Post on 26-Jun-2020
transcript
Better Care for Haringey Community Event
Marco Inzani
Commissioning Lead for the Better Care Fund, Haringey Council / NHS Haringey Clinical Commissioning Group
Housekeeping
Aim of today
• What is the Better Care Fund?
• How has your feedback shaped the Haringey Better Care Fund?
• What services are part of the Haringey Better Care Fund?
Meet Harry Gray
• 75 year old widower • Has several health conditions: COPD,
Dementia, Depression, Falls • Visited A&E 32 times in last year, admitted
10 times. • Cared for by his daughter
What is the Better Care Fund?
The £3.8bn Better Care Fund (formerly the Integration Transformation Fund) was announced by the Government in the June 2013 spending round, to ensure a transformation in integrated health and social care. The Better Care Fund (BCF) is one of the most ambitious ever programmes across the NHS and Local Government. It creates a local single pooled budget to incentivise the NHS and local government to work more closely together around people, placing their well-being as the focus of health and care services. (Accessed 28/11/14, NHS England Website, http://www.england.nhs.uk/ourwork/part-rel/transformation-fund/bcf-plan/ )
Haringey’s commitment to deliver better care
Beverley Tarka, Acting Director of Adult Social Care, Haringey Council
Jill Shattock, Director of Commissioning, NHS Haringey Clinical Commissioning group
Haringey CCG Priorities 2015/16
1. Alternative models of care
2. Integration
3. Engaging communities
4. Proactive and holistic primary care
Haringey Council Priorities 2015/16
1. Best start in life
2. Healthy lives
3. Clean and safe
4. Growth and employment
5. Choose to live
Haringey Better Care Fund Vision
“By April 2019, we want people in Haringey to be healthier and to have a higher quality of life for longer. We want everyone to have more control over the health and social care they receive, for it to be centred on their needs, supporting their independence and provided locally wherever possible.”
London Borough of Haringey/Haringey Clinical Commissioning Group
By 31st March 2016 we will:
• Have 705 fewer emergency hospital admissions • Support people to remain at home and avoid 2
more people from going into a care home • Support 6 more people so that they don’t return
to hospital within 91 days of being discharged • Maintain the number of people discharged from
hospital on time • Improve the experience of people with health
conditions measured with a patient survey • Have 10 fewer injuries due to falls in the over 65s
Beyond 2016: Value Based Commissioning
Supporting a single pathway and a single provider to:
• Measure outcomes that are important to you
• Design and run services to deliver these outcomes
• Provide financial incentives to achieve these outcomes
Haringey Better Care Fund
Marco Inzani
Commissioning Lead for the Better Care Fund, Haringey Council / NHS Haringey Clinical Commissioning Group
Haringey Older People (65+)
200 Local People Engaged
Public/Service User Priorities
1. Easy to access
2. Well managed
3. Person Centred
4. Provide good and timely information
5. Enable individuals to do things for themselves
6. Work together as one team
7. Promote wellbeing and reduce loneliness
Intervention Impact
Comprehensive geriatric assessment Reduces hospital re-admissions
Enhanced discharge planning Reduces hospital re-admissions
Re-ablement Reduces residential admissions
Strength and balance exercises Reduce falls
Medicines review Reduce falls
Home safety assessment Reduce falls
Advanced care planning Reduce hospital admissions at end of life
Befriending/community navigators Reduction in loneliness and isolation
National and International Evidence
Programme Impact
MDT discussions • Felt to be positive by MDT professionals. • Fall in acute activity following MDT discussions (but no
control group)
Rapid response service • Appears to be effective at preventing admissions
Integrated locality teams • Breaking down barriers between professionals • Successful case studies • Impact on cost and activity unclear • Selecting right patients is crucial
Home from hospital • Successfully supporting people on discharge from hospital
Local Evidence
BCF Scheme & Service Overview Scheme Service 2015/16
Scheme 1: Admission
Avoidance
Locality Team
£13.5m
MDT
Lymphedema
Rapid Response
Overnight District Nursing Service
Dementia Day Centre
Recovery College (incl. MH Employment)
Falls Prevention
Scheme 2: Effective
Hospital Discharge
Reablement
£3.9m Step Down
Home From Hospital
Scheme 3: Promoting
Independence
Neighbourhood Connects (incl. Info & Advice)
£0.6m Palliative Care
Supported Self-Management (Generic)
Supported Self-Management (Diabetes)
Scheme 4: Integration
Enablers
Interoperable IT
£2.6m Workforce Development (incl some service delivery)
Disabled Facilities
Care Act Responsibilities
Contingency £1,260,000
TOTAL £22m
Admission Avoidance
Named Care Co-ordinator
Health and Social Care Plan
Referral for bereavement counselling
Effective Hospital Discharge
Less time in hospital
Support to return home
Regain confidence to prevent falls
Promoting Independence
Identification
Link to an ‘expert patient’ group
Link to a local gardening group
Integration Enablers
All relevant professionals know important information
Services in the evening
Support for Harry’s daughter
Are We Meeting Public/Service User Priorities?
Public Priority Better Care Fund
1. Easy to access Named care co-ordinator; Single point of access; Evening/weekend services
2. Well managed Training and education
3. Person Centred Health and social care plan
4. Provide good and timely information Information, advice and guidance
5. Enable individuals to do things for themselves
Self-management; reablement
6. Work together as one team Multi-disciplinary team; access to information
7. Promote wellbeing and reduce loneliness
Neighbourhood Connects; support for carers
Key milestones
Aug 2013 – Mar 2014
• Haringey residents and professionals engaged
• Initial BCF plan developed and submitted
Apr 2014 – Sept 2014
• Implementation plan developed • Review of current services • Revised BCF plan submitted
Oct 2014 – Mar 2015
• Services piloted • Business plans and service models developed • Services procured • BCF Plan approved (7th Jan 2015)
Apr 2015 – Mar 2016
• BCF Plan implemented • Monitoring and review of services • Planning for future years
Beyond April 2016…
• Continued commitment to integration
• Outcome focused: e.g. No infections; I feel I am not a burden on my family/friends; I feel listened to; I am a carer and I feel supported; Person died without pain and where they wanted to be
• Lead provider for a whole pathway
What you can do
KNOW – Spread your knowledge of the Better Care Fund
FEEL – Get passionate about improving care for ‘Harry Gray’
DO – Find out what you could do to make a difference