AGENDA ITEM
REPORT TO ADULTS HEALTH AND WELLBEING PARTNERSHIP
7thMarch 2017
REPORT OF:Assistant Director Adult Social Care
INTEGRATED PERSONAL COMMISSIONING
SUMMARY
The purpose of this paper is to update the Health and Wellbeing Partnership on the current integration projects.
RECOMMENDATIONS
It is recommended that Health and Wellbeing Partnership note the report.
BACKGROUND
1.Following a Peer Review in January 2016, the Health and Wellbeing Board facilitated development day, which considered its approach to Health and Social Care integration.
2.The principles of integration agreed by the Board were:
- Integration from the perspective of the customer
- Areas prioritised by the benefit that integration may bring by application of viability testing through the existing Health and Wellbeing partnerships
- Partnership will determine the parameters of the options of integration and the commissioning groups will facilitate this.
3.The Board considered areas that currently present for change and prioritises three areas:
- Special Educational Needs and Disability (SEND)
- Older People
- Domestic Abuse
4.This report considers the progress of Health and Social Care integration from the perspective of the second priority area, Older People.
DETAIL
5.All the current integration initiatives are set out in one of three strategic plans:
6.The Sustainability and Transformation Plan (STP) and the Better Health Programme (BHP) consider opportunities to improve Out of Hospital Services to deliver early intervention and prevention, reduce the demand on Social Care and reduce the number of non-elective admissions to hospital. These plans are for the whole of the Health and Social Care population and have a bigger ‘footprint’ than Stockton.
7.The Better Care Fund (BCF) plan has two priorities: Multi-Disciplinary Service (MDS) and Improving Dementia pathways of care. The BCF plan is currently focused on people aged 65 and over. The Health and Social Care integration projects that are currently underway as part of the BCF are:
- Single Point of Access
- Multi-disciplinary Service (MDS): wider integration
- Integrated Discharge Liaison Team
- ICT Integration of systems and information sharing
- Integrated Personal Commissioning (IPC)
Single Point of Access
8.The purpose of the Single Point of Access (SPA) is to bring together the ‘front end’ of Health and Social Care services across both Stockton and Hartlepool, into a single integrated triage team. North Tees and Hartlepool Foundation Trust (FT) is providing the lead and the project management for this project.
9.In the current system, each team separately assesses each referral as it comes in and then decides how best to deal with the referral. This could include passing it on to other teams, which can cause delays and there is a risk that the referral is not dealt with by the most appropriate service(s).
10.General Practitioners (GPs) currently have to make separate referrals for both health and social care, whereas with a new single point of access, they would only need to make the referral once and the team will be able to assess which services are needed.
11.The benefit to the person is that they will only need to ‘tell their story once’ and all professionals in the SPA will be able to assess the person’s needs and ensure they receive the most appropriate services in a timely way.
12.Because of the complexity of the project, the timescales for the business case are December 2017 and implementation no earlier than April 2018.
Multi-Disciplinary Service: Wider Integration Health and Social Care
13.The MDS currently has the following services:
- Wellbeing Team
- Falls Services (early intervention and training)
- Stockton Welfare Advice Network
- Housing Occupational Therapy team
14.Their main focus is early intervention and prevention and they work with other Community Services collaboratively, although on occasion they also respond to crisis situations.
15.The wider integration project will look at how all of the following services work to see if further integration of teams will bring benefits, reduce duplication and remove the need for ‘hand-offs’:
Assessment Services / Provider Services- Wellbeing Team
- Stockton Falls Service
- Housing OT Service
- CIAT
- Stockton ART Service
- Stockton Social Care OT Team
- Rapid Response
- Pro-active ICLS
- Integrated Assessment Discharge Team (note: this does not currently exist as an entity but is a process)
- SWAN
- Stockton Reablement Service
- Rosedale
16.The project is currently in two parts:
- Data collection and background information: this is being collated and assessed and will be reported to the Steering Group in April / May 2017
- The NESTA 100 day challenge is looking at this in more detail with two teams working alongside GP practices to develop and explore different ideas and options for future service delivery: this work will be completed May 2017
Integrated Discharge Liaison Team
17.The purpose of this team is to aid appropriate discharge from hospital back home and reduce delayed transfers of care, in line with the Better Care Fund performance objectives.
18.Additional temporary resource has been provided for a period of six months, so that the discharge pathways can be assessed and business case made for improved joint working. The business case should be available by December 2017.
ICT Integration of Systems and Information Sharing
19.The BCF plan had an enabler project looking at how improved information sharing would lead to better decision-making and reducing the need for unnecessary admissions to hospital.
20.Initially, this project has concentrated on the Medical Interoperability Gateway, which enables Health to share Primary Care data. This system is live and currently used by Out of Hours GPs. The next stage is to share the GP data with North Tees and Hartlepool FT and Tees Esk and Wear Valleys FT. Eventually, it is hoped that the data can also be shared with Social Care.
21.The STP has a Digital Transformation Workstream, which is complementary to the BCF Integration workstream. This will consider how all Health and Social Care information can be shared appropriately. There is a regional project called the Great North Care Record (GNCR) and Connected Health Cities will take forward this objective.
Integrated Personal Commissioning
22.The Partnership had an update on IPC at its meeting in February. This project is about the integration of Health and Social Care personal budgets, which provide Voice and Choice for the person. The outcome of this work will lead to more joint commissioning and a different way of commissioning services in the future.
FINANCIAL AND LEGAL IMPLICATIONS
23.All projects start initially as pilots or business cases and new ways of working are only implemented if a strong case can be made. Integration is not pursued unless there are clear benefits to the key stakeholders, including the person their carers, families and advocates.
RISK ASSESSMENT
24.The risks are all managed within the individual programmes.
COMMUNITY STRATEGY IMPLICATIONS
25.The integration programme supportsthe delivery of the Stockton-on-Tees Community Strategy and Joint Health and Wellbeing Strategy. Making a significant contribution to a number of the key themes including: healthier communities and adults; helping people to remain independent; improved access to integrated health and social care services and promoting healthy living.
CONSULTATION
26.People with lived experience are directly involved in shaping the service.
Contact details:
Liz Hanley Assistant Director Adult Social Care
Telephone Number: 01642 527055
Email Address:
Sue Reay Transformation Team
Telephone Number: 01642 527018
Email Address:
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