1. Care Services Efficiency Delivery Programme Transforming Community Equipment Programme Keynote speech Lynne Horn National Implementation Manager NAEP Conference 25 th – 26 th June 2008 Blackpool

2. Care Services Efficiency Delivery Programme Where are we now

3. Care Services Efficiency Delivery Programme Agenda ■Policy context ■Who are we working with ■Fears and Concerns ■Moving forward

4. Care Services Efficiency Delivery Programme Policy Context – enabling people to live as independently as possible, – enabling people to exercise choice and control over the support they receive, – the promotion of high quality safe services; and – Supporting equality, human rights and social inclusion Ministers have committed themselves to – personalised social care and health services, – giving power and control to people to shape the services they need, – working with commissioners, providers and regulators of services to implement policy, – improving the status of services and of the workforce in health and social care, – developing and sustaining a vibrant and innovative third sector; and – ensuring value for money The new model is aimed at the total population, not just those who are supported by the state

5. Care Services Efficiency Delivery Programme Model designed to deliver policy Policy document Recommendations relevant to the Programme Included by programme Our health, Our care, Our say: a new direction for community services (‘OHOCOS’) People assessed as needing equipment can choose to buy the equipment that meets their needs through a direct payment. In the future, this may be part of Individual Budgets in the event of national roll out. People should be helped to live at home (e.g. through provision of community equipment) where possible. OHOCOS built on the Green Paper (Independence, Wellbeing and Choice) commitment that local authorities should, in considering strategic needs, take into account the care and support needs of the whole population, including those who have the ability to pay for the services themselves ‘Improving the life chances of disabled people’ - PMSU Piloting Individual Budgets to pull together funding streams, including funding for community equipment and Access to Work, to give people more say in the services they receive. Programme dependency Equipment must be updated and maintained Use centres for independent living to give disabled people greater say Better information and advice, particularly on transition services (e.g. moving from children to adult services) Key desired outcomes: Increased ability to live independently Children and their families able to lead ‘ordinary’ lives Young people and their families supported throughout transition More disabled people in employment Services should be personalised and be available at times so people can get to work

6. Care Services Efficiency Delivery Programme Model designed to deliver policy Policy documentRecommendations relevant to the ProgrammeIncluded by programme ‘Improving the life chances of disabled people’ - PMSU By 2012 the DH should work together with DfES and ODPM (CLG) to deliver equipment and adaptations that meets needs, is personalised, involves disabled people and acknowledges them as experts about their needs, maximises choice, minimises disincentive to seek employment or move locality and uses existing resources to reduce social exclusion. In 2006 the DH should assess whether the community equipment services, communication aids provision and wheelchair services are able to deliver NSF recommendations on children’s equipment. If not, make recommendations for improvement Standard eight: disabled children and young people and those with complex health needs These children and young people should “receive co-ordinated, high quality and family-centred services which are based on assessed needs, which promote social inclusion and, where possible, which enable them and their families to live ordinary lives”. The NSF states that children and young people will need to have increased access to therapy and equipment services and social services and that organisations should undertake ‘multi-agency transition planning’ to support disabled young people entering adulthood. National Service Framework for Children, Young People and Maternity Services Standard three: children, young-people and family-centred services Ensuring services are co-ordinated around the need of the child and family. Standard two: person-centred care Allow older people to make choices about their care package, regardless of traditional health/ social care organisation boundaries. E.g. through single assessment process, integrated commissioning and integrated community equipment and continence services.

7. Care Services Efficiency Delivery Programme Model designed to deliver policy The new model has included all the policy requirements above Policy documentRecommendations relevant to the ProgrammeIncluded by programme National Service Framework for Older People Standard one: rooting out age discrimination in health and social care Standard eight: promotion of health and active life. NHS should lead a programme to promote good health amongst older people, supported by local councils. Quality Requirement 7: Equipment and accommodation People with long term conditions should receive equipment (e.g. wheelchairs) and housing adaptations when they needs them, to help them lead independent lives and lead health lives. National Service Framework for Long Term Conditions Following should be considered when assessing people for equipment: For complex needs, provide specialist professional assessment with community equipment/ AT Equipment requirements to be part of the integrated care plan Consider providing equipment on trial Training on how to use equipment for users and carers Consider how to respond to changing needs, e. g. frequent reassessments/ reviews and flexible provision of equipment for people with rapidly progressing conditions Responsive collection and repair and loan, where equipment breaks down Consider changing needs of carers, e.g. due to illness, paid employment. Sir Peter Gershon ‘Releasing Resources to the front line’ Although this is not a policy requirement, both LA’s and PCT’s are required to meet efficiency targets, and we have identified efficiency release as part of the Financial case below.

