding (including DoLS & Mental Capacity Act) Respiratory Anxiety, Depression, Effective Purchasing budgets to support the Disorders, Personality and Trauma delivery of care and support Team (ADAPT) Diabetes Intensive Case management of Integrated Rehab Psychosis pathway (ICMP) Podiatry Early Intervention in Psychosis (EIP) Community Assessment & Rehab Team (Short term assessment and Reablement) Community Assessment and Approved Mental Professional Health Review Teams Rehab Team Team Neuro Community Mental Health Team Preparing for Adulthood Team rehab Rapid Response Community Mental Health Team; Hospital Integrated Discharge Team (HID) Older Peoples Meadowview Intermediate Intensive HTT Older Peoples Continuing Healthcare Nurses Care Unit 4 Holbrook MSK
Reason for Change These diagrams show the They represent the current population growth (%) 2017 - localities and by corresponding 27 local government wards 5
Bexley Care Service Delivery Model 6
Reason for Change 7
Reason for Change 8
Progress to new structure 1. Single Point of Contact • No wrong front door • One point of contact/telephone for new referrals to a range of services • Navigators able to ensure that person is signposted to the right place reaches the right service or signpost to other agencies • Triage function which helps address more complex needs or one off pieces of work 2. Single Assessment Process • Prevents duplicate assessments/telling story more than once • Been out to consultation including voluntary sector to promote/support self management 9
Implications 3 . Bexley Care Local Care Network Teams 10
Piloting the Clinical Model Integrated Case Management (ICM) Pilot • Co designed by 3 GP LCN leads, CCG and Bexley Care • Monthly meeting in each locality. Meeting chaired by GP LCN lead and an Associate Director for Bexley Care • Pilot of what we hope new model will look like • Brings together range of professionals from across adult social care, physical health, mental health, primary care • Admin support provided by BHNC and supervised by Bexley Care • Voluntary sector colleagues key partner in meetings • Outcomes record and evaluation to be undertaken • Example of outcomes one person presented 29 x at A&E in 3 months reduced to 6 in 3 month period 11
Implications: Topics for discussion • What are your thoughts on the Bexley care model and plans and implications? • How would you like us to keep you updated on progress? • How do we further engage and gather feedback from our local communities? 12
Next Steps 13
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