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The Care Act: Delivery and Expectation
21st November 2014
Glen Mason Director of People, Communities and Local GovernmentDepartment of Health
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Care and Support affect a large number of peopleMany people need some extra care and support during their adult years to lead an active and independent life. Three-quarters of people aged 65 will need care and support in their later years…
48 per cent of men and 51 per cent of women will
need domiciliary care only
33 per cent of men and 15 per cent of women will never need formal care
19 per cent of men and 34 per cent of women will need residential care
Who needs care? At age 65, what are your chances of needing different types of care within your lifetime?
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Drivers for Change in the English Care System
• Demographic pressure
• Unprecedented financial challenges
• Raising expectations
• Technological Change
• Systems failure eg: Mid Staffs Hospital and Winterbourne View
• A drive to integrate services
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We will change care and support in two fundamental ways:
The Care and Support Act – our vision
1. The focus of care and support will be to promote people’s independence, connections and wellbeing by enabling them to
prevent and postpone the need for care and support.
2. We will transform people’s experience of care and support, putting them in control and ensuring that services respond to what they
want.
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A shift in the care and support system
From To
RepairFocusing only on response after a crisis
PreventionActing earlier to prevent or delay needs
FragmentationIsolated services focused internally
IntegrationJoined-up services working as partners
PaternalState knows best
PersonalPerson knows best
Exclusive“Doing to”
Inclusive“Doing with”
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Choice, control and quality
People can choose between a range of high quality options, or create their own
People develop their own care and support plan
People have clear
information to make good
choices about care
People are in control of their own
budget
People’s views are heard and
help improve services
In the new, person-centred system...
i
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The Care Act is built around people
• People’s well-being will be at the heart of every decision
• Carers rights on the same footing as those they care for• Freedom and flexibility to encourage innovation and
integration• Preventing and delaying needs for care and support• Personal budgets giving people greater control over
their care
• Information and advice about the care and support system
• New guarantees to ensure continuity of care
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The Care Act is built around people
• Promoting the diversity and quality of the local care market, shaping care and support around what people want
• Ensure that no one goes without care if their providers fails
• Puts adult safeguarding on a statutory footing for the first time
• Young adults receive care and support during transition
• Reforms what and how people pay for their care and support
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• Funding: Estimates of additional costs arising from the reforms, and sufficiency of baseline funding for social care.
• Links to Better Care Fund and integration which are a key part of delivery of social care reform.
• Local authority readiness: Scale and complexity of the task facing local authorities and the demands on capacity, and competition for attention.
• Need to maintain engagement in key areas of policy, regulation and guidance, and consider further support needs for implementation.
• Communications challenge to ensure public awareness and local readiness for reforms.
• IT – meeting the requirements of the Act but also the future challenge of integration, shared records and customer access.
• Workforce – developing the skills, ensuring capacity, at the pace required to meet local needs and respond to local challenges.
Implementing the reforms: challenges ahead
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Implementing the reforms: support offerFinancial clarity on the costs of the reforms 1. Work is jointly underway to better understand both the short and long term costs2. Includes provision of models to use in financial planning, FAQs, and advice notes 3. Additional support and guidance has been provided to councils within each region
Information and tools to support planning for implementation1. Major sets of information have been made available (e.g. draft regulations and guidance) or are
about to be made available (e.g. timescales for the public awareness campaign and its resources for local communication teams)
2. L&D resources and final versions of capacity planning tools will be published immediately following the publication of regulations and guidance in mid-October
3. A range of products requirements identified by ADASS & DH policy leads to be available over autumn and details for each product are being communicated to the sector
4. Additional support needs identified in Sep / Jan national stocktakes of readiness
Change capacity management• £19m direct to authorities and £2.7m to establish 9 regional delivery partnerships for Care Act
implementation and BCF• Exploring additional support at a regional level to address local capacity needs in relation to
L&D of the workforce• Work planned to examine how best to manage the national asks of programmes such as Care
Act and BCF
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Better use of resources
Coordinated approach
Organised around users
Reduction in need to go to hospital
Bring skills together around the user
Services 7 days a week
Better outcomes for users
Benefits of integrated care
The Better Care Fund
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What is Government doing to support this?
The Better Care FundThe Better Care Fund
June 2013 announcement:
£3.8bn to be deployed locally in
2015/2016 on health and social care through pooled
budget arrangements
June 2013 announcement:
£3.8bn to be deployed locally in
2015/2016 on health and social care through pooled
budget arrangements
Local authorities and NHS Clinical Commissioning Groups must
agree a joint plan to deliver better, person-centred
care before receiving funding
Local authorities and NHS Clinical Commissioning Groups must
agree a joint plan to deliver better, person-centred
care before receiving funding
Part of the £3.8bn allocated to local
authorities includes a payment for performance element to
incentivise ambition and real change
Part of the £3.8bn allocated to local
authorities includes a payment for performance element to
incentivise ambition and real change
Autumn Statement
December 2013:Pooled budgets
will be an enduring part of
framework in future years
Autumn Statement
December 2013:Pooled budgets
will be an enduring part of
framework in future years
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The Better Care Fund (BCF) narrative
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The Better Care Fund (BCF) will accelerate the local integration of health and care services to deliver better outcomes for people
NHS and social care services are
now caring for people with increasingly
complex needs and multiple conditions.
There is consensus that to respond to
this care should be organised around
the person who needs it, and that
person’s care team should work
together to keep them better for
longer.
The Better Care Fund is one of the
most concrete steps ever towards
making this change happen
everywhere. This is the start and pooled budgets
are here to stay.
Areas put in draft plans in April, and
local areas are now revisiting
these to make sure they are as clear
and strong as possible to kick
start the change we need from next
April. As ever with
system transformation –
success depends on the people
who are leading it to make it
happen locally – people taking bold
steps to move away from their old
ways
The BCF has accelerated and made happen
conversations that have never
happened before about joint working across agencies.
Now we want this to happen
everywhere and we are
committed to support local
areas to achieve this. Local areas teams and local
government regions will have a crucial part to play.
It is challenging, and will
undoubtedly get harder before it
gets easier – but we have seen in
small pockets the immense value of
the prize for patients, users, families, carers
and staff.
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Examples of where it’s happening
Greenwich – avoided 2000 patient admissions with a joint emergency team
South Devon & Torbay – reduced physio waiting times from 8 weeks to 48 hours by bringing professionals together
Tri-borough in London have produced new joint model to help people manage chronic conditions
In Greater Manchester 10 local authorities and 12 CCGs have joined forces to support a large scale reconfirguation
of hospital services
The Better Care Fund
Northamptonshire - targets have been exceeded by 14% on preventing emergency inpatient admissions- targets on
preventing excess bed days exceeded by 4%
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Thank you and any questions?
Glen Mason
Director of People Communities and local Government
Department of Health
DH – Leading the nation’s health and care