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Making policy count: Developing performance indicators for health and social care partnerships Simon Medcalf Local Performance Strategy, DH Strategic Improving.

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Presentation on theme: "Making policy count: Developing performance indicators for health and social care partnerships Simon Medcalf Local Performance Strategy, DH Strategic Improving."— Presentation transcript:

1 Making policy count: Developing performance indicators for health and social care partnerships Simon Medcalf Local Performance Strategy, DH Strategic Improving Information Programme Board 29 September 2009

2 2 Progress report SIIP Board members have been briefed in the past of will be aware of the background and approach to this project, as well as the key principles by which the work is conducted. This paper gives an update on progress of work. There are three main workstrands which cover the breadth of the work’s aims: Managing development of performance indicators related to adult social care, predominantly through regional and local pilots; Managing overall development of the performance approach across the breadth of DH interest, and facilitating the cross-DH conversation to create a workplan for future PI frameworks; Influencing cross-Government discussions on the future of the performance architecture, to reinforce key messages and aspirations and better prepare for the next SR. These strands overlap and are interlinked. They also share a number of the same risks and considerations – not least of which, the uncertainty regarding the future shape of the national performance frameworks. One of the key aims across all strands is to ‘future-proof’ PI development in such a way as it is able to respond effectively to the new performance arrangements. This paper: Updates on recent progress related to adult social care PI development (slides 3, 6); Provides detail on timelines for PI development across the project (slides 4-5); Gives a latest cut of outcome themes tables (slides 7-11); Demonstrates the emerging overall PI picture, and how this relates to outcomes (slides 12-15);

3 3 Developing social care PIs The continued focus of work on adult social care PIs has been on engagement with internal and external stakeholders, and commissioning of new development work. Key actions include: Developing a detailed timeline for PI piloting, incorporating stages of data development and analysis, to set a route map towards April 2011 (and publication of new PIs in September 2010); Agreed proposals for central support to be offered to regional and local PI pilots – combining DH/IC/Local Authority (via ARG) contacts and funding; Continued engagement towards target date of mid-October for finalising all planned pilot work: held seminar with ULOs and expert users/carers (August), engaged ADASS policy networks through Coordinating Group for commentary (Sept) and internal DH consultation. Meeting with IT suppliers’ group, further user engagement and NCAS planned for October; Commissioned a new PI pilot project through ADASS North West Performance Group (led by Cumbria) to develop proposal to capture signposting function and outcomes achieved through outside organisations; Commissioned development work through Adult Review Group to consider options for further disaggregation of all data/PIs for client groups not currently available (in particular, dementia and autism) to improve data quality and analysis for all future PIs; The next slides (4-5) show the detailed timelines developed in consultation with the IC. The first of these is particularly relevant to adult social care PIs where a new collection is being worked on through a pilot. Together, there are some key milestones to draw to the Board’s attention: Mid-October 2009Deadline for commissioning of all pilot work for PIs requiring new national data collections, allowing allocation of central support and agreeing overall picture of work. February 2010All pilots to have developed PI collections/guidance for full month’s piloting (in March). September 2010Future PI requirements to be published/communicated to LAs for April 2011 start.

4 4 September 2009 October 2009 November 2009 December 2009 January 2010 February 2010 March 2010 April 2010 May 2010 June 2010 July 2010 August 2010 September 2010 October 2010 November 2010 December 2010 January 2011 February 2011 March 2011 April 2011 September 2011 September 2009 October 2009 November 2009 December 2009 January 2010 February 2010 March 2010 April 2010 May 2010 June 2010 July 2010 August 2010 September 2010 October 2010 November 2010 December 2010 January 2011 February 2011 March 2011 April 2011 September 2011 Review policy intent and commission new activity Deadline for commission of pilots requiring new collections Review proposals Decisions on candidates’ likelihood Meetings with pilot leads Allocate account managers/support ARG (12/11): Update on work parameters Pilot PI development ARG (mid-Feb): Finalise PI collections/ guidance for piloting Pilots develop PI proposals into Collection tables/guidance for testing Full pilot collection Refine Sites submit pilot data to IC for analysis Data analysis Analysis and recommendations to pilot sites for action Further development in pilots ARG (mid-July): Stocktake and further recs. Coordinated piloting across all sites Actions based on result of analysis Development of national collections ARG (early Sept): Sign-off collections SIGASC (mid Sept): Sign-off collections and publicise to LAs Consultation on NIS definitions Publication of NIS Technical Handbook Response to consultation NIS comes into effect Final preparations Effective date for six- monthly collections in first year Finalise IC guidance Publicise to LAs Manage queries Full pilot collection Sites submit pilot data to IC for analysis Data analysis Analysis and recommendations to pilot sites for action Further development in pilots ARG (early Sept): Sign-off collections SIGASC (mid Sept): Sign-off collections Consultation on NIS definitions Publication of NIS Technical Handbook Response to consultation ARG/SIGASC sign-off latest PI proposal from pilot for further development Final preparations Publicise final detail of PIs for late uptake in 2011/12 Wave 1: Pilot PI candidates for adoption from April 2011 Wave 2: Pilot PI candidates for adoption from September 2011 National Indicator Set Development Timeline Timeline 1 – Indicators from LA-level requiring new national collections

