Shifting the Balance of Care - the third sector contribution - Helen Tyrrell Director

Why Voluntary Health Scotland? Why involve the third sector in SBC? How the third sector contributes to the vision of success What are the challenges? How VHS will help

Voluntary Health Scotland Scotland’s national intermediary body for the third sector engaged in health. Established in 2000, supported by the SGHWD and NHS Health Scotland Through its 300 members and wider stakeholder group, VHS aims to maximise the impact of the third on health improvement, the reduction of health inequalities and health care and at the same time to involve as wide a range of people as possible in this activity Locally, works through CHPs

Why involve the third sector in SBC? Numbers over 4,000 groups and organisations Employs around 13,000 people Supports up to 120,000 volunteers (10% of all third sector activity) But – is quantity enough?

Why involve the third sector in SBC? We know….confirmed by VHS research (2007): Localised approach Practical knowledge of community, leaders, networks Ability to reach isolated, disadvantaged groups High levels of trust Holistic approach Works across service boundaries Close connection with service users Innovative services Speed and flexibility of response User values inform services(19 attributes identified)

Why involve the third sector in SBC? But, what about “added value”? “unique value”? The helped turned helper – from beneficiary to project worker Empowered individuals engage more in established services Volunteering – builds personal & social capital, creates cost-effective services Lever funding in to eg. CHP from eg. Big Lottery The breadth of third sector services appears to avert significantly community reliance on acute NHS services (Jen Foley for VHS 2008)

Improvement Area 1 - Maximise flexible and responsive care at home with support for carers What does success look like? Increased investment into intensive care at home and reduced residential care More extra care housing Increased investment into housing adaptations, improvement and equipment Development of active carer support networks More respite care available Smaller proportion of people being admitted to hospital Integrated rehabilitation services in the community Mainstream telecare

Improvement Area 2 - Integrate health & social care to support people in need & at risk What does success look like? Community planning teams developing robust joint plans using community care outcomes framework Multi-disciplinary teams co-located with joint budgets and joint equipment budgets using combined information systems Growth in Self Directed Support and personalisation to ensure care packages meet individual peoples’ needs and choices. Targeting people who are not yet in crisis (e.g. SPARRA risk prediction tool) Fewer hospital admissions for people with long term conditions Ensure care meets minimum standards (e.g. medicines management) Co-ordinating different care strands (e.g. case management)

Improvement Area 3 - Reduce avoidable unscheduled attendances and admissions to acute hospitals What does success look like? Growth in intermediate care solutions ( e.g. rapid response teams, use of community hospitals for step up step down care) Reduce unscheduled mental health admissions Reduced avoidable A&E attendances Links to End of Life planning (e.g. EOL care plans) Delivering 18 Week RTT

Improvement Area 7 - Improve access to care for remote and rural populations What does success look like? Obligate Networks working well Robust community emergency and urgent response systems are in place Increased use of technology to support local delivery, diagnosis and care at home care (telecare and telemedicine) Reduced travel (and carbon footprint) for consultation and routine care from remote and rural communities to specialist centres

Improvement Area 8 - Better joint use of resources What does success look like? Co located multidisciplinary teams works in the same space to facilitate integrated working Generic workers across health and social care Aligned / pooled budgets Continuity of information Reduced carbon footprint of local services

Challenges to third sector contribution Measures of impact Multiple impacts√√ Scalability√ Strength of evidence What is the value of unique third sector value? Numbers of people benefiting Needs much greater resources

Further challenges…. We asked CHP managers what they needed to engage us more…. (Research for VHS, Bill Weir, 2008) Better understanding of the capacity of local third sector organisations Re-assurance about the quality of third sector provision Re-assurance about the sustainability of third sector organisations An understanding of accountability within the third sector Improved communication with the third sector And, the third sector needs: Hearts and minds engagement Adherence to Compact principles Greater resources

Help is at hand… VHS resources – Advice Notes (X2); e-bulletin; website (120,000 hits/month0 VHS provides strategic support for CVS (the gateway to local third sector & third sector capacity builders) VHS supports Meeting the Shared Challenge, Equally Well, Keep Well VHS will collate, examine relevant quality systems VHS will support the NHS Review of resource support for the third sector VHS will showcase examples of good practice in third sector SBC VHS offers CHP managers support & hopes to work more closely with the ACHP

Sources of further information: Voluntary Health Scotland – Arthritis Care Scotland – arthritiscare.org,uk Shared Care Scotland - British Heart Foundation - British Lung Foundation - Citizens Advice Centre - Strathbrock Partnership Centre -