One Croydon Alliance Background and overview for inaugural meeting of Croydon Community Health Alliance (Croydon Voluntary Action) 7 December 2017

‘Working together to help you live the life you want’ OBC Alliance Vision ‘Working together to help you live the life you want’ The Alliance ambition is to shift health activity from an acute setting which is reactive in nature to proactive and preventative health and care in the community. Our Ambition is articulated in 3 main ways: Personal Outcome Improvements Improved financial sustainability Activity Shift – right place, right time Health and care partners are committed to an ambitious programme of innovation and change to transform the way we support the people in Croydon to be independent and healthy for longer and be able to access high quality care when necessary. We will work holistically to use our resources wisely supported by developments in digital technology, training and development of our workforce and improved communication and engagement to communities to empowering individuals to manage their physical, psychological and social care.

Personal Outcomes The 5 outcome domain “I-Statements” set with us by residents of Croydon provide the centre of our shared ambition I want to stay healthy and active for as long as possible I want access to the best quality care available in order to live as I choose and as independent a life as possible 2 1 I want good clinical outcomes 5 I want to be helped by a team/person that has had the training and has the specialist knowledge to understand how my health and social care needs affect me I want to be supported as an individual with services specific to me 3 4

Overview of background to Outcome Based Commissioning in Croydon (1) Croydon CCG and Croydon Council, as the primary commissioners of health and social care agreed in 2014 to establish the Outcome Based Commissioning (OBC) Programme for people over the age of 65 years. This was in response to a recognition that the health and social care economy in Croydon has a widening gap between the growing demands and expectations on services and the available resources to meet these demands. There followed an extensive engagement programme with local residents to agree the local outcome priorities including the production of 5 “I” statements and develop the OBC Outcomes Framework for over 65s.

Overview of background to Outcome Based Commissioning in Croydon (1) In April 2015, the main providers of health and social care in Croydon, signed a Memorandum of Understanding in response to the OBC Programme and formed an Accountable Provider Alliance(APA). The partners were Croydon Health Services, South London and Maudsley Mental Health Trust, Croydon GP Collaborative, AGE UK Croydon, and Croydon Council Adult Social Care. Beginning in August 2015, the APA underwent a detailed 3 stage Capability Assessment Process (CAP) that ended in July 2016 with the APA passing CAP3. However owing to the scale of risk still evident, the APA and commissioners agreed to form a commissioner/provider Alliance which was ratified in September 2016. In April 2017, commissioners and providers signed the Croydon Alliance Agreement. This is based upon a 1 year transition year with the aim of extending the Alliance for a further 9 years from April 2018 dependent upon satisfying a number of transition year criteria, namely a Year 2-10 Business Model underpinned by a robust system financial model.

Out of Hospital The beginning: The New Model of Care Outline vision in a few sentences Outline key attributes of the new model of care

Integrated Community Networks (ICNs) Thornton Health Network  Huddles A meeting in a GP practices with a multiagency team to discuss the care of people with complex health and care needs.  Personal Independence Coordinators A new role within the Multi-agency team, working with people who have complex needs to identify personal goals. They then work with them to develop support plans that include creating links with voluntary and community sector support.   Active and Supported Communities Engaging and supporting community groups to promote and facilitate self-care, prevention and independence. Shared Care Plans Using Coordinate My Care (CMC) to support the development of advanced care planning for patients with complex health needs. Mayday Network Woodside/ Shirley Network East Croydon Network New Addington/ Selsdon Network Purley Network

The Croydon Way Inspiring behaviour change and empowering individuals to take better control of their health and wellness. One Croydon’s plan for transformation over the next decade, includes a key strand to promote self-care and support community development that reduce social isolation and empower people to be more activated in making their own health and independence. The approach will include : Information and advice services Active Communities Group Consultations Personal Independence coordinators Reducing social isolation Volunteering “ My Life Plan” Digital Solutions e.g. Health Help Now App Just Be ABCD Patient Activation Health Coaching Social Prescribing

Broadening the Funding of Community and Voluntary Groups Local Authority Contracts & Grants Opportunities as resources shift from acute hospital care to more proactive community based care External Sources for funding CCG Contracts & Grants New Model of care seeks to shift focus from reactive acute hospital based care to a more proactive model that is delivered in the community and includes wider engagement in with voluntary and community groups in promoting independence and self care Collaborative working and use of resources to enhance opportunities to access external funds. Also enhance reputation for innovative working will attract further investment. Commissioning Intentions will reflect Alliance Priorities and inform focus of renewed contracts including delivery against share outcome measures

Active and Supportive Communities / Points of Access and Information Summary Draft modelling – initial discussions