Joint Commissioning Business Support Unit Three Year Plan for Health and Social Care of Vulnerable Adults 2011/2014

Joint Commissioning Business Support Unit JCBSU Governance Created July 2009 as a formal arrangement between Walsall Council and NHS Walsall to bring together the commissioning of health and social care services and thus achieve efficiencies from reduced duplication and bureaucracy e.g. single joint contract system instead of duplicate Head of JCBSU has simultaneous responsibility as an Officer of NHS Walsall and an Officer of Walsall Council Routinely accountable to NHS Walsall and Walsall Council – and also to a Joint Committee “Vulnerable Adults Executive Board”

Joint Commissioning Business Support Unit Scope During 2010/11 All of Walsall Council Adult Social Care (Circa £70 million per annum) NHS Walsall programmes for unscheduled care; continuing health care; learning disability; and mental health services Total financial responsibility – net spend of £298 million

Joint Commissioning Business Support Unit Over-riding Priority Promote good health and well-being in the people of Walsall by: 1.providing access to a range of universal services and community based health and social care services 2.reducing dependence on services and supporting independence and self directed support 3.commissioning good quality services that provide a diverse range of choice for people to achieve their outcomes 4.preventing people from becoming socially excluded and needing more intensive and costly health and social care services by providing a range of practical services close to hand 5.helping people to access mainstream services i.e. disabled shower in a leisure centre

Joint Commissioning Business Support Unit Three Year Plan To set out strategic commissioning intentions over the next 3 years to realise cash releasing savings, and subsequent reinvestment to improve outcomes for people using services To keep people out of hospital and keep people out of care homes who don’t need to be there, and support them to live in their own homes instead To clarify the major priorities of GP Commissioners and Walsall Council To continue a meaningful dialogue with the citizens of Walsall on priorities for the NHS and for social care including carers, providers and service users Our vision is to: “Improve health, well-being, life chances and independence of Walsall citizens”

Joint Commissioning Business Support Unit Benefits The JCU Business Plan aims to improve the quality of services, maximise independence and good health, and reduce current levels of spend by 20% over 3 years. We shall do this by obtaining: 1) Value for money (VFM) from the Core services that do meet needs effectively (i.e. standard fee levels instead of individually negotiated) 2) Savings from keeping Service Users in high cost services only as long as they need to be (i.e. emphasis on rehabilitation, recovery, intermediate care) 3) Savings because citizens will be signposted/diverted to alternative services, rather than to the core, costly services 4) Savings because there will be a range of interventions to help people stay independent longer 5) Further commissioned prevention services which the resultant savings will be reinvested in further prevention services

Joint Commissioning Business Support Unit Core Prevention tertiary Enablement secondary Universal primary Shift demand to lower cost interventions High focus on value for money on core Number of citizens high low Cost low high Diagram

Joint Commissioning Business Support Unit Commissioning Matrix Urgent Care Mental Health Learning Disability Prevention Care Homes: CHC Funded Council Funded Home Care Day Care Respite Care A Commissioning Matrix has been developed to gain a panoramic overview of expenditure across the JCU – both NHS and Council. This reveals: comparative spend between service areas e.g. OP, MH LD, PD, Carers comparative spend between prevention and core services comparative spend between service types e.g residential v community comparative spend between NHS and Local Government Comparative spend between in-house (e.g. NHS) and external distribution between providers distribution in/out of Borough provides opportunity to improve value for money e.g. unit costs provides opportunity for service rationalisation

Joint Commissioning Business Support Unit JCU Led Developments Early intervention of mental health services with enhanced primary care and psychological therapies Out of Area Placements Centre for Independent Living Hollybank as joint rehab ctre Learning disability supported living services and day services Investment in prevention services – i.e. vol agencies Rehabilitation and re-ablement Frail Elderly Pathway Urgent Care Centre Hospital discharge Unscheduled care programme Continuing Health Care Rapid Assessment Treatment Team – OPMH/Dementia Community meals service

Joint Commissioning Business Support Unit Headline Savings achieved by JCBSU in 2010/2011 JCBSU Outturn and Return on Investment 2010/11 The JCBSU controls a net contracted spend of circa £140 million in 2010/11 The current JCBSU costs (staffing, overheads etc.) amount to £1,657,281 and JCBSU estimates to save £11,918,357 in 2010/11. This gives a Return on Investment of 7.2 i.e. the value of JCBSU savings is 7.2 times the value of its cost.

Joint Commissioning Business Support Unit JCBSU SAVINGS ACHIEVED 2010/11 QIPP Savings in NHS: Mental Health £ 469,402 Unscheduled Care £2,900,000 Complex Care £ 175,000 Council Savings: Disability Services£6,263,000 Prevention£1,000,000

Joint Commissioning Business Support Unit Focus “Everything we do will improve the experience of using the service, and value for money”