Upload
rosamund-small
View
214
Download
0
Tags:
Embed Size (px)
Citation preview
Care Services Efficiency Delivery Programme
Transforming Community EquipmentProgramme
Keynote speech
Lynne HornNational Implementation Manager
NAEP Conference 25th – 26th June 2008 Blackpool
Care Services Efficiency Delivery Programme
Where are we now
Care Services Efficiency Delivery Programme
Agenda
■ Policy context
■ Who are we working with
■ Fears and Concerns
■ Moving forward
Care Services Efficiency Delivery Programme
Policy Context– enabling people to live as independently as possible,
– enabling people to exercise choice and control over the support they
receive,
– the promotion of high quality safe services; and
– Supporting equality, human rights and social inclusion
Ministers have committed themselves to
– personalised social care and health services,
– giving power and control to people to shape the services they need,
– working with commissioners, providers and regulators of services to
implement policy,
– improving the status of services and of the workforce in health and social
care,
– developing and sustaining a vibrant and innovative third sector; and
– ensuring value for money
The new model is aimed at the total population, not just those who are supported by the state
The new model is aimed at the total population, not just those who are supported by the state
Care Services Efficiency Delivery Programme
Model designed to deliver policy
Policy documentRecommendations relevant to the Programme
Included by programme
Our health, Our care, Our say: a new direction for community services (‘OHOCOS’)
People assessed as needing equipment can choose to buy the equipment that meets their needs through a direct payment. In the future, this may be part of Individual Budgets in the event of national roll out.
People should be helped to live at home (e.g. through provision of community equipment) where possible.
OHOCOS built on the Green Paper (Independence, Wellbeing and Choice) commitment that local authorities should, in considering strategic needs, take into account the care and support needs of the whole population, including those who have the ability to pay for the services themselves
‘Improving the life chances of disabled people’ - PMSU
Piloting Individual Budgets to pull together funding streams, including funding for community equipment and Access to Work, to give people more say in the services they receive.
Programme dependency
Equipment must be updated and maintained
Use centres for independent living to give disabled people greater say
Better information and advice, particularly on transition services (e.g. moving from children to adult services)
Key desired outcomes:•Increased ability to live independentlyChildren and their families able to lead ‘ordinary’ lives•Young people and their families supported throughout transition•More disabled people in employment
Services should be personalised and be available at times so people can get to work
Care Services Efficiency Delivery Programme
Model designed to deliver policy
Policy document Recommendations relevant to the Programme Included by programme
‘Improving the life chances of disabled people’ - PMSU
By 2012 the DH should work together with DfES and ODPM (CLG) to deliver equipment and adaptations that meets needs, is personalised, involves disabled people and acknowledges them as experts about their needs, maximises choice, minimises disincentive to seek employment or move locality and uses existing resources to reduce social exclusion.
In 2006 the DH should assess whether the community equipment services, communication aids provision and wheelchair services are able to deliver NSF recommendations on children’s equipment. If not, make recommendations for improvement
Standard eight: disabled children and young people and those with complex health needsThese children and young people should “receive co-ordinated, high quality and family-centred services which are based on assessed needs, which promote social inclusion and, where possible, which enable them and their families to live ordinary lives”. The NSF states that children and young people will need to have increased access to therapy and equipment services and social services and that organisations should undertake ‘multi-agency transition planning’ to support disabled young people entering adulthood.
National Service Framework for Children, Young People and Maternity Services
Standard three: children, young-people and family-centred servicesEnsuring services are co-ordinated around the need of the child and family.
Standard two: person-centred careAllow older people to make choices about their care package, regardless of traditional health/ social care organisation boundaries. E.g. through single assessment process, integrated commissioning and integrated community equipment and continence services.
Care Services Efficiency Delivery Programme
Model designed to deliver policy
The new model has included all the policy requirements above The new model has included all the policy requirements above
Policy document Recommendations relevant to the Programme Included by programme
National Service Framework for Older People
Standard one: rooting out age discrimination in health and social care
Standard eight: promotion of health and active life. NHS should lead a programme to promote good health amongst older people, supported by local councils.
Quality Requirement 7: Equipment and accommodationPeople with long term conditions should receive equipment (e.g. wheelchairs) and housing adaptations when they needs them, to help them lead independent lives and lead health lives.
