the gathering 23 february 2011 mike martin partnership improvement and outcomes division
TRANSCRIPT
The Gathering 23 February 2011
Mike Martin
Partnership Improvement and Outcomes Division
Doing it right – getting it wrong!!!
WHY we need to ‘Reshape’ Care:
Sustainability – Rapidly ageing population
– Declining public finances
Desirability – Promoting independence not dependence
PAUSE FOR THOUGHT:More of the same will cost an extra £1.1 billion
by 2016 – where will this come from?Over 1/3 of all money spent on health/social
care for over 65’s is on emergency hospital admission [£1.4 billion out of £4.5 billion each year]
89.5% of people over 65 yrs are not in the ‘care system’ [97% of people between 65-74 yrs]
3,000 people 65 yrs+ receive more than 20hrs paid care per week
40,000 people 65 years+ provide more than 20hrs unpaid care per week
How do we spend the £4.5 billion …
Other Social Work
Care Homes
Home Care
FHS
PrescribingCommunity
Other Hospital care
Emergency admissions
£1.4bn
£0.8bn£0.4bn
£0.4bn
£0.4bn
£0.3bn
£0.6bn£0.2bn
Current service provision by service type
People aged 65 and over
hospital est
care home
home care
all others
Current service provision by age group
75-84
85+
65-74
97%
88%
60%
The challenge of change – more HOW than WHAT?
WHAT:A new philosophy of care – partnership and co-
productionA shift of focus – enablement, empowerment,
responsibilityA shift of resources – from institution to
communityA conducive infrastructure to promote rather
than prevent integration
HOW
Build an enduring consensus for the long haul Clarity of ambition – what will success look like? A decommissioning strategy – will impact on the acute
sector A commissioning strategy – coherent service redesign
and development Mutually reinforcing national and local strategies Building Community Capacity – the ‘spine’ for re-
shaping care
HOW – THE CHANGE FUND
£70 million for 2011/12 [circa £300 million over 4 yrs]
Subject to Change Plans – developed/agreed by Council/Health Board/3rd sector/Independent Sector
To invest in community based provision – preventative and anticipatory
To impact on Core Budgets to promote de-commissioning
To promote effective partnership working
Reshaping Care for Older People – A Programme for Change 2011-2021
Publish on 4 March 2011 Our commitments:
Double proportion of spend on care at home – from 6.7% to 13.5%
Build capacity of community/3rd sector to support/grow “supported self care”
Change Fund introduced - £300m over 4 yrs Reduce unnecessary variation – potential to take out 11% of
hospital beds Reduce bed days for 75+ due to emergency admissions by
10% by 2015 No discharge direct from hospital to care home All over 75+ to be offered a telecare package based on
assessed need
OVERVIEW: COMMUNITY CAPACITY AND CO-PRODUCTION WORKSTREAM
CONTEXT
> DEMOGRAPHY/ECONOMY
> RESHAPING CARE FOR OLDER PEOPLE
> WORKSTREAMS
> CHANGE FUND
> OPPORTUNITIES/CHALLENGES
COMMUNITY CAPACITY AND CO-PRODUCTION WORKSTREAM (1)
> Values the capacity, skills, knowledge connections and potential in a community…sees citizens and communities as co-producers of health and well being (and) instead of doing things for people shares power and helps a community to do things for itself’
(Improvement and Development Agency, 2010)
COMMUNITY CAPACITY AND CO-PRODUCTION WORKSTREAM (2)
> Older People are an asset not a burden> Community capacity building is working with the
voluntary and community sectors to build a philosophy of care based on co-production principles and to develop new community driven models of care provision.
> A partnership between those providing care and support and those providing it.
COMMUNITY CAPACITY AND CO-PRODUCTION WORKSTREAM (3)
> Success has as much to do with shifting attitudes and expectations as it has about shifting resources, care institutions, providers and workforces.
> Change Fund/ Change Plan – Opportunity and Challenge!
OUR ROLE
> General Support for Partnerships> Developing the Knowledge and Evidence base> Building Networks and Communities of Practice> Sharing Good Practice> Signposting/Developing Guidance> Link to Scottish Government
Contact Details
Scottish Government leads for Community Capacity Building & Co-production
> Gerry [email protected] 244 2374
> Andrew [email protected] 244 5424
Co-production
> Delivering public services in an equal and reciprocal relationship between professionals, people using services, their families and their neighbours. Where activities are co-produced in this way, both services and neighbourhoods become far more effective agents of change.
National Endowment forScience, Technology & the Arts (NESTA)
& New Economics Foundation (NEF)