5 5 September 2009 October 2009 November 2009 December 2009 January 2010 February 2010 March 2010 April 2010 May 2010 June 2010 July 2010 August 2010 September 2010 October 2010 November 2010 December 2010 January 2011 February 2011 March 2011 April 2011 September 2011 September 2009 October 2009 November 2009 December 2009 January 2010 February 2010 March 2010 April 2010 May 2010 June 2010 July 2010 August 2010 September 2010 October 2010 November 2010 December 2010 January 2011 February 2011 March 2011 April 2011 September 2011 Review policy intent and development priorities PISG Meeting (19/10): Stocktake Review proposals PISG members engage policy teams in own area, discuss review of current PIs and options for future development PISG (early Feb): Finalise PI collections/ guidance for piloting DH teams develop PI proposals for testing, using standard format Full pilot collection Refine Data analysis PISG (early May): Analysis and recommendations to pilot sites for action Further development Coordinated piloting for all PI candidates Actions based on result of analysis Development of national collections PISG (early August): Sign-off PIs Performance Committee (mid August): Sign-off PIs Consultation on NIS definitions Publication of NIS Technical Handbook NIS comes into effect Final preparations Finalise guidance Publicise to NHS/LAs Manage queries National Indicator Set Development Timeline Performance Committee (10/12): Comment on first draft PI candidates Response to consultation Timeline 2 – Indicators from other (non-LA) sources PI development Extended development/analysis where existing data source means further ability to test in-house Spending Review negotiations Further SR planning General Election: latest possible date 2/6 Publication of national data requirements for Local Government Pre-Budget Report (early Nov) Potential timescales for 2009 Spending Review

6 6 Social care PI pilots There are now four regionally-led pilots underway to develop proposals for new national PIs, with further work being led nationally and other discussions ongoing: ADASS South East (led by Oxfordshire) – developing a PI to capture the success of services in achieving the ‘three things’ which matter most to people; ADASS West Midlands (led by PMG) – developing a PI to reflect the success of reablement and preventative services in reducing needs; ADASS South West (led by Plymouth) – developing an evidence base for ‘dignity and safety’, out of which key PI recommendations will be made; ADASS North West (led by Cumbria) – developing a PI on signposting, to show success of Councils information function and outcomes achieved through external organisations; ADASS London – initial discussions with lead Director to agree focus of pilot work. Over a third of Councils volunteered for involvement; likely topics including personal budgets. Adult Review Group – leading work on disaggregation to improve quality of data broken down for specific client groups (across all PIs and collections); Abuse of Vulnerable Adults Working Group – considering options for new PIs based on data collection developed by this group and being used for first time in 2009/10; User and carer experience – commissioned Personal Social Services Research Unit (PSSRU) at University of Kent to develop PI proposals from both social care user and carers surveys; The following slides provide a latest cut of the five outcome themes which will be familiar to Board members. This shows the latest position on each, in terms of the outcomes and PI candidates currently under consideration. Following initial discussions with user/carer groups, there have been a number of changes to the particular outcomes included under each theme, to clarify the overall ambitions and simplify the language. Further work and testing is planned to continue to refine this area.

