Health & Wellbeing Board Better Care Fund 11 th September 2014
Vision for Health & Social Care Services • Coordinated and integrated pattern of care, with less duplication • Increased focus on prevention • Better support of carers • Systematic shift towards supporting more people at home and in their community • A reduced dependency on hospitals • Increased choice and control for patients/services users and their carers. • Reducing dependence on paid support • Enabling and maximising individual independence • Developing resilient communities • Use of experts by experience to inform the development of services
Case for Change Drivers Our Local Drivers Policy Change Falls • • Changing pattern of illness Increase in long term conditions • • Higher expectations Increase of people living with • • dementia Reducing budgets • Increase in hospital admissions • Changes in population profile • and delayed discharges Rurality & access • Parity of esteem between • Quality & Safety • physical and mental health Two site working • Poor health in carers • Workforce • People not dying in the place of • Technology • their choice
Plan of Action Eleven Transformation Schemes Four Strategic Themes Integrated Falls Prevention Prevention • • Dementia Strategy • Early Intervention (Case • Proactive Care Programme Management) • Community & Care Coordinators • Supporting People in Crisis • Care Home Advanced Scheme • Supporting People to Live • Team Around the Practice • Independently for Longer Integrated Community Services • Mental Health Crisis Care • Resilient Communities • Integrated Carers Support • End of Life Coordination •
The Better Care Fund – Plan on a Page v11 Health and Wellbeing Vision “Everyone living in Shropshire is able to flourish by leading healthy lives, reaching their full potential and making a positive contribution to their communities” Outcomes that the Health & Wellbeing Board will strive to achieve Outcome 2 Outcome 5 Outcome 4 Outcome 1 Outcome 3 People are empowered to Health, Social care and wellbeing Older people and those with Better emotional, mental Health inequalities are services are accessible, good make better health and long term conditions remain reduced health and wellbeing for all quality and seamless independent for longer lifestyle choices The Challenge: To improve services and outcomes for the people of Shropshire and make the local health and wellbeing system financially sustainable for the future Better Care Fund Strategic Themes Early Intervention Supporting People in Supporting People to Live Prevention (Case Management) Independently for Longer Crisis Clinical Lead/Sponsor: Clinical Lead/Sponsor: Clinical Lead/Sponsor: Clinical Lead/Sponsor: Colin Stanford Sal Riding Governance Rod Thomson Colin Stanford Lead Officer : Kevin Lewis Lead Officer : Lead Officer : Lead Officer : Kerrie Allward Kerrie Allward Sam Tilley The identification of ‘at risk’ groups of Empowering people to make better In the event that an individual finds Reducing dependence on paid Theme people and the approach to support lifestyle and health choices for their own themselves in crisis, rapid, focused support and enabling those people through a process of joint and their families health and wellbeing, Objectives intervention with a view to helping independence. Maximising the use assessment, allocation of a ‘key-worker’ preventing the prevalence of ill health a person remain in their own home of community resources and joint care planning and active case and the need for intervention. or return there as quickly as natural support to develop management possible. community resilience. 1 st phase Care Home Advanced • Mental Health Support Services • Housing, Equipment & • Prevention Services • Existing Scheme Specialist rehab Adaptations • • Osteoarthritis Prototype 1 st Phase Community & Care Integrated Supported Housing • • • Diabetes Prevention Development Coordinators Activity • Pulmonary Rehab Carers Support • • End of Life Support Scheme Lead Scheme Lead Scheme Lead Scheme Lead Nina White B1 - Proactive Care programme Emma Pyrah C1 - Integrated Community Kate Garner Miranda Ashwell D1 – Resilient Communities Transformation A1 - Integrated Fall Prevention Services Tracey Savage B2 - Community & Care Schemes David Whiting D2 – Integrated Carers Support Coordinators Paul Cooper C2 - Mental Health Crisis Care Services David Whiting D3 - End of Life Coordination Tracey Savage B3 - Care Home Advanced Scheme Louise Jones D4 - Dementia Strategy Nina White B4 - Team Around the Practice Cross Cutting Themes Communities Workforce Information Technology Communication & Engagement 7 Day Working Quality & Safety
