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Developing a New Way of Working for adult health and social care in Kingston
Voluntary Sector Forum30th June 2016
KCC Design Team
DT June 2016 2
Looking at the wider picture• NHS Five Year Forward View (2014)This sets out how the NHS needs to change over the next five years, given the opportunities that science and technology offers patients, carers and staff, whilst also meeting a number of new challenges: we live longer, with complex health issues, sometimes of our own making. It also promotes a more engaged relationship with patients, carers and citizens so that we can promote wellbeing and prevent ill-health.
• South West London Sustainability & Transformation Plan (STP)Developed to meet the challenges faced across South West London as well as the national requirements set out in the Five Year Forward View. The following prioritised clinical themes have been identified;- Prevention and early intervention- Right care in the best place- Acute configuration and clinical networking- Efficiency and working together
• Kingston & Richmond Sustainability & Transformation Sub Regional PlanShared transformational programmes covering Primary care, Community health, Mental Health, Planned care and Urgent emergency care.
DT June 2016 3
Looking at the wider picture• Destination Kingston 2016 – 2020A Council vision of services publicly organised, but not necessarily publicly delivered, and a specific focus on;
- Improved direct engagement with residents and their communities
- Benefitting from the growth of the population as well as providing the infrastructure to support it
- Managing a reducing budget in the context of greater demands
DT June 2016 4
The more detailed picture
Kingston Coordinated Care- Asking people what was working and what
wasn’t (2014)
- Initial work streams;Integrated Customer JourneyActive and Supportive CommunitiesContracts and Commissioning
New Ways of Working
Commissioning and Contracting
Joint Commissioning Service – Phase 2
IT / Information Governance
Designing the operating model – functions, roles
and Structure
Organisational development
Deliver procurement process
Plan Procurement Route
Develop specification
Integrated community health /social care
pathway including OT
Home Care Transformation
Kingston Coordinated Care Projects and Work Streams
Active and Supportive Communities KCC Finance Group
Model finances for joint commissioning
Model benefits of KCC
Develop and monitor financial arrangements for S75 including BCF
Design TeamAction Learning
Kingston Care Passport
Interdependencies
Monitor KCC budget
Enablers
Develop commissioning strategy
Strengthening individual and community
engagement
Embedding support in universal Services
Outcomes-based commissioning of the
VCS
Decision-makingSupported by Kingston test via Commissioning Support Board
Kingston Commissioning Board (Commissioners)
Decision–makingSupported by Delivery Group and Finance committee
Joint Commissioning Service (Phase 2)
Commissioning & Contracting
New Ways of Working
Design Team Action Learning
Communications & EngagementFinanceICTHR & Workforce
•Whole Systems Leadership•Influence and Steer•Unblock barriers•KCC progress reports
Governance
Enablers
Health and Wellbeing Board
Estates
Prog
ram
me
Deci
sions
Proj
ect I
mpl
emen
tatio
n
KCC Programme Delivery Group (PDG)
(Commissioners & Providers)
KCC Finance
RBK Strategic Committees
Kingston CCG Governing Body
Kingston Coordinated Care Governance
Active and Supportive
Communities
DT June 2016 7
Design Team focus for 2016 Informed by the discoveries in 2015
Embedding the ‘New Way of Working’ The Essentials for Customers: Keeping the person at the centre The Golden Design Principles Value added – does it add value? It’s about capabilities not ‘bodies’ or
organisations Understand, Plan, Do with the person
The Essentials For Staff: Golden Ticket/Golden Fund All the information in one room DT must represent the whole system
Ambassadorial Role: Sharing the DT’s observations and learning from the new ways of working across the whole system
Action Learning: Deploying the new way of working across the system, using people’s stories
Identifying challenges and opportunities:Acting as a customer intelligence layer for the whole system. Identifying where there are opportunities for quick initial wins and marginal gains
DT June 2016 8
Ambassadorial Role - Getting the Message Across
Mental HealthASCYHKHFTVoluntaryG.P's Other
Proportion of staff numbers ‘touched’ by DT
DT June 2016 9
Action Learning has highlighted four key themes to date
Understanding the Whole Person (IT)
Readiness and Ability to Engage
Identify the capabilities to Plan & Do with the person
The Golden Ticket to use existing capabilities across boundaries
DT June 2016 10
Identifying Challenges & Opportunities
•
DT June 2016 11
Proposed Next Steps• Continue to win ‘Hearts & Minds’ across the community• Share learning with new initiatives and developments• Influence how the New Way of Working can improve
people’s access to care– GP Practices– Ambulance Service– Community Access
• Communicate the New Way of Working beyond the care system
This is a multiple year transformation programme. Current funding for the Design Team runs out end July, so here are
some collective observations….........
DT June 2016 12
Design Team collective observations There is a real opportunity to make a difference, but it is easy to underestimate the challenges in getting traction on all the
good ideas
• The power of people’s stories• The power of meeting people face-to-face• The influence of organisational culture and resistance to change
– The length of time things take to change (e.g. IT & Governance)– New ideas are easily trampled on
• The system too often requires instant answers, quick wins and ready made solutions
• Many small marginal gains will generate significant savings
People on the ground are really ‘up’ for this, but is the system ready for change?