7 7 Quality of life Performance indicators (service accountability) Performance indicators (population accountability) Link to outcome Avoiding inappropriate placements: Adults with learning disabilities/ mental health problems in settled accommodation (NI146 and NI149) Rate of admissions to residential care v. those to intermediate care % of acute admissions which results in discharge to residential care 3 Improving quality of life: Service users successfully achieving their three personal outcomes Self-reported experience of social care users (NI127) Improving quality of life: Experience of local health and care services (composite measure) Users who say they are able to spend their time doing things they value or enjoy (sub-set of NI127) 1 Supporting families and carers: Carers receiving a specific carers’ service, or information and advice (NI135) Supporting families and carers: Children in appropriate caring roles: numbers of days of education missed Carers’ experience of services 2 Reducing dependency: % of those receiving a Council-commissioned service which was deemed ‘good’ or ‘excellent’ % of users whose care needs have reduced following the conclusion of a reablement/prevention service Reducing dependency: People with a long-term condition supported to be independent and in control of their condition (NI124) Number of vulnerable people who are supported to maintain independent living (NI142) People over 65 who say they receive the information, assistance and support to live independently at home (NI139) 2 ARE ActivityResultsExperience A A E E E R R RA R R E E A E Outcomes for people and places 1People can live their own lives to the full, maintain their independence and manage their own condition as far as possible. 2People are less dependent on intensive services, and carers can balance their caring role and maintain an acceptable quality of life. 3People receive the support they need to be independent, and only go into hospital or care placements when they have a need to do so.

8 8 Performance indicators (service accountability) Performance indicators (population accountability) Link to outcome Control over own care and support: Social care clients receiving self-directed support (NI130) % of users who feel they have as much control over their life/services as they want to (sub-set of NI127) Percentage of people whose identified needs were met following a self-assessment Control over own care and support: People with a long-term condition supported to be independent and in control of their condition (NI124) 1212 Promoting information and advice: Signposting: people referred by Council to outside organisations whose needs have been met Promoting information and advice: Effectiveness of information/advice offered by LA to users/carers/public Avoidable contact: the average number of customer contacts per received customer request (NI14) 3 Advocacy and empowerment: % of users reporting that their family/carer was involved in their assessment and care planning Advocacy and empowerment: % of residents believing they can influence local decisions (NI4) 2 ARE ActivityResultsExperience A E Choice and control R R R E E A Outcomes for people and places 1People are put in control of the services the receive – they can design what, how and when they are delivered to match their needs. 2People have a genuine choice in how and where services are provided, and know how to access the support they need to make those choices. 3People know what is available to them locally, what they are entitled to, and who to contact when they need help. E

9 9 Performance indicators (service accountability) Performance indicators (population accountability) Link to outcome Active participation in communities: Social care users who report that they are able to have as much social interaction as they wish (sub-set of NI127) Active participation in communities: % of people who report feeling useful and valued in their home and family, and/or the wider community Percentage of people who feel that they belong to their neighbourhood (NI2) Participation in regular volunteering (NI6) or engaged in voluntary activity with NHS and/or LA organisations (LINks) Access to services and facilities by public transport, walking and cycling (NI175) 1313 Supporting economic stability: Carers maintaining additional employment alongside their caring role Supporting economic stability: Older people living in poverty Tackling fuel poverty – people receiving income-based benefits living in homes with a low energy efficiency rating (NI187) Adults with learning disabilities/mental health problems in employment (NI145 and NI150) People falling out of work and onto incapacity benefit (NI173) Proportion of children in poverty (NI116) year olds not in employment, education or training (NI117) Proportion of people whose health affects the amount/type of work they do (VSC28) 2 ARE ActivityResultsExperience E E R R R Inclusion and contribution A R R E R R R R Outcomes for people and places 1People are able to engage socially as much as they want to, and avoid loneliness or isolation. 2People are able to be financially secure, to find employment or to access benefits and allowances, no matter what their circumstances. 3People feel able to contribute to community life, and are able to access information and support when they need it.

10 10 Health and wellbeing Outcomes for people and places 1Everybody has the opportunity to enjoy a long and healthy life, and is able to manage their own health. 2Avoidable deaths, disease and injuries are prevented, and the local environment supports healthier lifestyles. 3When people become ill, recovery takes place in the most appropriate place, and supports people to regain their health and wellbeing. Performance indicators (service accountability) Performance indicators (population accountability) Link to outcome Overall health of communities: Self-reported measure of people’s overall health and wellbeing (NI119) Healthy life expectancy at age 65 (NI137) All-age all-cause mortality rate (NI120) Disability-free life expectancy 1 Preventing avoidable deaths, disease and injury: Amenable/preventable mortality rates Mortality rate for under 75 cancer/CVD (NI121/NI122) Rate of hospital admissions for alcohol-related harm (NI39) Acute admissions resulting from accidents in individuals’ own homes 2 Care supports recovery: % of service users who feel they get all the food and drink they need (sub-set of NI127) Care supports recovery: Emergency bed days associated with multiple (2+ pa) acute emergency admissions per 1,000 population Achieving independence through intermediate care/rehabilitation (NI125) Emergency bed days per head of weighted population (NI134) Delayed transfers of care from hospitals (NI131) 3 An environment which promotes healthy lifestyles: Smoking prevalence amongst people aged 16 and over (NI123) Percentage of infants breastfed at 6-8 weeks (NI53) Obesity amongst primary school-age children (NI54/NI55) Adult participation in sport and active recreation (NI8) Rate of physical activity 2 ARE ActivityResultsExperience R R R A R R R R R R E R R R R R R

