Developing a New Way of Working for adult health and social care in Kingston

Voluntary Sector Forum30th June 2016

KCC Design Team

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Looking at the wider picture• NHS Five Year Forward View (2014)This sets out how the NHS needs to change over the next five years, given the opportunities that science and technology offers patients, carers and staff, whilst also meeting a number of new challenges: we live longer, with complex health issues, sometimes of our own making. It also promotes a more engaged relationship with patients, carers and citizens so that we can promote wellbeing and prevent ill-health.

• South West London Sustainability & Transformation Plan (STP)Developed to meet the challenges faced across South West London as well as the national requirements set out in the Five Year Forward View. The following prioritised clinical themes have been identified;- Prevention and early intervention- Right care in the best place- Acute configuration and clinical networking- Efficiency and working together

• Kingston & Richmond Sustainability & Transformation Sub Regional PlanShared transformational programmes covering Primary care, Community health, Mental Health, Planned care and Urgent emergency care.

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Looking at the wider picture• Destination Kingston 2016 – 2020A Council vision of services publicly organised, but not necessarily publicly delivered, and a specific focus on;

- Improved direct engagement with residents and their communities

- Benefitting from the growth of the population as well as providing the infrastructure to support it

- Managing a reducing budget in the context of greater demands

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The more detailed picture

Kingston Coordinated Care- Asking people what was working and what

wasn’t (2014)

- Initial work streams;Integrated Customer JourneyActive and Supportive CommunitiesContracts and Commissioning

New Ways of Working

Commissioning and Contracting

Joint Commissioning Service – Phase 2

IT / Information Governance

Designing the operating model – functions, roles

and Structure

Organisational development

Deliver procurement process

Plan Procurement Route

Develop specification

Integrated community health /social care

pathway including OT

Home Care Transformation

Kingston Coordinated Care Projects and Work Streams

Active and Supportive Communities KCC Finance Group

Model finances for joint commissioning

Model benefits of KCC

Develop and monitor financial arrangements for S75 including BCF

Design TeamAction Learning

Kingston Care Passport

Interdependencies

Monitor KCC budget

Enablers

Develop commissioning strategy

Strengthening individual and community

engagement

Embedding support in universal Services

Outcomes-based commissioning of the

VCS

Decision-makingSupported by Kingston test via Commissioning Support Board

Kingston Commissioning Board (Commissioners)

Decision–makingSupported by Delivery Group and Finance committee

Joint Commissioning Service (Phase 2)

Commissioning & Contracting

New Ways of Working

Design Team Action Learning

Communications & EngagementFinanceICTHR & Workforce

•Whole Systems Leadership•Influence and Steer•Unblock barriers•KCC progress reports

Governance

Enablers

Health and Wellbeing Board

Estates

Prog

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me

Deci

sions

Proj

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mpl

emen

tatio

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KCC Programme Delivery Group (PDG)

(Commissioners & Providers)

KCC Finance

RBK Strategic Committees

Kingston CCG Governing Body

Kingston Coordinated Care Governance

Active and Supportive

Communities

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Design Team focus for 2016 Informed by the discoveries in 2015

Embedding the ‘New Way of Working’ The Essentials for Customers: Keeping the person at the centre The Golden Design Principles Value added – does it add value? It’s about capabilities not ‘bodies’ or

organisations Understand, Plan, Do with the person

The Essentials For Staff: Golden Ticket/Golden Fund All the information in one room DT must represent the whole system

Ambassadorial Role: Sharing the DT’s observations and learning from the new ways of working across the whole system

Action Learning: Deploying the new way of working across the system, using people’s stories

Identifying challenges and opportunities:Acting as a customer intelligence layer for the whole system. Identifying where there are opportunities for quick initial wins and marginal gains

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Ambassadorial Role - Getting the Message Across

Mental HealthASCYHKHFTVoluntaryG.P's Other

Proportion of staff numbers ‘touched’ by DT

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Action Learning has highlighted four key themes to date

Understanding the Whole Person (IT)

Readiness and Ability to Engage

Identify the capabilities to Plan & Do with the person

The Golden Ticket to use existing capabilities across boundaries

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Identifying Challenges & Opportunities

•

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Proposed Next Steps• Continue to win ‘Hearts & Minds’ across the community• Share learning with new initiatives and developments• Influence how the New Way of Working can improve

people’s access to care– GP Practices– Ambulance Service– Community Access

• Communicate the New Way of Working beyond the care system

This is a multiple year transformation programme. Current funding for the Design Team runs out end July, so here are

some collective observations….........

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Design Team collective observations There is a real opportunity to make a difference, but it is easy to underestimate the challenges in getting traction on all the

good ideas

• The power of people’s stories• The power of meeting people face-to-face• The influence of organisational culture and resistance to change

– The length of time things take to change (e.g. IT & Governance)– New ideas are easily trampled on

• The system too often requires instant answers, quick wins and ready made solutions

• Many small marginal gains will generate significant savings

People on the ground are really ‘up’ for this, but is the system ready for change?