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Southern Derbyshire
CCG
Integrated Care CCG & Adult Care View
Andy Layzell
Southern Derbyshire CCG
James Matthews
Derbyshire County Council
Southern Derbyshire
CCG
Adult Care Spend 2012/13
Southern Derbyshire
CCG
What is Integrated Care?
Different perspectivesPerson
Seamless meeting of health and social care needs Physical, mental and social needs Support wrapped round person Personalised response reflecting our individuality
Organisations Continuum of care and support without gaps Single ‘pathway’ for person without inter-organisational
disruption Joined up investments
What it can look like Jointly provided services Jointly commissioned services Aligned services Integrated organisations
Southern Derbyshire
CCG
Drivers for Integrated Care
Best experience and outcomes Demographic and associated pressures Potential for improved value for money National policies Care/support closer to home Health and Wellbeing Board and Strategy Technological Developments
Southern Derbyshire
CCG
Obstacles to Integrated Care
Increased specialisation – especially in NHS Multiplicity of providers Professionals sensitivities Legal constraints eg insurance Competition rather than co-operation Organisational boundaries Organisational change
Southern Derbyshire
CCG
Where have we got to so far?
Long history of joint commissioning, aligned investments and some joined up services and joint posts
New impetus: Integrated support for people with long term conditions Integrated approaches to avoid unnecessary acute hospital
admissions and delayed discharges Lead commissioning for carers and people with learning
disabilities Health and Wellbeing Board and Strategies County and City Leaders’ commitment across organisations
Southern Derbyshire
CCG
Voluntary and Community Sector Role
Universal Advocacy, advice and informationSupport systems in communities
Targeted Prevention of requiring health and social care servicesSupport for people in their own homesSupport for carersSupport for people with specific needs
But …Define what you want to do and where it fitsCompetitive procurementLimited funding
.
Southern Derbyshire
CCG
Andy
Andy Layzell
Chief Officer
Southern Derbyshire CCG
Southern Derbyshire
CCG
“The worst winter I can remember”
“The worst winter I can remember”
This comment by Derby Hospitals
Medicine Division’s medical director and echoed by many senior consultant colleagues
Southern Derbyshire
CCG
Doris is 85 and is taken to A&E after a fall one evening. The doctors in A&E have no clinical information about Doris but diagnostics tests indicate that some of her results are not normal. It is 10.30pm and with limited information about Doris’ normal health and her underlying conditions it is decided that there is no alternative but to admit her to hospital.
The following day the clinical team decide Doris can be discharged but there are concerns about her support at home. An assessment is organised but this takes several days to organise and meanwhile Doris is transferred to an acute ward due to pressure in the Medical Assessment Unit. During this time Doris has become slightly confused and has lost confidence, she has become more dependent on care staff and is anxious about going home.
Southern Derbyshire
CCG
Where is the money spent?2010/11(provisional figures) (From
Nuffield Trust) “The worst winter I can remember”
Southern Derbyshire
CCG
Principles for changing services in the NHS (1)
All services will be person-centred and will meet the needs of the person and their families or carers rather than meeting the needs of the system
We will provide care flexibly across all health and social care organisations by listening to, and understanding the person’s complete needs and meeting them by using all services and resources available.
We will challenge assumptions about the way we work and have the courage to make changes for the better that will improve the patient experience and obtain the best value for money.
Southern Derbyshire
CCG
Principles for changing services in the NHS (2)
We respect and value the people who use and work in health and social care services in Derbyshire and we will invest resources to support the health and well-being of our communities.
We will actively seek and listen to the views of people who use and work in health and social care in Derbyshire so that we can plan and deliver services in partnership and be accountable to them.
We will support people to help them to make an informed choice about lifestyle and services and identify and provide extra support for those who need and want to make positive lifestyle changes.
Dr Sheila Newport | Chair | Southern Derbyshire CCG
What we would like to share todayIntegrated Care
Southern Derbyshire
CCG
Some of the Challenges
Low level support
Self management
Shared decision-making
Care Homes
Joined up consultation
Making the best use of scarce resource
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