11 11 Performance indicators (service accountability) Performance indicators (population accountability) Link to outcome Keeping people safe: Percentage of all referrals which are repeat referrals Percentage of all referrals in which alleged abuse took place in a service commissioned by the Council Percentage of completed referrals where there is a risk of abuse leading to a protection plan being put in place / action taken against perpetrator Keeping people safe: Incidences of abuse against people in own homes Acute hospital admissions resulting from abuse, neglect or self-harm People who report feeling safe in their own home 1 Respecting dignity: User-reported dignity and respect in their treatment (NI128) Respecting dignity: Perceptions that people in the area treat one another with respect and dignity (NI23) 2 Fairness and equality: Availability of services to meet the needs of local communities Proportion of all complaints received from certain groups v. their representation in the wider community Fairness and equality: Fair treatment by local services (NI140) 3 ARE ActivityResultsExperience A E Dignity and safety A A E E A E A R R Outcomes for people and places 1Everyone enjoys physical safety and feels secure. People are free from abuse, harassment, neglect and self-harm. 2People respect each others’ dignity, and feel that services are sensitive to their own circumstances and right to privacy. 3People feel that they are treated fairly and equally in the community and by services.

12 12 The overall picture Developing the strategic view across PI proposals is crucial to the narrative which binds together the performance framework. If the next NIS is to be more coherent, it is important that the overall balance of priorities is the right one, and it is clear how different PIs work together. Ensuring that this happens is one of the key aims of the cross-DH steering group set up to manage the conversation on PI development. Aside from adult social care, much of DH will have a strong interest in the future NIS, and its overlap to the NHS Vital Signs. The areas of overlap should represent those areas of common interest for local partnerships, where different services can focus together on common priorities. This would include public health areas, health inequalities, health protection, children’s issues, and other areas. Each of these will have their own views on current indicators, and proposals for new ones, and one of the three workstrands of this project is facilitating the conversation which leads DH to an agreed overall position for the next SR. The following slides show some simple mapping exercise based on the detail in the previous outcome themes. It demonstrates the spread of current proposals using the outcome themes, and also shows how the information can be presented in different ways, depending on the type of indicator. This mapping will be expanded during October to present the PIs around other frameworks, including Quality, Innovation, Productivity and Prevention (QIPP) and Putting People First. Such mapping will be important to maintain a strategic view across the work. It will also be important in ‘future- proofing’ the project against the unknown direction for overarching performance frameworks. We will not know what shape the future framework(s) may take until mid 2010 – but we need to undertake development work now. By being clear what level indicators operate at (service or population), what type of information they provide (activity, results, experience) and how they work together (in baskets), we will be able to respond to any of the numerous possible options for the future framework. For instance, if there is to be a single national outcomes framework for the whole public sector, population-level indicators will be most appropriate (others need not be lost, but could be shared through NASCIS, or become part of Self-Assessments).

