gill ruecroft: integrating personal health budgets into the new landscape of clinical commissioning

Northamptonshire Integrated Care Partnership

Integrating Personal Health Budgets into the new landscape of clinical

commissioning


• Health professionals/patients working in partnership, different conversations, real choice & control

• The plan is the key to coordinate integrated services • New role required - support, brokerage and advocacy • Improved quality = reduced demand on services • Tension – current service provision/decommissioning

to make savings real • This was much more complex and difficult to

implement than we envisaged – its not a QIPP fix!

Learning from PHB


• CCGs x 2 • Nine localities • Mirrors local authorities boundaries • NHFT (community services provider)

provision locality based • 3rd sector tend to be locality based • Health & Well Being Fora in each locality

New County Landscape


Two pilots in Northamptonshire working from one agreed model concept

• Daventry – Risk stratification approach – Based on MDT and use of specialists – Centralised

• Kettering – Not condition specific, high users of emergency services – Generic team who coordinate an individualised MDT – Practice based

LTC integrated model pilots


THERE IS NO “CURE”… THIS IS ABOUT MANAGING AND LIVING YOUR LIFE

INDIVIDUAL PLAN

NEIGHBOURHOOD TEAM

FRIENDS

FAMILY

VOLUNTARY

HOUSING

SOCIAL SERVICES

MENTAL HEALTH NURSES

MDT H&SC NEEDS

H&SC OUTCOMES TO ACHIEVE


• LTC integrated pilots - MH low level support to start with

• Exploring how to commission PHBs further this year

• Develop a CQIN for inclusion in 2013/14 contracts

• Future plan, to include in LTC integrated model


Claire - in her early twenties, using MH services for 4 years, has been unwell since she was 17. When Claire applied for her PHB she was living with her

parents. Last year 9 contacts with crisis resolution team and 67 inpatient stays.

• Total cost of health care 12 mths previous = £56,291.89 (excl medications)

• PHB = £12,930.56 (planned spend to date £10,426.00)

• Claire’s progress against the outcomes in her plan she aimed to achieve: No inpatient stays, one contact with the crisis resolution team Reduced contact with care coordinator, from 2 weekly to 4 weekly Self harmed twice (‘Nowhere as many as I used to’) Weight loss, new clothes, improved self esteem Reduced reliance on family, living more independently, in control, making decisions

• Claire’s plans for next year and the future To complete year 2 of college course Make more new friends and move to next level of independent living Continue to stay out of hospital To work in a Zoo – dream…to work in another country on and endangered breeding programme

gill ruecroft: integrating personal health budgets into the new landscape of clinical commissioning

Health & Medicine