1. Safer Staffing – Integrated Care Teams The Right Staff, with the Right Skills, in the Right Place at the Right Time Sara Courtney – Head of Professions East ISD Paula Hull – Head of Professions West ISD

2. Wider Policy
Context

3. Drivers for change in community model of care delivery
National Drivers for change - Integrated Care delivery models (NHS England, 2014), Case Management models and supported self care models (RCN, 2006), Better Care Fund, Professional workforce challenges, £20bn Nicholson challenge, technology development. Current care models are often fragmented with services reflecting professional and institutional boundaries
Population Drivers for change - by 2030 the number of people aged over 65 will have more than doubled
Physiological Drivers for change - Increasing numbers of people living with multiple long term conditions (set to rise from 1.9 million in 2008 to 2.9 million in NHS England, 2014)
Improved Outcomes Driver for change - Remove gaps and duplications in existing service provision and improve effectiveness, safety, and the experience of patients and people who use services
Local Drivers for change – Primary Care challenges (ie Gosport), wide variation in Acuity and Dependency across areas of Hampshire, clear Commissioning Intentions
Historical basis for staffing levels based on population numbers and travelling distances
Historical efficiencies sought through isolated teams

4. Integrated Care Teams Complex Case Management function
Crisis Response function
Enhanced Supported Discharge function
Rehabilitation and Reablement function
General (non-complex) function

5. Remodelling approach for Integrated Care Teams
WORK PROGRESSED:-
Review of current establishments (from TCS modelling – based on population numbers)
Current ‘work rates’ (recent activity referral levels and targets, waiting times)
Leadership structures to support Integrated team working (Locality Management team, Lead Clinician, Team Leader roles and responsibilities)
Number of clinical teams determined from Practice Population size
Band 7s have developed Core Competency framework with LEaD and CCGs
Agreed ICT Co-ordinator role and admin support to clinical teams
NEXT STEPS:-
Apply an acuity and dependency model to apply to core ICT size and skill mix
Level of socio economic deprivation
Long Term Conditions (ACG)
Number of nursing / care homes
Location of ICTs
Launch Core competency framework for all ICT members, determine gap analysis and training plan
Standardise some Job Descriptions
Modelling new Integrated SPA referral process and Clinical Triage
Evaluation of current Virtual Ward model
Full Patient and Staff engagement
Staff Consultation