Well Connected: History

A reminder - previous presentation in December 2013:

• Arose out of Acute Services Review • Formal collaboration between WCC, all local NHS

organisations, Healthwatch and voluntary sector• Builds on long history of successful partnership • National Integration Pioneer status • Clear agreement that patients/service users and the

public come first, not organisational interests

• The future does not just pose challenges, it presents opportunities

• A health service, not just an illness service

• Giving people greater control and greater choice over their health and well-being

• Harnessing transformational technologies – online and digital inclusion

• Sharing data and knowledge so people tell their story once

• Developing personalised rather than ‘one-size fits all’ model of care

• Pooled budgets –with, where appropriate, personal control

What will the future look like?

Strategic context

• National requirement : each health and social care system agree

five year strategy

• Nationally requirement integrate budgets: The Better Care Fund

• Locally agreed integrated commissioning strategy - extended

role and purpose for the new Integrated Commissioning Unit

• Local agreement to increase provider collaboration

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You plan your care with people who work together with you to understand you and your needs, allow you control and co-ordinate

and deliver services that support you to achieve the outcomes important to you.

National Voices

Our vision for health and care in Worcestershire

Our vision for health and care in WorcestershireYou plan your care with people who work together with you to understand you and your needs, allow you control and co-ordinate and deliver services that support you

to achieve the outcomes important to you.

• A seamless health and social care system delivering high quality, timely and effective care;

• As much care and support provided in or as close to people’s homes as possible;

• Individuals and families will be able to take greater responsibility and greater control over their own health and care;

• Specialist hospital services, primary care and community care provided from high quality safe environments, with appropriate qualified, supported and skilled staff working across 7 days.

• Investment in prediction, prevention and early intervention where we can be confident that this will reduce future demand on services;

• Residents helped with technology supported self care to ensure that specialist resources are focused more effectively on those in most need;

• Reduced differences between social groups in terms of health and social care outcomes;

• A financially sustainable model of care that targets the use of resources in those areas that will have greatest impact.

Worcestershire 5 year Health and Care Strategy

Future of Acute Hospital Services

Specialised ServicesFuture LivesOut of Hospital

CareUrgent Care

Well Connected Transformation Programmes

Well Connected Programme Enabling Projects

1. Information technology and information governance2. Integrated assessment and support plans3. Strong voluntary and community sector4. Workforce5. Communications and engagement6. Developing system leadership7. Provider Development8. Commissioning

Programmes and Enablers

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Enabling workstreams

Some headlines:

• Using our nationally approved BCF to join up care and support services

• Single approach to assessment and care planning

• Information technology – developed roadmap of current systems and how to get to our goal

• Information governance – IG issues impeding info sharing

• Systems leadership -working together towards shared aim

Using the BCF to commission integrated care

Commissioning

genuinely pooled budget for health and adult social care to commission integrated services.

CCGs and Council budgets combined with shared accountability, decision making and risk/benefit sharing

Commissioning on a capitated basis from a provider (or group of providers) most effective services (in terms of cost and quality) around the patients needs.

Commissioners would no longer purchase hospital care from one provider, community care from another, neither would they need to have complex coordination arrangement with the separate commissioners for primary care or those that commission social care.

Providing

Separate providers would need to come together in federations, alliances, joint ventures, or prime contracting arrangements etc.

Commissioners would specify the outcomes they wanted for the patient cohorts and the resources that they will make available to pay providers to meet those outcomes.

Providers design the services they believe are required to best meet those defined outcomes and would receive the entire budget to put those services in place.

Shared risk and gain share between providers and commissioners

2015/16 – Funding Allocation

Consistent with our Five Year Strategy for Health and Care we have allocated the pooledbudget for 2015/16 to commission services in the following groups:

Summary 2015/16 (£'000)

Admission Prevention 11,796

Facilitated Discharge 8,254

Independent Living 7,454

Payment for Performance and ring-fenced fund 9,689

BCF Total 37,193

Our integrated commissioning strategy

1Normally healthy but sometimes need some form of health

or social care support, either

through a planned or an emergency

event, from which they fully recover

and return to their previous way of life

4Normally unwell and require some form of on going health and social

care support to live their everyday lives.

2. One off significant event that results in them from moving from group one to group four and

remaining there for a considerable time or for the rest of their lives.

3. “Rising tide” of health problems (which could be preventable) resulting in them moving from group

one to group four and remaining there for a considerable time or for their rest of their lives

12Midlands and Lancashire CSUwww.midlandsandlancashirecsu.nhs.uk

Segmentation comparison groups

Health Social Care

1. Very High

B. Cost bandsA. Service User Cohorts

Using information technology to improve care

What does this mean for our service users/patients?

1. There is a secure, timely and accessible understanding of which organisations are supporting me.

2. Key patient information is available across all organisations so that people like me only need tell their story once.

3. I have a clear understanding of what information is being shared between practitioners and commissioners and there is an agreed basis for this.4. Practitioners, from all

organisations, can access information about me anytime, anyplace and anywhere.

5. There is a bottom up approach to developing person centred applications and services with me and my circle of care and support.

6. There are opportunities for research based on place & person (not organisation) that helps to improve the quality of my care.

7. There is a robust, locality-wide approach to keeping information safe which secures my trust.

8. Organisations can communicate quickly and securely about me.