13 13 Population Accountability Indicators which capture a whole- population effect or outcome and are relevant to more than one service or sector. PIs provide basis for partnership working locally, since different contributions are required from individual partner organisations. Service Accountability Indicators which capture the effect or outcome achieved by a single service or sector acting on its own. Can be client outcome or activity measure, but is result of only one service. Not a basis for partnerships, but part of judgment of public service efficiency etc. Dignity and safety NI146 – Adults with LD in accommodation Health and wellbeing Inclusion and contribution Quality of lifeChoice and control NEW – Acute admissions to res. care NEW – Res. v int. care admissions NI149 – Adults with MH in accommodation NEW – Patient/user experience NEW – Children in caring roles NEW – Carers’ experience NI124 – LTC independent and in control NI142 – Vulnerable people independent NI139 – OP receive support to live at home NEW – Three personal outcomes NI127 – Social care experience NI135 – Carers receiving services NEW – % receiving excellent services NEW – Care needs post-reablement NI130 – Self-directed support NEW – Needs met post self-assmt NI14 – Avoidable contact NEW – Signposting NEW – Effectiveness of information NI4 – Influence local decisions NEW – Advocacy in care planning NI2 – Belong to neighbourhood NI175 – Access by public transport NEW – Feel valued in community NI6 – Participation in volunteering NEW – Users’ social interaction NI116 – Children in poverty NI145 – Adults with LD in employment NI150 – Adults with MH in employment NI117 – NEET NEW – Carers in employment NI187 – Fuel poverty NEW – Older people in poverty NI173 – Falling onto incapacity benefit NEW – Health problem affects work NI119 – Reported health and wellbeing NI137 – Healthy life expectancy NEW – Disability-free life expectancy NI120 – All age all cause mortality NI121 – Under 75 cancer mortality NI39 – Alcohol admissions NEW – Amenable/preventable mortality NI122 – Under 75 CVD mortality NEW – Admissions from accidents NI131 – Delayed transfers of care NI125 – Independence through rehab. NEW – EBDs for multiple admissions NI134 – Emergency bed days NEW – Users’ nutrition needs NI53 – Breastfeeding rates NI8 – Participation in sport/recreation NI123 – Smoking prevalence NI55/NI56 – Childhood obesity NEW – Rate of physical activity NEW – Adult obesity NEW – Admissions from abuse/self-harm NEW – Abuse in people’s homes NEW – % repeat referrals to safeguarding NEW – People feel safe in own home NEW – % abuse cases in LA services NEW – % referrals leading to protection NI128 – User dignity and respect NI23 – People treat one other with respect NEW – Services to meet local needs NI140 – Fair treatment by services NEW – Complaints from groups NEW – Users’ control over life Mapping the next NIS How does the overall framework fit together? Mapping across the thematic outcomes framework by ‘baskets’ – what is the balance between service and population accountability indicators?

14 14 Dignity and safety NI146 – Adults with LD in accommodation Health and wellbeing Inclusion and contribution Quality of lifeChoice and control NEW – Acute admissions to res. care NEW – Res. v int. care admissions NI149 – Adults with MH in accommodation NEW – Patient/user experience NEW – Children in caring roles NEW – Carers’ experience NI124 – LTC independent and in control NI142 – Vulnerable people independent NI139 – OP receive support to live at home NEW – Three personal outcomes NI127 – Social care experience NI135 – Carers receiving services NEW – % receiving excellent services NEW – Care needs post-reablement NI130 – Self-directed support NEW – Needs met post self-assmt NI14 – Avoidable contact NEW – Signposting NEW – Effectiveness of information NI4 – Influence local decisions NEW – Advocacy in care planning NI2 – Belong to neighbourhood NI175 – Access by public transport NEW – Feel valued in community NI6 – Participation in volunteering NEW – Users’ social interaction NI116 – Children in poverty NI145 – Adults with LD in employment NI150 – Adults with MH in employment NI117 – NEET NEW – Carers in employment NI187 – Fuel poverty NEW – Older people in poverty NI173 – Falling onto incapacity benefit NEW – Health problem affects work NI119 – Reported health and wellbeing NI137 – Healthy life expectancy NEW – Disability-free life expectancy NI120 – All age all cause mortality NI121 – Under 75 cancer mortality NI39 – Alcohol admissions NEW – Amenable/preventable mortality NI122 – Under 75 CVD mortality NEW – Admissions from accidents NI131 – Delayed transfers of care NI125 – Independence through rehab. NEW – EBDs for multiple admissions NI134 – Emergency bed days NEW – Users’ nutrition needs NI53 – Breastfeeding rates NI8 – Participation in sport/recreation NI123 – Smoking prevalence NI55/NI56 – Childhood obesity NEW – Rate of physical activity NEW – Adult obesity NEW – Admissions from abuse/self-harm NEW – Abuse in people’s homes NEW – % repeat referrals to safeguarding NEW – People feel safe in own home NEW – % abuse cases in LA services NEW – % referrals leading to protection NI128 – User dignity and respect NI23 – People treat one other with respect NEW – Services to meet local needs NI140 – Fair treatment by services NEW – Complaints from groups NEW – Users’ control over life Mapping the next NIS How does the overall framework fit together? Activity Indicators which are linked to the inputs or outputs of a single service. The indicator may capture service performance or quality, or meeting a minimum standard. May be closely related to achievement of an outcome, but is based solely on activity undertaken. Results Indicators which capture the outcome or result achieved for people and communities. The outcome may be the result of the input of a single service (client outcomes) or the aggregate of a number of services and/or wider factors (population outcomes). Experience Indicators which reflect individual or public perceptions about a particular issue or service. An important component of determining the overall performance of public services, but open to external influences. Mapping across the thematic outcomes framework by ‘baskets’ – what is the balance between different types of indicator?

