challenge summit eddie clarke presentation 12 december 2014

WMADASS Challenge

Summit 12 December 2014

Progress Since 4 April

Summit

11 out of 14 peer challenges now completed since July 2013

5 completed since April Shropshire, Herefordshire, Warwickshire, Sandwell and Solihull

Birmingham and Staffordshire both postponed until February 2015. Wolverhampton to be arranged in 15/16

Cabinet Members and Experts by Experience involved in all 5 since April

Good feedback on the value, both as a participant in a Team and as a Host

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eddieclarke/wmadass/12dec2014

Strengths from Peer

Challenges (1)

Shropshire: the vision and direction of travel on early intervention, including community

enablement officers and an engaged DPH all with a real ambition for doing things differently, and P2P:

community led not-for-profit social work practice

that uses an asset based approach to assessments

Herefordshire: 2013-16 Integrated ASC Workforce Plan and a workforce plan on a page, MiR Board

re-launch with one of the Experts by Experience

subsequently employed to develop personalisation

and engagement/co-production, and the re-

integration of ASC back into the Council

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Strengths from Peer

Challenges (2)

Warwickshire: jointly commissioned and provided services with the NHS such as Discharge2Assess and Reablement, a QA Framework that seeks a whole system picture on outcomes and outputs, a PA collective which avoids people being employers, and commissioning modelling tools

Sandwell: an ambitious transformation programme with Health and the VCS, including a Community Offer in the six townships for early intervention/prevention, strong carer support/services and dementia care support in co-production with BUDS and Agewell

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Strengths from Peer

Challenges (3)

Solihull: ICASS programme (Prev and EI, Out of Hospital care and Hospital transformation) with

the CCG and partners, very strong Corporate

partnerships and support, excellent Experts by

Experience group and use of skills, MSP progress

and commissioning for people with complex

needs

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Challenges (1) Personalisation has lost its way in some Councils not just

DP performance but leadership and frontline culture, market shaping, creative support planning, micro enterprise development etc. A commissioning as well as a practice challenge

Integration with Health is complex, especially on Social Work Solihull, Herefordshire and Staffordshire. Structural integration seems to be more difficult and big savings from integration is not realisitic

BCF has been satisfactory (strategic direction and protection for ASC) for most Councils, but some of the metrics are optimistic previous year on year increase and now national ave of -3.07% starting Jan 15 (national range is an increase to >10% reduction). Regionally: 8 Councils approved with support, 5 with conditions and 1 approved (Worcs)

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Challenges (2) Assessing the Care Act impact seems to be an art rather

than a science (DH stocktake regions RAG rating: 1 green, 10 amber, 3 red. Info from the Balanced Scorecard))

Money pressures are growing eg projected overspend of 2m+ (around 4%) demand pressures, cost pressures, unachieved savings. Savings plans/spend varies in the Region (data from the Balanced Scorecard):

14/15: % savings from net ASC budget vary from 2.96% to 15.85%. Majority are in 5-10% range

Gross Exp per Head 13/14 varies from 388 to 532 in the Shires and 412 to 573 in the Unitaries

But there can be further savings/improved outcomes eg John Bolton: a clear vision and care pathway, and targeting reablement on those with the most complex needs


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Challenges (3) Making Safeguarding Personal needs drive and

leadership its not business as usual

The governance on transformation and major projects is not always clear at the Corporate level is it a risk for the DASS

The Transformation Model (observed in Councils) is stronger in some elements than others eg community capacity building, telecare as part of Early Intervention/Prevention or Promoting Independence (ADASS survey Oct 2014 DASSs want more evidence of the benefits)

The associated Vision and Care Pathway is often less developed or not available as a plan on a page for all to understand and own

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Community Capacity Building

Info and Advice

Prevention & Early

Intervention

Reablement and Promoting Independence

Health and Social Care Integration

2014 - Observed

Transformation Model

Person

Centre

d Care


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Prevention and Early

Intervention Walsall Operating Model and Care Pathway


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Conclusions There are clear signs of progress: Development of the Operating Model but not all

Councils are strong in all areas, notably community capacity building

Strong examples of integration (not structural) with Health both in commissioning and in services eg reablement. PH could play a stronger role on evidence base/evaluation

Personalisation in all its aspects needs refreshing/re-launching in some Councils an issue for commissioners too

Care Act, DoLs, and on-going demand/cost pressures are becoming much more evident

Many initiatives are a leap of faith rather than grounded in an evidence base, but.


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eddieclarke/emadass/12sept2014

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The Future of the The Peer

Challenge Programme

Some Questions:

Continue with a new round after Wolverhampton?

If so, continue with the 3.5 day length and Team membership?

Review the self assessment pro forma?

Are the performance data and balanced scorecard sufficient to complement the self assessment?

Conduct shorter and more focused challenges on one specific area? Either as a replacement or as an

optional addition to the standard visit

Does peer challenge and other SLI activity enable us to answer the so what? question?


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challenge summit eddie clarke presentation 12 december 2014

Government & Nonprofit

peer challenges

reintegration of asc

dementia care support

practice challenge integration

hospital care

structural integration

social work solihull

creative support planning