Transcript Document

Community Health
Partnerships
Gill McVicar
Demography
“The most important policy issue facing European
Governments over the next 50 years is how to cope
with ageing populations……For Scotland the future is
now……Its population is ageing faster and dying
quicker than any other industrialised nation.”
The Scottish Report – Scotland the Grave (2003)
Ageing
population
Financial
position
Capacity
Capability
Health
inequalities
Contracts, MMC, EWTD
18 week
RTT
Long Term Conditions
Collaborative
Other initiatives
Projects/targets
Mental Health
Collaborative
Shifting the balance of care
Our Iceberg
WANT TO CHANGE
V
HAVE TO CHANGE
Partnership for Care
• “New Community Health Partnerships,
more accountable to local
communities, better matched with
Social Work services and better able
to represent local interests within NHS
Boards”
Partnerships will….
• Ensure patients and a broad range of
healthcare professionals are fully
involved
• Establish a substantive partnership
with Local Authority services
• Have greater responsibility and
influence in the deployment of
resources by NHS Boards
• Play a central role in service redesign
locally
• Act as a focus for integrating health
services, both primary and specialist
at local level
• Play a pivotal role in delivering health
improvement for their local
communities
Better Health Better CareCHPs
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Key to delivery
Partnership re emphasised
Broader range of delegated resources
Greater flexibility in decision making
Integrated resource framework – joint
commissioning, collaborative contracts,
budgets devolved to local level
• Extend responsibility and accountability
Expectation of CHPs
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Shift the balance of care
More local services
Improve access
Waiting times – new targets
Manage demand
Reduce unnecessary referrals to
specialist services
• Provide better community care
services
Specialist
Services
Referral
Ambulatory
Management Centres Care
Community
Consultants in
Hospitals
Community
Specialist
Hospital
Intermediate
Roles in PC
at home
care
Case/Care
Management
Practice Access
programmes
Nurse/AHP
Consultants
Community
Demand
Rehab
management
Team approach
LTC
Home
Extended roles Management Care access
Seek out those Promote/support
Better
Most at risk
Self care
Information
Community Community
Health
Culture
Learning
Planning
Improvement Leisure
Early
Text
Mental
Intervention
messages Well being
Food
Community Community
IT
Nutrition Development Resilience
Local
Authority
Patients
Public
Voluntary
Sector
Staff
Communities
Carers
Primary
Care
Independent
Sector
Secondary
Care
Tertiary
Care
Voluntary Independent
Carers
Primary
Care Patient
Community
Specialist
Local
Care
Authority
Web of connections
and communications
Integrated
Teams
Better
?Joint Standards
Anticipatory care
New flexible
Joint Inspection
Whole system engagement
Training and learning
Right person
Early
opportunities
Right place,
intervention
Self care
Right time
Health
support
Right information
Improvement
New roles
Information sharing
Technology
Leadership
Integrated
Resource
Framework
Considerations
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Staff
New roles, development opportunities
££
Partnership
Community
Time
Support to shift the focus?
• Sensible governance and performance
management v time consuming
bureaucracy
• Freedom to manage
• Flexible training and education, quickly
• Bust the barriers
• Public awareness
• Mutuality
• Manage expectations
Anticipatory Principle
• Collective imagination and discourse about
the future
• Image of the future guides current
behaviour
• Project ahead – horizon of expectation
• Bring future powerfully to present (mobilise)
• Inquire in ways that serve to refashion
anticipatory reality
(Cooperider et al, Appreciative Inquiry, 2000)
…a time for bold
imaginings, thinking
the unlikely, doing the
unreasonable.
Charles Handy