Anne Hagan Head of Commissioning & Contracts Brighton & Hove City Council

Council Budget

Adult Social Care Budget ASC Current Gross Budget £105.3 million (Savings delivered: £16m over 5 years) Savings target 15/16: £7.14m  over next 4 years: £22m 90% of services purchased in the independent sector

Current Spend in the City Spend on health and social care services: approximately £420m CCG - just under 50% of budget is spent on acute services (£316 million per year) Adult Social Care - 50% of budget is spent on care homes ( £105 m per year)

Changing Demand Resource intensive Ageing population More people with complex needs

Local Care Market People have increasingly complex needs Costs are rising Providers exiting the market New Providers: LA can’t place Home Care providers: volatility in the market The Living Wage

Care Market - A plan Demand Capacity Fees

Influencing the Direction…… Better Care: Integration with health The Care Act Value for Money – Opportunities for smarter commissioning

The Vision Prevention: Keeping people well Personalisation Core Business: Safeguarding/ Helping people maximise their independence Joined up services - maintain quality

Doing things Differently Build on existing partnerships: Integration with Health Prevention Emphasis on reabling care Coordinated care – less duplication 24/7

Better Care Umbrella

Priority for Brighton & Hove: Frailty Frailty- not just about age Reflects Brighton and Hove demographics& complexity of need – mental health & substance misuse, homeless, more people with multiple health conditions Test out in one GP Cluster

Brighton and Hove Current Configuration of Services

Brighton and Hove Future Configuration of Services

The vision – A ‘primary care home’

Services working together around the whole person Focus on self management, early intervention and prevention Better population health and well being. Improved happiness. The bigger picture

Better outcomes for individuals Early interventions with a focus on self management Seamless, coordinated care – bespoke and personalised Population health improvement Reductions in health inequalities, multiple morbidities and risk of premature mortality More cost effective Joined up systems increase efficiency Wise stewardship of resources to ensure high value care Why integrate?

Shift of focus from ‘What’s the matter?’ to ‘What matters to you?’ Person centred – care and support designed around the individual Proactive and preventative – focus on wellbeing, staying healthy and encouraging self management Responsive, coordinated and integrated care – available whenever the person needs it The vision – What matters to you?

People act on what matters to me I am in control and self managing, where possible I have had a whole person holistic needs assessment which focuses on my health and wellbeing I have 1 point of access, 1 assessment and 1 care plan. I do not tell my story twice. I know my early warning signs and am confident that I will receive the care I need in a timely fashion What does it mean for people using services?

Meaningful integration with community teams Meeting needs of population at cluster level Access to key information to help guide service delivery Greater harm reduction with a more cohesive and flexible team Far greater triangulation and ability to ensure safe support of clients What does it mean for adult social care?

Support for providers Involved in MDTs Involvement in decision making 7 day working Level of need: support required

Improving health and wellbeing: the new architecture………. Sometimes it feels like

Health and Wellbeing Boards Key leaders work together to improve H&WB The public should experience more joined- up services The Board will encourage commissioners to work in a more joined up way Nice, see you in three months

Partnerships: Why Bother? We are in this together - transparency Work with providers/ community & voluntary sector Build relationships, agreed ways of working Challenge current processes Engagement with wider partners/ co-production Better outcomes for people Better use of resources