1. NHS Harrogate and Rural District CCG Better Care Fund – overview Systems Leadership Approach Amanda Bloor Chief Officer Harrogate and Rural District CCG

2. The Government has created a £3.8b pooled budget for 2015/16, intended to help move care out of hospital and into the community and improve working and integration between Health and Social Care. For North Yorkshire, this equates to £39.8m: this is not new money The 2015/16 fund includes the Disabled Facilities Grant funding with the stipulation that it passes directly to Districts. Approximately £10m of the local funding will be performance related based on delivery of local reduction in emergency admissions. Better Care Fund – a reminder of the key elements

4. Vision for North Yorkshire Care centred on the needs of the individual and their carers, empowering people to take control of their health and independence. We are committed to: Become an exemplar for how CCGs and Local Government can work together to lead a complex health and social care system. Improve self –help and independence Invest in Primary and Community Services Create a sustainable local system which protects Adult Social Care and partners with hopsitals to reduce reliance on acute services and residential care.

5. We aim to improve outcomes for, patients and carers and customers, improving their experience of services as well as improving our use of resources. Our aims are encompassed in three key areas of focus: Improve health, self-help and independence for North Yorkshire people Invest in Primary Care and Community Services Create a sustainable system Better Care Fund – Key Principles

6. Making it work - Harrogate and Rural District Co-terminous CCG/District Council Strong relationships Established a Public Sector Leadership Board Desire to recognise and act on ‘place’ Concept of ‘public sector pound’ Sign up to joint commissioning framework Pooled budget – some progress 6

7. Plan on a Page Insert PSLB Harrogate slides 7

8. Our collective vision is for: Together we will lead and support the delivery of high quality services that are efficient, innovative and reflect the specific needs and priorities of our local communities, ensuring better outcomes and improving the lives of local people HaRD CCG, HBC and NYCC are committed to the following principles for how local people should experience services: Promoting health and wellbeing Care is integrated around people rather than organisations Treating the patient’s home as the main focus of care and services No health without mental health No decision about me without me 8

9. A Unique Point in Time – why now? People and Place 20.7% older people (>65) living in Harrogate and its surrounding area (16.7% Eng.) Growth in long term conditions Strong leadership teams Harrogate Public Services Leadership Board; Health and Well Being board Policy and Resource A new era for Health and Social Care in North Yorkshire (Better Care Fund) Five year Forward View Care Act Local organisational plans Converging universes Diminishing resources 9 SHARED PURPOSE COMMON VISION

10. System Leadership – Local vision Opportunity to behalf differently Place based initiatives Leadership behaviours – Trust, sharing power, real partnership Outcomes over process Culture change Addressing the ‘wicked’ issues – No easy solution 10

11. Our “wicked issue” 11

12. Why “Wicked”… How do we ensure our elderly people with LTC including dementia, are supported to live independently and well at home for longer? 2 tier complex health and social care economy Challenging provider economy Personalisation agenda – health and social care Diminishing resources Public and political scrutiny and expectation Ensuring a dementia friendly community with responsive services 12

13. ‘Living Well’ in Harrogate 13

14. Underpinning delivery of our ambitions Integrated approach to voluntary sector commissioning and development Better developed, stable, provider market; including voluntary sector Pooled budgets and resources: – Better alignment of public health, NHS and Social Care plans and funding for the commissioning of health, wellbeing care services – to achieve better outcomes and value for money Choice and personalisation: – Our population to have choice and be empowered through support with decision making around their health and care needs 14

15. Finally….. what will we do differently? 15

16. NHS Harrogate and Rural District CCG Welcome to Questions?