1. 8th November 2007 NORTH EAST LINCOLNSHIRE Care Trust Plus MAKING A DIFFERENCE Jane Lewington, Chief Executive

2. 8th November 2007 Presentation to Directors of Informatics Integration and Improvement - a shared ambition

3. 8th November 2007 OVERVIEW OF NORTH EAST LINCOLNSHIRE N E LincsEngland Unemployment Rate5.2%2.8% Average weekly earnings (male)£485£520 % of private household deemed unfit for habitation 18%7.0% Household burglary rate per 10,000 households399215 % of children in low income households42%27% Number of pupils gaining 5 or more GCSEs46%50%

4. 8th November 2007 25% of local population amongst the most deprived 10% in England Nearly ¾ of the local population live in wards that are amongst the 30% most deprived in England OVERVIEW OF NORTH EAST LINCOLNSHIRE

5. 8th November 2007 WHAT DOES THIS MEAN FOR HEALTH INEQUALITIES? Although deaths from cancer are reducing the inequalities gap has increased by 42% Deaths from CHD and Stroke have reduced overall but death rates from CHD in NRF areas show a different picture Life Expectancy – Inequality in male life expectancy has increased (4.2 years) – Male life expectancy in West and East Marsh Wards has gone down – Gap between female and male life expectancy has increased Two wards have the worst teenage pregnancy rates in Western Europe

6. 8th November 2007 OVERVIEW OF NORTH EAST LINCOLNSHIRE CTP Established – 1 Sept 07 Population – 168,000 89 GPs – 34 General Practices 32 General Practices hold PMS Contracts 1500 Directly Employed Staff 4 Commissioning Groups 2007/08 budget – NHS £229 million, Adult Social Care £56 million 37 contracts for provision of health care 130 Providers of Social Care, challenge of individual budgets

7. 8th November 2007 ELEMENTS TO THE CARE TRUST PLUS 1. Integrated approach to commissioning and delivering health and social care (adults) 2. Local Authority formally delegated delivery of its social care responsibilities to the Care Trust Plus 3. The Care Trust Plus has formally delegated delivery of its health improvement responsibilities to the Local Authority 4. Children’s Trust – joint commissioning and joint delivery of children’s services and hosted by the Local Authority

8. 8th November 2007 SCOPE OF THE CARE TRUST PLUS Community service provision, for example, District Nursing, specialist nursing Wider primary care management Psychological therapies/psychology Commissioning of health and adult social care Learning disability services (including specialist) Substance misuse services and community safety GP out of hours service Mental Health services Palliative care Corporate and HQ support functions eg Finance, HR, Informatics, IT services etc Care management and Community Matrons Adult care management Adult community services (home care, day centres, meals on wheels, transport) Intermediate care services Occupational therapy Physical and sensory disability services Hospital social work and District Nursing Liaison Team

9. 8th November 2007 Delivering the Change Meeting the Challenges

10. 8th November 2007 KEY PRIORITIES OF THE CARE TRUST PLUS Greater personalisation and better access Pathfinder approach to Commissioning Group development Learning Disability Mental Health Development Programme Tackling health inequalities Better outcomes for children and young people

11. 8th November 2007 Greater Personalisation and Better Access - Challenges 18 week care pathways Introduction of individual budgets New service delivery models and new types of contract eg home care

12. 8th November 2007 Pathfinder Approach to Commissioning Group Development - Challenges Introducing new forms of commissioning Integration, population and individual Integrated provision Integrated systems and processes

13. 8th November 2007 Learning Disability - Challenges Moving to commissioning of personalised services Addressing health inequalities Community membership

14. 8th November 2007 Mental Health Development Programme - Challenges Integration of primary and secondary care Community –based personal services Developing the Social Enterprise model Demonstrating service performance

15. 8th November 2007 Tackling Health Inequalities - Challenges Identifying the target audience; targeted services Co-design and co-production Taking a health improvement approach to Local Authority functions

16. 8th November 2007 Better Outcomes for Children and Young People - Challenges New integrated service models and co- location Integrated assessment Demonstrating improved outcomes Wide range of players involved

17. 8th November 2007 NPfIT Our Expectation

18. 8th November 2007 What do we expect of NPfIT? Fit for purpose systems and services A programme that reflects our commissioning role Commitment to delivery on-time and to specification Effective service management model including all components of the service (Local Service Providers and National Service Providers) Service engagement

19. 8th November 2007 What do we expect of NPfIT? Empowerment of local communities Specifying standards, but effective consultation Value added Reflecting the diversity of provision Flexibility and realism

20. 8th November 2007 What do we expect of Informatics To lead a service fit for the 21 st century To contribute effectively to service modernisation and redesign To deliver a ‘core’ service to the organisation which is resilient, reliable and fit for purpose To offer value added

21. 8th November 2007 Are you up to the Challenge? Questions