8. Care Services Efficiency Delivery Programme Who have we been working with in the North West? Lead Partners Current Micro Site Macro Sites Live Micro Sites

9. Care Services Efficiency Delivery Programme Pre shadow running concerns and fears

10. Care Services Efficiency Delivery Programme Early feedback from Practitioners In house service Assessment process CE Stores Early messages from Oct – Dec 2006 showed positive view of policy – but not in my back yard!

11. Care Services Efficiency Delivery Programme Concerns ■Older people do not want choice ■Frail and vulnerable people prefer professionals to select items for them ■Older people are incapable of understanding what to do with a prescription. Our clients are housebound and can’t visit a retailer ■Practitioners would have to spend more time on assessments because of the need to revisit the user ■Unscrupulous retailers will sell vulnerable users equipment they don’t need ■The model is wasteful as it does not encourage recycling

12. Care Services Efficiency Delivery Programme Evidence from shadow running

13. Care Services Efficiency Delivery Programme Evidence Older people do not want choice: 75% - 90% of Users believed in the importance of having a choice of aids they receive and retailers to go to for their aids

14. Care Services Efficiency Delivery Programme Evidence Frail and vulnerable people prefer professionals to select items for them: An overwhelming majority of Users (90%) valued the ability to ‘top up’

15. Care Services Efficiency Delivery Programme Evidence Older people are incapable of understanding what to do with a prescription. Our clients are housebound and can’t visit a retailer: All Users surveyed had redeemed their prescription with over 80% redeeming it for themselves

16. Care Services Efficiency Delivery Programme Evidence Practitioners would have to spend more time on assessments because of the need to revisit the user: Lead Partners: ■Experienced a reduction in the average number of days from referral to assessment from 18 to 9 days (a reduction of 50%) and from assessment to case closure from 45.5 to 27.5 days

17. Care Services Efficiency Delivery Programme Evidence Unscrupulous retailers will sell vulnerable users equipment they don’t need: Over 90% of Users were satisfied with the service received from retailers and as many as 73% would speak highly of them

18. Care Services Efficiency Delivery Programme Evidence Unscrupulous retailers will sell vulnerable users equipment they don’t need: Reassuringly, although Users had limited awareness of their option to ‘top up’, there was no attempt by retailers to exploit this concept

19. Care Services Efficiency Delivery Programme Evidence The model is wasteful as it does not encourage recycling: ■Case Study available ■Template that you can complete yourself to understand true cost of refurbishing simple aids to daily living

20. Care Services Efficiency Delivery Programme Implementation

21. Care Services Efficiency Delivery Programme We are working with 70 organisations across England x6 - Retail model active x30 - Phase 1 implementation – Business Case prep x34 - Key Decision Makers Meetings

22. Care Services Efficiency Delivery Programme The Minister’s decision – to implement the model across England ■He is considering writing, jointly with David Nicholson, NHS Chief Executive, to all LA/NHS partnerships to encourage implementation He has asked me to ■Recruit national implementation team ■Support local authorities and their health partners to implement ■Continue to evaluate more effective options for complex aids to daily living The implementation plan has been completed and is under review

23. Care Services Efficiency Delivery Programme We will support LA/NHS partnerships to implement These tools and techniques are available and being used now SPONSORHIP PROJECT MANAGEMENT PROJECT RESOURCING PROJECT PLANNIN G 1 2 3 4 Start up readiness assessment packs Partnership agreement Project management toolkit Local business case template Initial Contact Needs Assess ment Local Financial Model (Impact on budgets: Loan store overheads, equipment and back office budgets) Retail Model Back Office Prescription Issue Demand Mgmt Refurbishment case study and template 9 x pulses (how to transition packs)

24. Care Services Efficiency Delivery Programme Thank You