Plan of Action • Governance Structure • Scheme Descriptions – Papers available • Scheme Overview • Programme Plan
Better Care Fund Governance Structure v10 Health & Wellbeing Engagement/Development/Participation Groups Healthwatch, Partnership Board, Patient Groups, BCF Reference Group etc. Health & Wellbeing Board Governing Scrutiny Chair: Cllr. Karen Calder Bodies Health & Wellbeing Delivery Group Joint Health CCG Governing Overview Scrutiny Purpose: Body Committee Responsible for the delivery of (Inc. T&W) the Health and Wellbeing work/action plans Health Overview NHS England Scrutiny Local Area Team Committee Children's Local Authority Services Scrutiny Cabinet Committee Better Care Fund Better Care Fund Finance, Contracts & Council Service Transformation Group BCF Task & Finish Performance Group Group (Temporary Group) Chair: Julie Davies Chair: Stephen Chandler Purpose: Sub-group of Purpose: Purpose: H&WB Delivery Group Coordinate the redesign of health formed to deliver one-off Produce the detailed Budget for • tasks e.g. BCF Submission and social care services within the the year scope of the Better Care Fund and Monthly monitoring of finance, • implement any resulting re- contracts and performance. commissioning and/or de commissioning as required.
Better Care Fund Governance Structure v10 Core Group: Service Transformation Group • CCG Director of Strategy & Service Redesign CCG Head of Programmes & Redesign • CCG Clinical Director for the BCF • Better Care Fund Manager • Patient/public representative • • Head of Service: Improvement and Efficiency – Adult Services Director of Preventative Health Programmes • Head of Children’s Social Care & Safeguarding • Commissioning Manager – People • Clinical Leads • Lead Officers & Scheme Leads (by invite) • Chair of Finance, Contracts & Performance Group • • VCSA & Providers (by invite) Strategic Themes Transformation Schemes Cross-cutting Schemes
Better Care Fund Governance Structure v10 Finance, Contracts & Performance Group Core Group: Deputy Director of Finance, CCG Finance Lead LA Finance, Contracts and Performance Group Contracts Leads CSU/LA Performance Leads CSU/LA Chair: Stephen Chandler Patient/Public Representative Better Care Fund Manager Purpose: Produce and monitor the detailed budget for the year and monthly performance monitoring of Strategic Theme Lead Officers finance, contracts and Performance. Report finance, contracts and performance monitoring information to Chair of Service Transformation Group the H&WB Board Finance Contracts Performance Transformation Projects Transformation Projects Transformation Projects
Risks & Contingency Partnership agreement to be developed by October 2014. Principles that are likely to be included: Contingencies Non commitment of Pay for Performance element of the fund • Integration efficiencies • Review and renewal of contracts • In year slippage through phased implementation • Risk Sharing Collective responsibility for delivery • Financial risks managed within pool in first instance • Financial risks shared on basis of relative contributions • Shared risk of maintaining other services if related activity levels continue to grow • H&WB Board will make recommendations to trigger new risk share agreements •
Alignment • Brings together existing integrated activity & transformation schemes • Aligns CCG 2yr Operational and 5yr Strategic Plans, Council Business Plan & Financial Strategy and the Health & Wellbeing Strategy • Alignment with Primary Co-commissioned o Home is normal o Sustainability of services o Empowerment of patients, clinicians and communities o Future proofing our future through new ways of working
Local Health & Social Care Economy Alignment v10 This diagram shows the joint priorities that feature in both the CCG and Council Strategies 7 Day Mental Health & Plans that will Modernisation Working deliver the outcomes SEN of the Health & Reforms Future Wellbeing Strategy. Fit The diagram also demonstrates how the Children's Better Care Fund will Services Early support the alignment Help System of these priorities. Strategy Resilience Plan Public Health Help to Change ASC New Operating Model Communit Transformin y g Primary Resilience Care
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