National Service Framework for Long Term Conditions
Following should be considered when assessing people for equipment:For complex needs, provide specialist professional assessment with community equipment/ ATEquipment requirements to be part of the integrated care planConsider providing equipment on trialTraining on how to use equipment for users and carersConsider how to respond to changing needs, e. g. frequent reassessments/ reviews and flexible provision of equipment for people with rapidly progressing conditionsResponsive collection and repair and loan, where equipment breaks downConsider changing needs of carers, e.g. due to illness, paid employment.
Sir Peter Gershon ‘Releasing Resources to the front line’
Although this is not a policy requirement, both LA’s and PCT’s are required to meet efficiency targets, and we have identified efficiency release as part of the Financial case below.
Care Services Efficiency Delivery Programme
Who have we been working within the North West?
Lead Partners
Current Micro Site
Macro Sites
Live Micro Sites
Care Services Efficiency Delivery Programme
Pre shadow running concerns and fears
Care Services Efficiency Delivery Programme
Early feedback from Practitioners
Q6 I would like to see this in my Local Authority or Trust
0% 20% 40% 60% 80% 100%
1
Q6 Strongly agree Q6 Agree Q6 Neutral Q6 Disgaree Q6 Strongly disagree
Q4 A supply market driven by 'choice' rather than state funding - this is good for:
0% 20% 40% 60% 80% 100%
Users
Practitioners
Commissioners
Providers
Suppliers
Q4 Strongly agree Q4 Agree Q4 Neutral Q4 Disgaree Q4 Strongly disagree
Q9 I would give up the following to make this happen:
0% 20% 40% 60% 80% 100%
CE store
Assessment process
In-house service
Q9 Strongly agree Q9 Agree Q9 Neutral Q9 Disgaree Q9 Strongly disagree
In house service
Q3 Open access to needs assessment w hich makes full use of therapeutic skills of practitioner - this is good for:
0% 20% 40% 60% 80% 100%
Users
Practitioners
Commissioners
Providers
Suppliers
Q3 Strongly agree Q3 Agree Q3 Neutral Q3 Disgaree Q3 Strongly disagree
Assessment process
CE Stores
Early messages from Oct – Dec 2006 showed positive view of policy – but not in my back yard!
Early messages from Oct – Dec 2006 showed positive view of policy – but not in my back yard!
Care Services Efficiency Delivery Programme
Concerns
■ Older people do not want choice■ Frail and vulnerable people prefer professionals to select
items for them■ Older people are incapable of understanding what to do
with a prescription. Our clients are housebound and can’t visit a retailer
■ Practitioners would have to spend more time on assessments because of the need to revisit the user
■ Unscrupulous retailers will sell vulnerable users equipment they don’t need
■ The model is wasteful as it does not encourage recycling
Care Services Efficiency Delivery Programme
Evidence from shadow running
Care Services Efficiency Delivery Programme
EvidenceOlder people do not want choice:
57
72
21
17
2
24
13
6
53
% Very good % Fairly good % Neither good nor poor% Fairly poor % Very poor % Don't know
The Importance of Choice
How important, if at all, do you feel it is that patients . . .
Base: 102 Patients, October 2007 - April 2008
are offered a choice of retailers to go to for their aids/
equipment prescriptions
have the opportunity to make a choice about the aids/equipment
they receive.
75% - 90% of Users believed in the importance of having a choice of aids they receive and retailers to go to for their aids
75% - 90% of Users believed in the importance of having a choice of aids they receive and retailers to go to for their aids
Care Services Efficiency Delivery Programme
EvidenceFrail and vulnerable people prefer professionals to selectitems for them:
61%
29%
5%3%
Importance of topping up
Fairly important
Very important
Neither/nor (1%)
How important, if at all, do you feel it is that patients are able to ‘top-up’ their prescriptions in this way. Would you say it was…
Base: 102 Patients, October 2007 - April 2008
Not important at all (1%)
Not very importantDon’t know
An overwhelming majority of Users (90%) valued the ability to ‘top up’An overwhelming majority of Users (90%) valued the ability to ‘top up’
Care Services Efficiency Delivery Programme
EvidenceOlder people are incapable of understanding what to do with a prescription. Our clients are housebound and can’t visit a retailer:
84%
7%9%
Who Redeems the Prescriptions?
