Integrating Health and Social Care in Sheffield

An update for the Health and Wellbeing Board on the Better Care Fund work

Tim Furness, Director of Business Planning and Partnership, NHS Sheffield CCG

Joe Fowler, Director of Commissioning, Sheffield City Council26 June 2014

Better Care Fund is reallocated money that Health and Wellbeing Boards can spend on collective priorities that support integration.

Our plans build on a engagement work done as a Board looking at integration of health and social care.

Sheffield’s final plan was submitted April 2014, full amount £280m. We are looking at four main areas for commissioning:

1. Keeping people well in their local community.2. Intermediate care.3. Independent living solutions.4. Long-term high support.

Recap: what are our plans for the Better Care Fund?

Progress since our last update The Joint Commissioning Executive has been looking at the

following areas: A ‘shadow year’, including governance of the new system and

how we will make decisions jointly and the mechanics of pooling a budget and sharing risks and issues.

How we will measure the performance of the new system. Declaration of Joint Working has been produced for staff. Commissioning projects have been making progress, such as:

Events for providers. Appointment of project managers. First drafts of specifications.

Health and Wellbeing Board e-newsletters have updated over 1,500 people who are signed up about progress – many of whom have expressed an interest in being involved in the future.

Officers have spoken to the Service Improvement Forum and Provider Reference Group about the work.

In-depth look at: Keeping People Well in their Local Community

What is it? Builds on work we have done in Sheffield –

particularly as part of Right First Time Project 1 – to help people be independent, safe and well in their local community

Challenge is how we scale some of the successful pilots into a large-scale preventative approach that demonstrably reduces costs in social care and the health service

We are not alone in having this challenge!

the magic ingredients?

the magic ingredients?

Community development –the right local activities and support

‘Risk stratification’ – people at risk are identified

Advice – people can access good local advice and info

Fix / signpost – common sense sorting out and signposting

Care planning – goal settingand support planning

Care co-ordination – helping people maintain independence and control

the magic ingredients?

Community development –the right local activities and support

‘Risk stratification’ – people at risk are identified

Advice – people can access good local advice and info

Fix / signpost – common sense sorting out and signposting

Care planning – goal settingand support planning

Care co-ordination – helping people maintain independence and control

Increased independence and wellbeing

Fewer A&E attendances

Fewer unscheduled hospital admissions

Fewer Social Care Assessments

Reduced size/cost of formal care

Delayed need for formal care

the magic ingredients?

Community development –the right local activities and support

‘Risk stratification’ – people at risk are identified

Advice – people can access good local advice and info

Fix / signpost – common sense sorting out and signposting

Care planning – goal settingand support planning

Care co-ordination – helping people maintain independence and control

The ingredients are important – but it is how they are used together that makes the recipe

work

Our proposed approach…

• Inviting providers to tell us how they would work together to improve outcomes

• Anticipating groups of providers coming together for discussions about how they would get the recipe right within a community

• Willing to consider devolving funding – but the real prize here is shifting significant investment from treatment to prevention; from illness to wellness; from dependence to independence

• If we can do that we can improve outcomes for the people of Sheffield and reduce costs

Risk Stratification

Local Inform & Advise

Fix and signpost

Community Asset

DevelopmentCare Planning

Care Coordination

The people at most risk of declining health and wellbeing are known (including children and young people)

People get advice and support locally that helps them to stay safe and well

People at risk are connected to community activities/support that helps them to be independent and well

Good activities and support are available locally

People are supported to live healthy lifestyles

People needing extra help and support have an agreed plan for what they, friends/family and services will do

People have someone to help them navigate the system and stay in control

Resources are targeted at those most at risk

Those at risk are contacted and offered advice and support to resolve issues affecting health and wellbeing

RS combines data from more than one source

Hidden carers identified

GP’s report fewer people seeking none medical advice

CARS/Access report fewer information only contacts

Increased attendance at existing community activity

Carers signposted to support

Successful AA claims increase

Reduction in DNA’s at GP practices and outpatients

Emergency services/CWCA report a reduction in false calls

Fewer contacts with Access

Increased Community Transport Reg

People at risk report having more friends

Increased take up of existing community activities by those at risk

New community activities started based on the needs of those at risk

Increase in people volunteering

People actively engage with their care plan and value it

Carers report they feel supported in their role

The majority of people referred to this function are identified via risk stratification

Individual CPM scores improve

People report experiencing seamless integrated services

People have a named contact to turn to when they need it.

Medication regimes enhance quality of life

Health and social care appointments are coordinated

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rsDraft Outcomes Framework – Keeping People Well in their Community

Working on the main areas of commissioning and governance. This will involve some recommissioning activity over the next

year, although the timescales for all the four commissioning programmes are still to be agreed.

Engagement with members of the public, service users, providers. E.g.: Events and co-production initiatives – will vary depending on the

commissioning project. Communication through Health and Wellbeing Board e-newsletter and

other tools. Update at September Health and Wellbeing Board meeting.

So what’s next?

Questions?