15 15 Dignity and safety NI146 – Adults with LD in accommodation Health and wellbeing Inclusion and contribution Quality of lifeChoice and control NEW – Acute admissions to res. care NEW – Res. v int. care admissions NI149 – Adults with MH in accommodation NEW – Patient/user experience NEW – Children in caring roles NEW – Carers’ experience NI124 – LTC independent and in control NI142 – Vulnerable people independent NI139 – OP receive support to live at home NEW – Three personal outcomes NI127 – Social care experience NI135 – Carers receiving services NEW – % receiving excellent services NEW – Care needs post-reablement NI130 – Self-directed support NEW – Needs met post self-assmt NI14 – Avoidable contact NEW – Signposting NEW – Effectiveness of information NI4 – Influence local decisions NEW – Advocacy in care planning NI2 – Belong to neighbourhood NI175 – Access by public transport NEW – Feel valued in community NI6 – Participation in volunteering NEW – Users’ social interaction NI116 – Children in poverty NI145 – Adults with LD in employment NI150 – Adults with MH in employment NI117 – NEET NEW – Carers in employment NI187 – Fuel poverty NEW – Older people in poverty NI173 – Falling onto incapacity benefit NEW – Health problem affects work NI119 – Reported health and wellbeing NI137 – Healthy life expectancy NEW – Disability-free life expectancy NI120 – All age all cause mortality NI121 – Under 75 cancer mortality NI39 – Alcohol admissions NEW – Amenable/preventable mortality NI122 – Under 75 CVD mortality NEW – Admissions from accidents NI131 – Delayed transfers of care NI125 – Independence through rehab. NEW – EBDs for multiple admissions NI134 – Emergency bed days NEW – Users’ nutrition needs NI53 – Breastfeeding rates NI8 – Participation in sport/recreation NI123 – Smoking prevalence NI55/NI56 – Childhood obesity NEW – Rate of physical activity NEW – Adult obesity NEW – Admissions from abuse/self-harm NEW – Abuse in people’s homes NEW – % repeat referrals to safeguarding NEW – People feel safe in own home NEW – % abuse cases in LA services NEW – % referrals leading to protection NI128 – User dignity and respect NI23 – People treat one other with respect NEW – Services to meet local needs NI140 – Fair treatment by services NEW – Complaints from groups NEW – Users’ control over life Mapping the next NIS How does the overall framework fit together? Mapping across the thematic outcomes framework by ‘baskets’ – what is the balance between different types of indicator? Current or planned indicators owned by other Government Departments; requires wider engagement. (23) Indicators under consideration but unlikely to be robust candidates for next SR. Includes those broken down from higher- level PIs and not standalone. (10) Most likely Candidates for Future DH Contribution To SR. (34) Current regional pilots

16 16 Next steps One of the key milestones for the project is that by December 2009 there is an agreed ‘first cut’ of the proposals for the next NIS, including all social care pilots underway and a workplan for proposed PIs across health and wellbeing and the breadth of DH’s agenda. Over the next couple of months the priorities will be: To step up engagement and ensure that all main social care priorities are covered in work either underway or planned for PIs – to identify and fill gaps as far as possible; To establish a clear view of all work underway in local pilots, their aims, timescales and likelihood of developing PI proposals; To develop picture of all work underway at all levels for adult social care, and prioritise based on progress and forward plan; To agree central support offer to local pilots, and allocate as appropriate; To continue discussions across DH policy areas to build understanding of performance, agree position on current national indicators and gaps, and start to create workplan for next 6-8 months. The first of these actions is most critical – we are now entering the final phase for identifying gaps in the proposed outcome framework, and commissioning new work. By late October, timescales will mean that starting new work requiring major development (for new national collections) will not be realisable for April Support from Board members, by providing commentary or sharing within their organisations, would be welcome to ensure that the current proposals reflect the most important outcomes and support key policy objectives as far as possible. Updates, reports from pilots and new data will continue to be posted at: https://govx.socitm.gov.uk/spaces/nisdevelopment


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