For myself
On behalf of someone else -Carer
And can I just check, for your recent prescription are you redeeming this for yourself or on behalf of somebody else? And are you that persons carer or not?
Base: 102 Patients, October 2007 - April 2008
On behalf of someone else - Other
All Users surveyed had redeemed their prescription with over 80% redeeming it for themselves
All Users surveyed had redeemed their prescription with over 80% redeeming it for themselves
Care Services Efficiency Delivery Programme
EvidencePractitioners would have to spend more time on assessments because of the need to revisit the user:
Lead Partners:
■ Experienced a reduction in the average number of days from referral to assessment from 18 to 9 days (a reduction of 50%) and from assessment to case closure from 45.5 to 27.5 days
Care Services Efficiency Delivery Programme
76
71
13
19
2
31 7
4 4
% Very satisfied % Fairly satisfied % Neither good nor poor% Fairly dissatisfied % Very dissatisfied % Don't know
Satisfaction with the Retailer
How satisfied were you with the . . .
Base: 102 Patients, October 2007 - April 2008
Length of time it took for your aid/equipment to arrive once you had
presented your prescription
Individual retailer you used for your aids/equipment prescription
48%
25%
11%
13%
2%
Advocacy of the Retailer
Neutral Speak highly without being asked
Don’t know/no opinion
Be critical if asked
Speak highly if asked
Be critical without being asked (1%)
And which of these phrases best describes the way you would speak about the individual retailer that provided you with your prescription? Would you…
Base: 102 Patients, October 2007 - April 2008
EvidenceUnscrupulous retailers will sell vulnerable users equipment they don’t need:
Over 90% of Users were satisfied with the service received from retailers and as many as 73% would speak highly of them
Over 90% of Users were satisfied with the service received from retailers and as many as 73% would speak highly of them
Care Services Efficiency Delivery Programme
EvidenceUnscrupulous retailers will sell vulnerable users equipment they don’t need:
Patients’ views on Topping up
Aware% Yes % No
44%56%
Topped up
7%
93%
Were you aware that you are able to ‘top-up’ your prescription for an aid or equipment that better suited your needs?
Did you ‘top up’ your prescription?
Base: 102 Patients, October 2007 - April 2008Base: All who are aware they were able to ‘top up’ their prescriptions (45)
Reassuringly, although Users had limited awareness of their option to ‘top up’, there was no attempt by retailers to exploit this concept
Reassuringly, although Users had limited awareness of their option to ‘top up’, there was no attempt by retailers to exploit this concept
Care Services Efficiency Delivery Programme
EvidenceThe model is wasteful as it does not encourage recycling:
■ Case Study available■ Template that you can complete yourself to understand
true cost of refurbishing simple aids to daily living
Care Services Efficiency Delivery Programme
Implementation
Care Services Efficiency Delivery Programme
We are working with 70 organisations across England
x6 - Retail model active
x30 - Phase 1 implementation – Business Case prep
x34 - Key Decision Makers Meetings
Care Services Efficiency Delivery Programme
The Minister’s decision – to implement the model across England
■ He is considering writing, jointly with David Nicholson, NHS Chief Executive, to all LA/NHS partnerships to encourage implementation
He has asked me to■ Recruit national implementation team■ Support local authorities and their health partners to
implement■ Continue to evaluate more effective options for complex
aids to daily living
The implementation plan has been completed and is under review
The implementation plan has been completed and is under review
Care Services Efficiency Delivery Programme
We will support LA/NHS partnerships to implement
These tools and techniques are available and being used nowThese tools and techniques are available and being used now
SPONSORHIP
PROJECT MANAGEMENT
PROJECTRESOURCING
PROJECT PLANNIN
G 1
23
4
Start up readiness assessment packs
Partnership agreement
Project management toolkit
Local business case template
Initial Contact
NeedsAssessment
Local Financial Model
(Impact on budgets: Loan store overheads,
equipment and back office budgets)
Retail Model
Back Office
PrescriptionIssue
DemandMgmt
Refurbishment case study and template
9 x pulses (how to transition packs)
Care Services Efficiency Delivery Programme
Thank You