www.hertsdirect.org

‘New Ways’Transformation Programme

Health and Adult Care Cabinet Panel 6 December 2011

www.hertsdirect.org

New Ways: Four main projects

• ‘Social Care Access Service’ with Serco

• ‘Lean review’ of Older People’s Teams

• ‘Lean review’ of Learning Disability Teams

• Assessment and care management of older people with dementia

www.hertsdirect.org

Consultation to date

• Consultation event with service users and carers, local groups and vol orgs

• Second event for people with learning disabilities, their carers and vol orgs

• Workshops with people and carers using dementia services and GP consortia

• Staff consultation events and feedback

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Government vision for social care

• More informed people and families through better information and advice

• People told if they are eligible quickly

• People empowered to take control

• Choice in the care and support available

• People are safe and providers high quality

www.hertsdirect.org

Project 1:Social Care Access Service

Health and Community Services

New Ways Programme

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Project 1: ‘Social Care Access Service’

• Partnership with Serco as part of HCC’s shared and managed services contract

• Quality advice at first point of contact

• Eligibility assessments and options

• ‘Channel shift’ and new ‘eMarketplace’

• Service finding and care reviews

www.hertsdirect.org

Project 1: Social Care Access Service

Calls to the Customer Service Centre 44,000

Number of new referrals per year 15,500

Eligibility assessments per year 8,000

Care package changes per year 20,000

Scheduled care reviews per year 5,000

www.hertsdirect.org

Social Care Access - Social Care Access - from the way we do it now …from the way we do it now …

CSC

Referral Management Teams

Service Solutions

Unscheduled Reviews

Scheduled Reviews

Other professionals

Social Work

Locality TeamsEnablement

TIER 1

WebServicesSERCO

Increasing access to direct support Increasing access to direct support and self-help opportunitiesand self-help opportunities Reducing the need for Reducing the need for

longer term provisionlonger term provision

Slide 9Slide 9

Enablement

Social Care AccessInformation

Advice

Triage

Service Finding & Brokerage

Reviews

Extended Involvement

Other professionals

TIER 2

SERCO/HCS SERCO/HCS PartnershipPartnership

Goldsborough Goldsborough PartnershipPartnership HCSHCS

Hos

pita

ls

Hosp Teams /

HCT

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Project 1: ‘Social Care Access Service’

Web-based services fit for 21st Century

• …for use by service users and their families – a web portal with user account

• New ‘eMarketplace’ – allows people to buy care and support services directly

• IT system integration to improve back–office efficiency – linked to SAP etc

www.hertsdirect.org

www.hertsdirect.org

www.hertsdirect.org

Project 1: ‘Social Care Access Service’

Housing Solutions Service:

• Adaptations to people’s homes (inc DFG)

• More consistent OT assessments

• Working with Serco and 6 Districts• Shorter and simpler processes

• Standardised electronic applications

• eMarketplace for builders

www.hertsdirect.org

Project 1: ‘Social Care Access Service’

Monitoring quality and safeguarding:

• Partnerships & Quality Unit• Key performance indicators agreed

• Activity levels agreed and staffing matched

• Interfaces with other teams automated

• Audit mechanisms in place

• Satisfaction levels monitored

• Budget levels monitored

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Assistant Director Older People and Physical Disabilities

Head of Partnerships and Quality

County OT Development

Manager

Performanceand Quality

Manager

Performanceand Quality

Manager

InformationQualityOfficer

SERCO Goldsborough

Project 1: ‘Social Care Access Service’

Monitoring quality and safeguarding

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Project 2:‘Lean review’ of Older

People’s Social Work Teams

Health and Community Services

New Ways Programme

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Project 2: Lean review of OP Teams

WHAT IS A LEAN REVIEW?

• Reduce duplication and waste

• Appropriate delegated authority to spend

• Eliminate bureaucracy

• Shorten forms and paperwork

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Project 2: Lean review of OP Teams

Success of enablement – key stats:

• Of 1,708 people into enablement this year, 50% needed no on-going service

• Homecare population fell by 700 last year with a further reduction projected

• This has led to a 40% reduction in the number of personal budget assessments by Older People’s Teams

www.hertsdirect.org

Project 2: Lean review of OP Teams

Processes made lean:

• ‘Trusted assessors’ – budget authorisers• New universal assessment process• New pathways for enablement services• Review of caseload expectations• Design new operational structure• Define roles and responsibilities

www.hertsdirect.org

Project 2: Lean review of OP Teams

Efficiency drivers:• Success of enablement services• More streamlined assessments• Target reduction in managementBenefits:• Financial savings of £1.6M per annum• Headcount reduction of approx 70 – trying

to avoid compulsory redundancies

www.hertsdirect.org

Project 3:‘Lean review’ of Learning

Disability Teams

Health and Community Services

New Ways Programme

www.hertsdirect.org

Project 3: Lean review of LD Teams

Processes made lean:• Universal assessment• Expectations at care review• Alternative sources of care and support• Authorisations and approvals

Review of team structures:• Maintain community teams• Changes to transition team

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Project 3: Lean review of LD Teams

Older Family Carer’s Workers (4 posts):• Staff who provide support to family carers

over the age of 70 caring for an adult with LD at home

• This work has been mainstreamed into the community social work role

• Support managed through teams• Named team lead for older family carers

www.hertsdirect.org

Project 3: Lean review of LD Teams

Efficiency drivers:• Better throughput required in teams• More streamlined assessments• Reduction in specialist postsBenefits:• Financial savings of £0.5M per annum• Headcount reduction of approx 15 – trying

to avoid compulsory redundancies

www.hertsdirect.org

Project 4:Assessment and care management of

older people with dementia

Health and Community Services

New Ways Programme

www.hertsdirect.org

Project 4: Older People with Dementia

Current arrangements:• HPfT have provided assessment and care management for

all older people with mental ill health in integrated teams since 2005

Perceived problem:• Whilst integrated health and social care input works well for

older people with functional mental illness (e.g. depression or schizophrenia) it does not work well for older people with dementia

• Care purchasing budget was never given to HPfT

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Project 4: Older People with Dementia

Drivers for change:• Delays to appropriate social care interventions• Delayed transfers of care• Slow uptake of enablement services• Relatively high permanent admission to care homes• High numbers of complaints

Proposed solution:• Transfer back the care management responsibility

for older people with dementia and Alzheimer’s

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Project 4: Older People with Dementia

Detailed proposals:• Transfer approx 40 social care staff who work in the

Specialist MH Teams for Older People (HPfT) back to HCC via TUPE

• Integrate the workers into newly configured locality social work teams to support all older people

• Ensure that any older person who is referred to HPfT navigates the system quickly

• Transfer the care purchasing budget for older people with functional MH problems to HPfT

www.hertsdirect.org

Equality Impact Assessments

• Have been developed iteratively for impact on both service users and staff

Impact Mitigation

Web services inaccessible to some group

Use accessibility technologyContinued use of other channels‘Assisted’ access to technology

Reduction of support to older carers of individuals with LD

Maintain support through CLDT

Staff restructures could negatively impact on certain groups

Maintain flexible working, monitoring workforce profileTransparent change processes

www.hertsdirect.org

Decision-making and next steps

Health and Adult Care Panel – Presentation on consultation

6 Dec 2011

Formal staff consultation ends 19 Dec 2011

Health and Adult Care Panel – Recommendation to Cabinet

31 Jan 2012

Cabinet Decision 20 Feb 2012

Changes Go Live 2 April 2012