1. Integration of Health and Social Care Wellbeing and Health Open Forum March 2016

2. Why is change necessary? National position  Rising demand and constrained resources  Growing pressure - more people living into older age with multiple long term conditions  Finances deteriorating  Workforce  Public expectation  Major challenges to be tackled within an incredibly fragmented landscape

3. NE Regional Context  High levels of deprivation  Lower life expectancy than the national average  Some excellent health services but poor population health  Unsustainable Health Economy Commissioner and provider financial positions Over reliance on hospital care o 20% higher than the national average A&E Activity continues to rise year on year o 2014/15 average 2,041 per day o 2015/16 average year to date 2,172 per day

4. NHS Planning  Plans, plans and more plans!  Emphasis on sustainability and transformation  Systems of care  Place based approaches  No appetite for a national blueprint of structural change  New Models of Care - Pioneers, Vanguards  Integration with other NHS organisations as well as with Social Care

5. Why Integrate with Social Care?  Interdependence  Public experience fragmented service delivery  Reduction in funding for adult social care beginning to bite  Greater efficiency in delivery  Prevent reduce delay  Need for fundamental rethink

6. Barriers to be overcome  Universal and free v eligibility and means testing  Nationally governed v locally controlled  Different funding streams  Legal frameworks  Performance frameworks  IT  Medical v Social  Culture

7. What next?  Plan for integration by March 2017 – Gov’t Spending Review Requirement  Sustainability and Transformation Plan by July 2016  Health and Social Care Commission – reports in September  Integrated IT across the system by 2020  Better Care Fund rolls on – broadly stable policy framework  All planning requirements expect a whole systems approach from 2017-2020

8. Write a Plan or Do Something? Better Care Focus Children &Young People Ways to Wellness Falls Prevention Intermediate Care

9. Proof of Concept Localities Bottom up approach 2 localities – coalition of the willing Using GP registered lists Use Design Principles to share hunches, develop ideas, refine, test Move quickly from idea to testing Influence our Newcastle Model of Care

11. The story so far 2 design Labs held Think about the people not services Be creative Identify challenge themes Form initial working groups

12. How can we integrate health and care around people How can we support people with the services they need? Where could we have maximum impact?

13. Emerging thinking Amazing start Connecting Communities Learn to Prevent Compass – access for marginalised people Multiple needs and Year of Care Homesafe - improving hospital discharge