Transcript Slide 1

ADPH Conference
21st May 2010
How does partnership
working between Health
and Local Government
Benefit my Role?
John Dixon
Executive Director Adults and Children
The Big Themes 2010
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Personalisation
Families
Recession
Workforce
Integration/Integrated working
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Personalisation
 Personal Budgets 200,000
 Personal Health Budgets Starting out
 Key PPF Milestone Areas for April 2010:
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Effective Partnerships with People using Services etc.
Self-Directed Support and Personal Budgets
Prevention and Cost-effective Services
Information and Advice
Local Commissioning
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Recession
20% reductions in Local Authority Budgets
20bn in NHS
Pace of reductions?
Total Place – Cross party interest
Reshaping of public sector :
takeover/merger or integrated working?
 Tories promise to winnow out ‘bureaucrats’:
SHAs/PCT’s/Field Forces/Regulators etc.
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West Sussex
Integration:
Joint Adults and Children’s Department
Integrated working: PCT and Council
£200m pooled budgets/joint
commissioning. Plans for £800m
Seconded PCT Executive Director – Joint
Commissioning
Joint DPH and Commissioning Posts
Personalisation:
Personal Budgets from 1700 in Sept.
2009 to 2600 in March 2010
Personal Health Budgets based on PbC :
Carers, CHC, Children with Disabilities
Families:
Whole life disability service being
developed.
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Integration : The Policy
“To make our vision for the future of care and support a reality… we need
more joined up working between health, housing and social care
services and between care and benefits services”
Care & Support Green Paper
“We need to reform adult social care services, improve integration with
health and make services more preventive in nature… we will greatly
increase the integration of services by doing more to shape them
around patients and to ensure that the boundaries between
organisations do not fragment care”
NHS From Good to Great
“At the heart of this is transforming patient pathways, leading to the
integration of services and in some cases, the integration of
organisations”
NHS Operating Framework
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Takes time.....more
time...and more time
Divided by a common
language
Don’t just move the desk
chairs
Prescribed partnerships
limited value
Health is not democratic
NHS is wealthy relation
Professional empires
threatened
Remember the added
value
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Integration : Top Facilitating Factors
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Friendly relationships
Leadership
Commitment from the top
Joint strategy
Joint vision
Coterminosity
Additional funding
Patient and user focus
Front-line staff commitment
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Integration : Top hindrances
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Performance regimes
Financial pressures
Organisational complexity
Changing leadership
Financial complexity
Culture
Data and I.T.
National policies
Local history
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So………….
 None of the top 6 factors which help are mainly
national
 But the top 2 and 3 of the 5 factors which hinder are
national
 Only 20% of the factors which help are national
issues
 So the centre can probably do more harm than good
– it can limit local ambition and progress but can
probably do little to create and stimulate joint
working
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Effective Joint Commissioning
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All about patient/care pathways
Best mix for patients of health/social
care/Third Sector input
From self-care to tertiary care
Choice and control – from professionals to
users/patients
Transferring activity and finance within care
pathways - the ‘5% plus’ test
Joining the two commissioning frameworks
Achieving:
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user satisfaction
clinical outcomes
reconfiguration
financial sustainability
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Familiar Problems, New Solutions
Familiar problems
Old solutions
New solutions
Working with users and carers
•Formal consultation on plans
•Nominal representation on
planning groups
•User-led services
Managing budget pressures
•Holding vacancies
•Gate-keeping panels
•Slippage savings
•Central control
•Long-term strategic perspective
•Aligned operational and financial
management
•Reliable delegated systems
Workforce pressures
•Agency staff
•Acting up/cover arrangements
•Posts left vacant
•Unmanaged workload
•Workforce strategy
•Improving skill mix
•Integrated teams
•Better forecasting information
Modernising social services
•Innovative projects
•Focus on process/procedures
•Reinvesting in old services
•Incremental change
•Mainstream change via Best Value
Commissioning ethos
•Defining critical success factors
•Evidence-based
Getting the best from
partnerships
•Joint planning forums
•Spending ring-fenced monies
•Sharing information about
intentions
•Pooled budgets
•Joint commissioning
•Integrated frontline teams
•Joint management
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