Presentation on theme: "Integrated Personal Commissioning, the workhouse, the pit & the Yarnfield Isolation Hospital Luke O’Shea NHS England T: @lukeoshea1 Sam Bennett TLAP."— Presentation transcript:
1 Integrated Personal Commissioning, the workhouse, the pit & the Yarnfield Isolation Hospital Luke O’Shea NHS England Sam Bennett TLAP Matt Bowsher- ADASS Personalisation Co- Chair
2 Why is Integrated Personal Commissioning needed? National context
3 Personalisation timeline IB Evaluation__________2007Think Local Act Personal__________2010Care Act2014PHB Evaluation__________2012Our Health, Our Care, Our Say__________2005Putting People First_________2007Liberating the NHS White Paper_________2010Caring for our future White Paper_________2012IPC2015Five Year Forward View2014
4 Integration and empowerment is a fundamental response to future health & social care challenges “There is broad consensus on what the future needs to be. It is a future that empowers patients to take much more control over their own care and treatment. It is a future that dissolves the classic divide, set almost in stone since 1948, between family doctors and hospitals, between physical and mental health, between health and social care, between prevention and treatment.”Five Year Forward View, 2014
5 Integration and personalisation Addresses:Fragmented service deliveryDuplicative processesSystemic disincentivesBudgetary pressuresDelivers:Seamless experienceBetter health outcomesMore care closer to homeChanging expectationsDisempowering processesSystemic paternalismOne size fits all provisionChoice and controlEnhanced wellbeingCommunity resilienceSo, two parallel policies both with much support BUT not always connected. Each positive about the other, many reports on integration talk positively about personal health budgets and personal health budgets advocates see real benefits in integration.But neither policy area will take off and really power up substantial change in the model of service delivery if they do not now work in concertMuch focus on integration has focused on bringing together systems, services, budgets and teams. IPC combines this ethos with integration at an individual level – people themselves as the best integrators
6 Integration – between services or between people and professionals? Integration debate should start with people not structuresPeople themselves have the biggest interest in getting things rightToo often fail to harness energy, expertise and motivation of individuals, networks and communities to address our greatest challenges.Evidence shows that with the right support, people themselves are the best integrators of care**Forder et al (2012) Evaluation of Personal Health Budget Pilot Programme, University of Kent. Showed significantly improved quality of life for individuals and carers, benefits higher for more complex needs, more flexible services & reduced hospital admissions
7 Challenge of increasing complexity. Multiple LTCs 1. 9 m in 2008 to 2 Challenge of increasing complexity. Multiple LTCs 1.9 m in 2008 to 2.9 m in The new typical LTC. Integration & Personalisation keyRef: Kasteridis et al (2014) University of York.data from S Somerset. Symphony Project
9 IPC demonstrator sites Stockton-On-TeesCheshire W & ChesterLincolnshireBarnsleyLutonTower HamletsPortsmouthHampshireSouth WestThe real expertsFirst, massive thank you and congratulations to everyone here. tremendous response from many areas about IPC and your ideas, passion and experience stood out.Today marks the start of our work together to develop a pioneering programme. The first of its kind in the world. If we get it right, it will do great things for the people we serve. Simon wants to do some national publicity with you next week on an official national launch, so grateful if don’t tweet this slide, but everything else please feel free.
10 Design a 21st century care system that gets very different results for key groups Children and young people with complex needs, including those eligible for education, health and care plans.People with multiple long-term conditions, particularly older people with frailty.People with learning disabilities with high support needs, including those who are in institutional settings or at risk of being placed in these settings.People with significant mental health needs, such as those eligible for the Care Programme Approach or those who use high levels of unplanned care.
11 National objectives - from “what’s the matter with you”, to “what matters to you” People with complex needs and their carers have better quality of life and can achieve the personal outcomes that are important to them and their familiesPrevention of crises in peoples’ lives that lead to unplanned hospital and institutional care – both reshaping care and increasing self managementBetter integration and quality of care
12 Integrated Personal Commissioning model -change conditions & create strong partnerships Care model: Person-centred care and care planning, combined with an optional personal health and social care budgetPersonalised care and support planning,advocacy and brokeragepeer supportAND a clear offer of integrated personal budgets across health & social care for those who will benefit.Financial model: An integrated, “year of care” capitated payment modelTo remove existing financial barriers to prevention and integration, as well incentives for unnecessary activity that drive up costs.Funding model that brings together NHS and local authority funding for a defined target population.
13 Both the finance & care model should be designed to support local aims Detailed design ofCommissioning ModelDecideContracting ApproachIdentifyPopulationDetermine ServicesIn/out of ScopeDevelop ServiceDelivery ApproachDesign Payment ApproachLeadership & Shared PurposeYOUR AIMSIdentify Key OutcomesLinked Data Records/IT Workforce Skills EvaluationCULTUREENABLERSCARECONTRACTSSlide adapted from Monitor’s Pricing & Integration team
14 Person-centred care offered to the wider identified population & personal budgets for a subset of those
15 To change outcomes for a large population we need to be clear about what is universal & what is targetedCare & support planningInfo, advice, advocacyVCSrolePeer supportPeople & carers shaping all their servicesShared Decision Making, self- mgmt
16 Focus on what matters to people, create conditions for change & build partnerships Mental health service users, mortality 3.6 times general population
17 Questions for you…What are the key things we need to learn from the social care experience as we take forward IPC?What opportunities can you see for IPC in your area?
18 Calderdale “Quest for Quality in Care Homes” Innovative new partnership model of care – CCG, acute trust and Council invest in telehealth and telecare solutions, benefitting up to 1,000 people in 25 care homesWhy introduce technology in care homesCalderdale has a higher rate of older people in care homes compared to other regions across EnglandGPs didn’t want to come out to care homes and discharge teams didn’t want to send people to particular care homes who weren’t in the quest for quality schemeCQC radar about poor quality care at some homesObjectivesto avoid unnecessary hospitalisation through early intervention, management of risks and improved medicine complianceto support people with round the clock assistancemyclinicCarry handleBest practice personalisation should include technology enabled care services (TECS)Personal health budgets still in infancyWe know people would like better control over their lives“Telehealth and telecare provides us with the opportunity to encourage self-management and better care and support. In turn this can help reduce costs on the NHS caused in part by unnecessary hospital and GP visits” Dr Steven Cleasby, Clinical Lead for Care Homes and Safeguarding, at NHS Calderdale CCG
19 Thank you Kevin.firstname.lastname@example.org 01977 660524 Q&AThank you