Transcript ARE THERE ANY LESSONS FOR US FROM A ‘CARE TRUST …

ARE THERE ANY LESSONS FOR
US FROM A ‘CARE TRUST PLUS’?
‘Making Partnerships Work in Health & Local Government’
Peter Melton
PEC Chair, North East Lincolnshire Care Trust Plus
14 February 2008
AIMS OF THE CARE TRUST PLUS
• Create and develop a formal key strategic partnership
between the Local Authority and Local NHS
• Drawing on respective strengths in order to deliver
improved and accelerated outcomes
• Adopting a holistic and integrated approach for those
residents with the most complex needs
• A Children’s Trust for whole population
THE KEY ASPECTS OF THE CARE TRUST PLUS
• Transfer Adult Social Care Commissioning responsibilities
and budget from LA to NHS
• Transfer Social Care Provision (LD, Adult Care,
Intermediate Care, Mental Health) from LA to NHS
• Transfer Public Health Directorate and responsibilities
from NHS to LA
• Transfer NHS community child services from NHS to LA
which leads the Children’s Trust
DRIVING PRINCIPLES OF THE CARE TRUST PLUS
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Align Accountability with Responsibility
Deliver integrated services and decision making
Deliver holistic services and decision making
Bringing services and decision making as close to the
patient, user, carer or citizen as possible
• Balancing the rights and responsibilities of the individual
and wider community
STRATEGIC EXAMPLES OF HEALTH AND SOCIAL
CARE IMPROVEMENT
• Integrated review of home care services aligned to
commissioning group plans
• Re-commissioning GP OOH services to form an
integrated health and social care provider
• Re-aligning of health and social care teams to the four
commissioning groups to support SAP and MDT working
• Aligning PBC and Social Care budgets to support joint
planning at individual and population level
• Open Door
• Open Mind, The Willows, Tukes
• Joint Strategy and investment in LD
OPERATIONAL EXAMPLES OF HEALTH AND
SOCIAL CARE IMPROVEMENTS
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Monthly MDT case planning meetings
Monthly commissioning group meetings
Reduced emergency hospital admission rate
Reduced residential care home admissions
Commissioning group plans around elderly, mental
health, children and health improvement
EXAMPLES OF IMPROVEMENT HEALTH AND
TACKLING INEQUALITIES
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Established a LA portfolio holder for Healthier Communities
Formulated jointly owned health inequalities action plan
Health inequalities adopted as a top 6 LA priority
LA investment in alcohol and tobacco control, reducing harm in the
workplace
Health Impact Housing Strategy
Re-fresh teenage pregnancy strategy
Sports and active recreation strategy
LEGI
Social Marketing to reduce delayed cancer presentations
Neighbourhood renewal areas, housing, police aligned to
commissioning groups
EXMAPLES OF IMPROVEMENTS IN CHILD
SERVICES
• Moving towards a health and well being model of care
• Shifting focus of delivery from practice to community
and children’s centres
• Common IT solution
• Early support programme
• Changing role of Health Visitors and School Nurses
• LAPs and children’s centres aligned to commissioning
groups
ADDED VALUE OF CARE TRUST PLUS APPROACH
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Management cost savings
Accelerates resolution of interface restraints to delivery
Positive cultural change
Constructive tension and challenge
Accelerated delivery of LAA
Greater workforce opportunities and satisfaction
Redressing ‘democratic deficit’
CARE TRUST PLUS – THE FUTURE
• Expanding health and social care provider teams to
include secondary care, third sector and private
• Commissioning group plans expanded to become ‘Mini
LSPs’ leading to ‘Mini LAAs’
• More individual commissioning
• Key local private businesses becoming more active
partners of community leadership
• Parents agreeing joint annual well being plans with the
Care Trust Plus for each child
ENABLERS TO THE CARE TRUST PLUS
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Geography
Co-terminosity
Leadership
Strategic Fit
Clinical Engagement & PBC
Robust Legal Framework
Performance Agreements
Governance
Financial Parity
FeSC
ISSUES IN ESTABLISHING A CARE TRUST PLUS
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Scepticism / Trust
Risk aversion
Change fatigue
Change management capacity
Timing
Practical barriers
Perceived loss of control
Untested
CONCLUSIONS
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Initial local and external evaluation positive
Created boost to joint strategic directions
Brings complimentary skills
Creates a more robust system to balance the rights and
responsibilities between individual and community
Redresses the balance between ‘looking out’ and ‘looking
up’
Creating ‘empowered communities’
?Transferable
Questions: [email protected]