Virginia McClaneCommissioning ManagerOctober 2014

Commissioners intentions for supporting people to live

in their own homes

Kent Housing Group 22 October 2014

“Life, not a service”

£330 million…new savings estimated between April 2014 and March 2017

Savings

£18 million…Adult Social Care Savings for 2014/15

Phas

e 1

Phas

e 2

Phas

e 3

Current Operating Model

• Panel-focused care pathway• Traditional system adjusted with independence-

promoting services• Time-consuming internal processes• Time and task contracting relationships• Large provider networks

Wave 2: Increased breadth of services• Broader suite of commissioned services

throughout the FSC pathway• Improved internal systems for efficient

delivery of services

Delivering the Future Vision• Pathway working within the principles of care• Integrated health and social care pathway,

commissioning and provision• Shaping the market through strategic

engagement with key primary suppliers

Wave 3: Integrated commissioning• Integrated internal processes in the

care pathway• Work with partners to develop joint

strategic commissioning arrangements

Wave 1: Best use of existing systems• Improved use of enablement-based

services• Improved internal systems• Reshape provider markets (incl.

rationalisation) to lay the foundations for future transformation

c£30M savings

Transformation Model (Phase 1)

Phase 1 – Better outcomes less cost

Accommodation and Homecare Strategies

Partnership with Housing Provider Commissioning, OT’s, Case Management & Care ProviderFully furnishedLicence agreement issued by KCCShort term - up to 6 weeks stayBookable in advance55 + Eligibility Criteria

Trial TenancyAdjusting to a new condition or

disabilityAssessment step up/down

Respite

Negotiations with providers for more flats

Independence & wellbeing apartments

Affordability

Review completed in 2014- Support the Accommodation Strategy- Does it act as a deterrent? - Comparisons with other LA’s- Develop consistent approach

- 70% don’t pay- 27% pay full amount - 3% pay reduced amount- Kent expensive compared with other LA’s - Affordability can act as a deterrent

Key decision taken September 2014£15 for existing schemes effective April 2015 and immediately for new schemes .

Wellbeing, lifestyle & peace of mind in Extra Care

Still some work to do where Housing Providers are also care providers. Housing business models may be based on the assumption that they will also be the care provider and apply a

“lifestyle” charge within tenancies

£27.96

Phas

e 1

Phas

e 2

Phas

e 3

Current Operating Model

• Panel-focused care pathway• Traditional system adjusted with independence-

promoting services• Time-consuming internal processes• Time and task contracting relationships• Large provider networks

Wave 2: Increased breadth of services• Broader suite of commissioned services

throughout the FSC pathway• Improved internal systems for efficient

delivery of services

Delivering the Future Vision• Pathway working within the principles of care• Integrated health and social care pathway,

commissioning and provision• Shaping the market through strategic

engagement with key primary suppliers

Wave 3: Integrated commissioning• Integrated internal processes in the

care pathway• Work with partners to develop joint

strategic commissioning arrangements

Wave 1: Best use of existing systems• Improved use of enablement-based

services• Improved internal systems• Reshape provider markets (incl.

rationalisation) to lay the foundations for future transformation

Scope• Demand management through community capacity (Vol. Sector) • Integration with the NHS as a mechanism to improve outcomes

and drive further efficiencies• Increase breadth of commissioned services, focused on enabling a

more holistic approach to care in the community

Transformation (A Waved Approach) Phase 2

Integration – Whole System Transformation

Whole System Transformation

KCC’s Adult Social Care

Transformation Plan

The Better Care Fund – 2016

(£101m for Kent – not new money)

The Health and Wellbeing

Strategy – 2017

Kent’s Pioneer Programme –

2018

CCG Strategic Plans – 2019

Our Model of Integrated Services

Integrated Discharge Teams: Acute Hospital sites; 7 days a week working.

“I can plan my care with people who work together to understand me and my carer(s), allow me control, and bring together services to achieve the outcomes important to me.”

Crisis Response Services: Access to shared anticipatory care plans by the ambulance

service, enhanced rapid response, enablement services

and voluntary sector based crisis response services.

Integrated Care Home Support: Integrated teams including

Consultant and GP support; Use of technology to Care Homes / Extra

Care Housing providers.

Integrated Equipment, DFGs, capital adaptations & assistive technologies

at the front end of all services, video conferencing with clinicians and development of new pathways.

Improved data sharing:Promotion of NHS number, better

exchange of health information, use of the health and social care information centre, patients

accessing own health records, GPs linked to hospital data.  

Operating model: Integrated skill mix, assessors

accessing integrated care direct: i.e. nurses accessing social care and case

managers nursing care, skills for mental health/dementia/LD.

Non Acute Bed Provision: Consultant and GP support;

Integrated Care Centres; Extra Care; Rehab Units; Community

Hospital beds; Private Residential and Nursing bed provision.

Integrated Enhanced Rapid Response:

Rapid Response; active reablement; “Going Home Teams”

Integrated Long Term Conditions/ Neighbourhood teams:

24/7 access to multi-disciplinary teams coordinated by the GP, inc

mental health/dementia; risk stratifying patients; access to one shared care

plan for patient & professionals.

Integrated Access: Integrated Locality Referral Unit; 7 days a week direct access and 24/7 crisis response; Access to shared care plan on an integrated platform.

thank you

Virginia McClaneCommissioning Manager – October 2014