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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 • • • • • 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 • • • • • • 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 • • • • • • 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