Well Connected: History A reminder - previous presentation in December 2013: Arose out of Acute Services Review Formal collaboration between WCC, all local NHS organisations, Healthwatch and voluntary sector Builds on long history of successful partnership National Integration Pioneer status Clear agreement that patients/service users and the public come first, not organisational interests

The future does not just pose challenges, it presents opportunities A health service, not just an illness service Giving people greater control and greater choice over their health and well-being Harnessing transformational technologies – online and digital inclusion Sharing data and knowledge so people tell their story once Developing personalised rather than ‘one-size fits all’ model of care Pooled budgets –with, where appropriate, personal control What will the future look like?

Strategic context National requirement : each health and social care system agree five year strategy Nationally requirement integrate budgets: The Better Care Fund Locally agreed integrated commissioning strategy - extended role and purpose for the new Integrated Commiss i oning Unit Local agreement to increase provider collaboration

5 You plan your care with people who work together with you to understand you and your needs, allow you control and co-ordinate and deliver services that support you to achieve the outcomes important to you. National Voices Our vision for health and care in Worcestershire

You plan your care with people who work together with you to understand you and your needs, allow you control and co-ordinate and deliver services that support you to achieve the outcomes important to you. A seamless health and social care system delivering high quality, timely and effective care; As much care and support provided in or as close to people’s homes as possible; Individuals and families will be able to take greater responsibility and greater control over their own health and care; Specialist hospital services, primary care and community care provided from high quality safe environments, with appropriate qualified, supported and skilled staff working across 7 days. Investment in prediction, prevention and early intervention where we can be confident that this will reduce future demand on services; Residents helped with technology supported self care to ensure that specialist resources are focused more effectively on those in most need; Reduced differences between social groups in terms of health and social care outcomes; A financially sustainable model of care that targets the use of resources in those areas that will have greatest impact. Worcestershire 5 year Health and Care Strategy

Future of Acute Hospital Services Specialised Services Future Lives Out of Hospital Care Urgent Care Well Connected Transformation Programmes Well Connected Programme Enabling Projects 1.Information technology and information governance 2.Integrated assessment and support plans 3.Strong voluntary and community sector 4.Workforce 5.Communications and engagement 6.Developing system leadership 7.Provider Development 8.Commissioning Programmes and Enablers

8 Enabling workstreams Some headlines: Using our nationally approved BCF to join up care and support services Single approach to assessment and care planning Information technology – developed roadmap of current systems and how to get to our goal Information governance – IG issues impeding info sharing Systems leadership -working together towards shared aim

Using the BCF to commission integrated care Commissioning genuinely pooled budget for health and adult social care to commission integrated services. CCGs and Council budgets combined with shared accountability, decision making and risk/benefit sharing Commissioning on a capitated basis from a provider (or group of providers) most effective services (in terms of cost and quality) around the patients needs. Commissioners would no longer purchase hospital care from one provider, community care from another, neither would they need to have complex coordination arrangement with the separate commissioners for primary care or those that commission social care. Providing Separate providers would need to come together in federations, alliances, joint ventures, or prime contracting arrangements etc. Commissioners would specify the outcomes they wanted for the patient cohorts and the resources that they will make available to pay providers to meet those outcomes. Providers design the services they believe are required to best meet those defined outcomes and would receive the entire budget to put those services in place. Shared risk and gain share between providers and commissioners

2015/16 – Funding Allocation Consistent with our Five Year Strategy for Health and Care we have allocated the pooled budget for 2015/16 to commission services in the following groups: Summary2015/16 (£'000) Admission Prevention11,796 Facilitated Discharge8,254 Independent Living7,454 Payment for Performance and ring-fenced fund9,689 BCF Total37,193

Our integrated commissioning strategy 1 Normally healthy but sometimes need some form of health or social care support, either through a planned or an emergency event, from which they fully recover and return to their previous way of life 4 Normally unwell and require some form of on going health and social care support to live their everyday lives. 2. One off significant event that results in them from moving from group one to group four and remaining there for a considerable time or for the rest of their lives. 3. “Rising tide” of health problems (which could be preventable) resulting in them moving from group one to group four and remaining there for a considerable time or for their rest of their lives

12 Midlands and Lancashire CSU Segmentation comparison groups Health Social Care 1. Very High B. Cost bands A. Service User Cohorts

Using information technology to improve care

What does this mean for our service users/patients? 1. There is a secure, timely and accessible understanding of which organisations are supporting me. 2. Key patient information is available across all organisations so that people like me only need tell their story once. 3. I have a clear understanding of what information is being shared between practitioners and commissioners and there is an agreed basis for this. 4. Practitioners, from all organisations, can access information about me anytime, anyplace and anywhere. 5. There is a bottom up approach to developing person centred applications and services with me and my circle of care and support. 6. There are opportunities for research based on place & person (not organisation) that helps to improve the quality of my care. 7. There is a robust, locality- wide approach to keeping information safe which secures my trust. 8. Organisations can communicate quickly and securely about me.