1. Voluntary Sector Health Forum 5 August 2014
Health and Wellbeing Boards
Voluntary Sector Health Forum
5 August 2014

2. What are Health and Wellbeing Boards?
Designed to bring together people and partners required to modernise health and social care by:
Ensuring stronger democratic legitimacy and involvement and accountability to the local community
Strengthening the working relationship between health and social care
Encouraging the development of more integrated commissioning of services
Vehicle for addressing health inequalities

3. What specifically are they meant to do?
Have strategic influence over commissioning decisions across health, public health and social care and support integrated solutions
Have a shared understanding of the health and wellbeing needs of their communities and develop a strategy to best meet these needs
Engage the public and interested communities in decisions about the commissioning and provision of services

4. Operating principles
Provide systemic leadership to improve health and wellbeing outcomes
Be inclusive through membership and links to relevant county and local networks
Be accessible and accountable for shared decisions
Address inequalities through quality integrated services
Identify key priorities across all partners to make the best use of available resources

5. H&WB Strategy (Hampshire)
Starting well – with a focus on transition
Living well
Ageing well
Healthier communities

6. Agreed Priorities for Action
Commissioning Services and Support for people with :
long term care and support needs
learning disabilities
mental health needs
complex physical disabilities
NHS continuing care

7. Key Issues
Aligning commissioning processes across partner organisations
Agreeing and signing off joint commissioning intentions
Communicating systemically within localities and across the County
Tapping into existing networks and work streams so as to not duplicate

8. Things we are grappling with
Finance and the lack of it
Communicating with the public and the key messages –
Use A&E sparingly
Fragmented commissioning
Priorities within the transformation process – what is going to have the most impact
How to manage and deploy the Better Care Fund
Knowing what success will look like and agreeing a joint strategy

9. What could be better
Voluntary Sector considered to be a body to be consulted with rather than as partners
Connectedness with sub-groups – sometimes feels like your commenting rather than co-creating
Balancing the rhetoric of integrated commissioning with the reality of individual sovereignty

10. Well Being Strategy identifies four key objectives:
Starting Well: so every child can achieve its potential and will thrive through transition to adulthood
Living Well: empowering people to fall ages to live healthier lives
Ageing Well: supporting people to remain independent, in control with timely access to high quality services
Healthier Communities: helping communities to be resilient, strong and support those who may need extra help

11. Our Vision
Avoiding unnecessary cost in the system, moving to lower cost solutions
Preventing dependency and demand for longer term publically funded services
Delaying people’s dependency on long term health and social care interventions

12. Our Vision
We have adopted the National Voices definition of integrated care as meaning person-centred, co-ordinated care reflected in the statement: “I can plan my care with people who work together to understand me and my carer(s), allow me control, and bring together services to achieve the outcomes important to me.” We are working together to ensure the services that we commission meet our strategic aims and programme objectives.

13. Our Strategic Framework
Provide the right care in the right place at the right time
To increase the proportion of people benefitting from evidence based prevention and early intervention
To increase the proportion of people with complex and long-term health and social care needs receiving planned and coordinated care in, or close to home
To ensure people have their health and care needs met seamlessly in the most appropriate setting
Maximise health, wellbeing and quality of life
To improve the health related quality of life and wellbeing of people with long-term conditions
To maintain or improve independence and recovery for people with long-term health and care needs
To reduce the difference between those with the best and worst health
Place the person at the centre of care
To empower key population groups to maximise their capabilities and to manage their health and wellbeing
To increase the proportion of people with health and social care needs that have choice and control of care
To improve satisfaction with health and social care services

14. Our Plan

15. Re-shaping and Developing the Health and Social Care Market
Independence is the expectation with support at home in the community empowering people to manage their own health and well being
Care is co-ordinated around individuals and targeted to their specific needs and they will know about and be able to access information, care and support in their local community to keep them at home
Proactive and “joined-up” case management reduces the likelihood that people will have to rely on more specialist services and rapidly regain their independence when they do
Experience of care is positive with the appropriate services available where and when they are needed
Outcomes improve reducing premature mortality and reducing morbidity

16. Re-shaping and Developing the Health and Social Care Market
In Phase 1 we will ensure we address the three key challenges:
Avoiding unnecessary cost in the system, moving to lower cost solutions
Preventing dependency and demand for longer term publically funded services
Delaying people’s dependency on long term health and social care interventions.

17. The Plans will deliver the following changes
Our CCG and Social Care Commissioners will commission and procure jointly
Investment and procurement will support integrated care delivery
Our Community Providers will implement new models of service delivery that they have co-produced, drawing on assistive technologies where this is appropriate to do so
Our General Practitioners will be collaborating in wider networks focused on populations of 20 – 50,000 within agreed geographical areas to deliver primary care at scale
Investment in Integrated Care Teams will deliver 7 day working with care co-ordinated around individuals
Access to high quality emergency care with services delivered locally where possible, central where necessary will be sustained
The volume of emergency and planned care activity in hospitals, nursing and residential care homes will be reduced

18. Summary Keep people well, supported by effective care co-ordination
Implement a sustainable model of primary care and integrated care teams embedding key characteristics of risk stratification and proactive case management; shared decision making; lead professional; standard operating procedures; strong partnerships at a local community level; strong clinical leadership
Moving to 7 day services operating a round the clock “pull model” where the community resources take the lead in helping people navigate the system
Individuals will be supported to participate in their care including using personal health budgets
Care pathways e.g. dementia, wound care, falls will be reviewed
Commissioning a robust approach within teams to ensure programmed review and right-sizing care and support packages is routine
Enhanced psychological support will be available for people with long term conditions

19. Summary Manage proactive intervention Support recovery
Through primary care based urgent care access; Rapid Advice and Assessment Units; Integrated Geriatrician; Targeted therapies and End of Life Care
Developing approaches to share data in real time so that people can make the best choices
Support recovery
Redesigning the intermediate care model including reablement and personal care
Developing and supporting the care market so that skilled carers work in synergy with clinical teams and enable people to retain their independence

20. Summary
Respond to the Care Bill - early joint priorities to meet the Care Bill’s ambitions for integration will include:
Developing a joint strategy to meeting the needs of carers who will gain new rights to receive a service under the Care Bill
Ensuring that early intervention and prevention services operate effectively to reduce or delay the demand for more expensive social care
Developing an effective knowledge base and more accessible information/advice resources to support individuals to navigate through the social care and health system in a more seamless way

21. Conclusion Clear strategy – need to work through and agree the how
We will need to be bold to grasp the broader transformation agenda and address reducing spend in acute care
Working with the public to engage them better
Potential to make a real difference – offer solutions