CCN Annual Conference

Health & Social Care Integration workshop“breaking borders, improving outcomes”

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Why bother?

System reform

System benefits

Service user

needs

Service user

benefits

• Current model is unsustainable

• Legislation and Government policy drivers

• Cost and demand pressures

• Not enough prevention and early intervention

• Overreliance on hospitals and residential care

• Reduced commissioning and service delivery costs

• Reduced care home admissions• Reduced bureaucracy and

duplication• Reduction in bed days• Reduced emergency admissions• Reduction in readmissions• Improved job satisfaction

• Ageing population, people are living longer

• More people are living with chronic long-term health conditions and co-morbidities

• Services are variable and not always well coordinated

• Improved user and carer experience

• Improved clinical and social outcomes

The unique role of local government

• Countywide leadership role with democratic accountability

• Stability – with changing NHS architecture

• Strong history of engagement with the public/VCS

• Integrating public health and ASC

• Leadership role of HWB – and Integration Transformation fund

Worcestershire case study

What does our local experience say for the wider issue?

Essex case studyWhy?• Scale: Health and social care services

in Essex collectively spend £3.1bn per annum

• Complexity: 5 CCG’s, 1 ECC, 12 districts

• Pressures:– Older population expected to grow

28% by 2033– ECC needs to save £235M by

2016/17– Essex CCGs need to save £354M

by 2017

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How?Key elements of our joint Integration Programme:• A Whole system plural approach:

• Different models of integration e.g. Care Trust, bundles of care, Year of Care

• Integrating commissioning as enabler of integrated provision

• 2013/14 priorities: • Older people/ frailty and learning

disabilities• Focus on outcomes and quality• Managing escalating demand

• Enablers Programme• Work streams on governance, data

sharing• Focus on cultural change and

relationships• Empowering individuals and

communities• Building a deeper understanding of

patient/ user experience

Wider Essex learningWho Will Care? Commission (chaired by Sir Thomas Hughes-Hallet)

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Leadership

Prevention

Community

Technology

Understanding

Our lessons learnt

• First health and social system wide transformation in a generation.

• Different relationships are required between partners and with our citizens.

• Don’t under estimate how hard it will be and expose those difficult issues.

• Need to spend time on building genuine relationships, trust and ownership across partners

• Need to address enablers• Value in co-design, locally and nationally• Evidence base on efficiencies may not yet be

proven but the opportunities may outweigh the risks of doing nothing

• The system is dynamic so new ways of working must be flexible and responsive

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Economic Benefits

Reducing worklessness and driving economic growth e.g. reducing NEETS, supporting employer-led approaches to skills provision, investing in rehabilitation of offenders.

Social Benefits

Demand management through more resilient individuals and communities with greater independence and choice, reducing dependency on public services.

Whole System Benefits

Financial Benefits

Efficiency savings achieved through integrated commissioning and delivery, early intervention and prevention.

Contribution to Public Sector Reform

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