1. Homecare within N. Ireland’s Integrated Health & Social Care Structures An Overview Martin McGeady Head of Homecare Services An Overview Martin McGeady Head of Homecare Services

2. N. Ireland – Some Facts Population 1.7 million 5,400 square miles 6 Counties 26 District Councils NI Assembly – devolved government since 1998

3. Derry D.C. Limavady D.C. Strabane D.C. Omagh District Council Fermanagh D.C. Coleraine D.C. Moyle D.C. Ballymoney D.C. Ballymena D.C. Magherafelt D.C. Cookstown D.C. Antrim D.C. Dungannon D.C. Armagh D.C. Newry & Mourne D.C. Banbridge D.C. Craigavon D.C. Down D.C. Lisburn D.C. Ards D.C. Castlereagh D.C. Belfast D.C. North Down D.C. Newtownabbey D.C. Carrickfergus D.C. Larne D.C. MAP OF NORTHERN IRELAND Western Area Population 295,192 Area (Hectares) 484,080 Population Density 0.58 Northern Area Population 449,623 Area (Hectares) 435,567 Population Density 0.98 Eastern Area Population 671,579 Area (Hectares) 175,124 Population Density 3.80 Southern Area Population 342,754 Area (Hectares) 318,768 Population Density 0.98

4. N. Ireland Assembly Power-sharing Executive since 2007, dominated by DUP & Sinn Fein Health Minister – Edwin Poots, DUP Health Committee – Joint Chair Block grant determined by Westminster [Barnett Formula] allocated to priorities by the NI Executive Policy and legislative authority in N. Ireland for almost all health and social care issues

5. Evolvement of N. Ireland’s Health & Social Care Structures 1948 – 1972 Tripartite Arrangement 1972 HPSS (NI) Order – 4 Boards 1991 creation of 19 Hospital & Community Trusts By 2000 NI had 48 H&SC Institutions 2002 – 2007 review of Public Administration 2012 – Today’s Integrated Structures

6. N. Ireland’s H&SC Structures

7. Roles & Responsibilities of the Various Bodies DHSS & PSPolicy Legislation H&SCB Commission Services Deploying & Manage Funding Work with Trusts to ensure public needs are met Performance Management Health & Social Care Trusts 6 Trusts [N, S, W, SE, Belfast & NI Ambulance Provision of health & social services to local population Patient Client CouncilListen and act on the public’s views Encourage & facilitate user involvement Advice & information Business Services Organisation Central support to all H&SC bodies on a range of business functions, e.g. procurement, legal services

8. Cont’ Public Health Authority Promote improvement in health and social well-being Health Protection Local Commissioning Groups 5 LCG’s co-terminus with Trust’s Commissioning Health & Social Care for local population RQIA Regulation Inspection Service Improvement Community & Voluntary Sector Complementing the work of the other bodies

9. An Overview of Homecare in NI Home Help – Home Care – Reablement In-House (42%) : Independent Sector (58%) Estimated 23,000 service users 86% Service Users 65+ Annual Spend £200m Estimated 10,000 staff employed 283 Providers* [likely less than 100] Regulated since 2009 * RQIA – significant double counting of multiple site providers and supported living facilities

10. Integration in Action - ISD Integrated Service Delivery Formalised approach mid 2000’s Standardised Approach [RPA] Co-location [Health & Care Centres] Overcoming professional and organisational boundaries Fully [?] integrated multi-disciplinary working Locality sensitive approach Single Assessment Tool [NISAT].

11. The Team Locality Services Manager [WHSCT 2x Nurse,1xSW & 1xOT] Primary & Community Care Co-ordinators [13 staff – professional mix] Social Workers Community Nurses AHP’s – Aligned Homecare – Aligned Admin Support

12. ISD – The Benefits Co-location Improved Communication Better understanding of each other’s roles Easier Access to other professionals Shared patient / client input Single Assessment Tool Improved Service

13. Actual or Virtual? “Could do Better”! Examples where staff are co-located but not necessarily integrated Challenges – Facilities, other change processes Good Examples

14. Best Practice Dementia Team Reablement Community Rehabilitation

15. The Future Transforming Your Care Integrated Working Re-visited and Re-emphasised Health & Care Centres Importance of GP engagement

16. Any Questions???? Thank You! martin.mcgeady@westerntrust.hscni.net