Better Care for Haringey Community Event Marco Inzani Commissioning Lead for the Better Care Fund, Haringey Council / NHS Haringey Clinical Commissioning Group
Housekeeping
Aim of today • What is the Better Care Fund? • How has your feedback shaped the Haringey Better Care Fund? • What services are part of the Haringey Better Care Fund?
Meet Harry Gray • 75 year old widower • Has several health conditions: COPD, Dementia, Depression, Falls • Visited A&E 32 times in last year, admitted 10 times. • Cared for by his daughter
What is the Better Care Fund? The £3.8bn Better Care Fund (formerly the Integration Transformation Fund) was announced by the Government in the June 2013 spending round, to ensure a transformation in integrated health and social care. The Better Care Fund (BCF) is one of the most ambitious ever programmes across the NHS and Local Government. It creates a local single pooled budget to incentivise the NHS and local government to work more closely together around people, placing their well-being as the focus of health and care services. (Accessed 28/11/14, NHS England Website, http://www.england.nhs.uk/ourwork/part- rel/transformation-fund/bcf-plan/ )
Haringey’s commitment to deliver better care Beverley Tarka, Acting Director of Adult Social Care, Haringey Council Jill Shattock, Director of Commissioning, NHS Haringey Clinical Commissioning group
Haringey CCG Priorities 2015/16 1. Alternative models of care 2. Integration 3. Engaging communities 4. Proactive and holistic primary care
Haringey Council Priorities 2015/16 1. Best start in life 2. Healthy lives 3. Clean and safe 4. Growth and employment 5. Choose to live
Haringey Better Care Fund Vision “By April 2019, we want people in Haringey to be healthier and to have a higher quality of life for longer. We want everyone to have more control over the health and social care they receive, for it to be centred on their needs, supporting their independence and provided locally wherever possible.” London Borough of Haringey/Haringey Clinical Commissioning Group
By 31 st March 2016 we will: • Have 705 fewer emergency hospital admissions • Support people to remain at home and avoid 2 more people from going into a care home • Support 6 more people so that they don’t return to hospital within 91 days of being discharged • Maintain the number of people discharged from hospital on time • Improve the experience of people with health conditions measured with a patient survey • Have 10 fewer injuries due to falls in the over 65s
Beyond 2016: Value Based Commissioning Supporting a single pathway and a single provider to: • Measure outcomes that are important to you • Design and run services to deliver these outcomes • Provide financial incentives to achieve these outcomes
Haringey Better Care Fund Marco Inzani Commissioning Lead for the Better Care Fund, Haringey Council / NHS Haringey Clinical Commissioning Group
Haringey Older People (65+)
200 Local People Engaged
Public/Service User Priorities 1. Easy to access 2. Well managed 3. Person Centred 4. Provide good and timely information 5. Enable individuals to do things for themselves 6. Work together as one team 7. Promote wellbeing and reduce loneliness
National and International Evidence Intervention Impact Comprehensive geriatric assessment Reduces hospital re-admissions Enhanced discharge planning Reduces hospital re-admissions Re-ablement Reduces residential admissions Strength and balance exercises Reduce falls Medicines review Reduce falls Home safety assessment Reduce falls Advanced care planning Reduce hospital admissions at end of life Befriending/community navigators Reduction in loneliness and isolation
Local Evidence Programme Impact • MDT discussions Felt to be positive by MDT professionals. • Fall in acute activity following MDT discussions (but no control group) • Rapid response service Appears to be effective at preventing admissions Integrated locality teams • Breaking down barriers between professionals • Successful case studies • Impact on cost and activity unclear • Selecting right patients is crucial • Home from hospital Successfully supporting people on discharge from hospital
BCF Scheme & Service Overview Scheme Service 2015/16 Locality Team MDT Lymphedema Scheme 1: Admission Rapid Response £13.5m Avoidance Overnight District Nursing Service Dementia Day Centre Recovery College (incl. MH Employment) Falls Prevention Reablement Scheme 2: Effective £3.9m Step Down Hospital Discharge Home From Hospital Neighbourhood Connects (incl. Info & Advice) Scheme 3: Promoting Palliative Care £0.6m Supported Self-Management (Generic) Independence Supported Self-Management (Diabetes) Interoperable IT Scheme 4: Integration Workforce Development (incl some service delivery) £2.6m Disabled Facilities Enablers Care Act Responsibilities Contingency £1,260,000 TOTAL £22m
Admission Avoidance Effective Hospital Discharge Named Care Co-ordinator Less time in hospital Health and Social Care Plan Support to return home Referral for bereavement Regain confidence to prevent falls counselling Integration Enablers Promoting Independence All relevant professionals know Identification important information Link to an ‘expert patient’ group Services in the evening Link to a local gardening group Support for Harry’s daughter
Are We Meeting Public/Service User Priorities? Public Priority Better Care Fund 1. Easy to access Named care co-ordinator; Single point of access; Evening/weekend services 2. Well managed Training and education 3. Person Centred Health and social care plan 4. Provide good and timely information Information, advice and guidance 5. Enable individuals to do things for Self-management; reablement themselves 6. Work together as one team Multi-disciplinary team; access to information 7. Promote wellbeing and reduce Neighbourhood Connects; support for loneliness carers
Key milestones • Haringey residents and professionals Aug 2013 – engaged Mar 2014 • Initial BCF plan developed and submitted • Implementation plan developed Apr 2014 – • Review of current services Sept 2014 • Revised BCF plan submitted • Services piloted Oct 2014 – • Business plans and service models developed Mar 2015 • Services procured • BCF Plan approved (7 th Jan 2015) • BCF Plan implemented Apr 2015 – • Monitoring and review of services Mar 2016 • Planning for future years
Beyond April 2016… • Continued commitment to integration • Outcome focused: e.g. No infections; I feel I am not a burden on my family/friends; I feel listened to; I am a carer and I feel supported; Person died without pain and where they wanted to be • Lead provider for a whole pathway
What you can do KNOW – Spread your knowledge of the Better Care Fund FEEL – Get passionate about improving care for ‘Harry Gray ’ DO – Find out what you could do to make a difference
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