master presentation - health & wellbeing event 14.03.13
DESCRIPTION
This is a master presentation comprising of slides by Richard Humphries (the King's Fund), Jane Moore (Coventry City Council), Andrea Pope-Smith (Dudley MBC), Sarah Norman (Wolverhampton City Council), Peter Hay (Birmingham CIty Council) and Wendy Saviour ( NHSCB)TRANSCRIPT
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Health & Wellbeing in the West Midlands:
Making it work across the NHS & Local Government
14th March 2013
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Logistics
Mobiles to silent please No scheduled fire alarmWiFi password is…Refreshments and lunch will be served next doorLinks to slides and outputs from the day will be available on iewm blog: www.iewm.net/making-it-work
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Welcome & introduction to day
Richard HumphriesThe King’s Fund
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Our purpose today:
To identify the big challenges for the West Midlands arising from national developments
To better understand each other’s agendas – for local government, public health & CCG leaders
To showcase examples of behaviours leading to innovation & transformation across the region
To consider options for how you work together across the West Midlands
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The national picture
Four burning platforms
• Changing needs & demography• Organisational change• Austerity• Quality & safety
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8
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NHS structures have become more complex...and new roles for local government-
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....in the West Midlands
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Source: NIESR
Austerity - economic & fiscal prospects are dismal
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Quality & safety
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Local authority total
£6.9 billionEducation
£4.5bChildren’s social care
£0.7b
West Midlands spend on health, care & wellbeing
Adult Social Care
£1.5b
Housing£0.2b
CCG allocations
£6.6 billion
Public health£0.3b
Other health commissioning (NHSCB/CSU)
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Total
£13.8b billion
The total resource
Not including:• Commissioning spend on primary care etc• Specialised commissioning• Public health spend by PHE and NHSCB• Local govt spend on wellbeing related provision• Housing revenue account & RSLs• Other relevant government spending• Private spend on care services & support• Value of estate• Community assets & social capital• Monetised value of unpaid carers, volunteers
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Nick Bell, CEO, Staffordshire County Council
David Hegarty,CCG Lead, Dudley
What’s it like for you ?
Jo Davidson, DASS/DCS,Herefordshire Council
Dr Richard Harling, DPH, Worcestershire
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Opportunities & challenges: raising our sights, raising our ambitions
Table discussion:
1. What are three biggest challenges & opportunities for the West Midlands in the current climate ?
2. What are your top three ambitions for what you want to achieve in the West Midlands ?
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Coffee11.15-11.30am
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Building relationships, changing behaviours
Integrated commissioning in Staffordshire
New ways of working for public health in Coventry
Integrated dementia care in Dudley
New approaches to Troubled Families in Wolverhampton
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Integrated commissioning & partnerships
Eric RobinsonStaffordshire County Council
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New ways of working for public health
Jane MooreCoventry City Council
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Dr Jane Moore
Director of Public Health - Coventry
Coventry: “New Ways of Working for Public Health”
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Variation in life expectancy across Coventry
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How do we Maximise the Life Opportunities of People in
Coventry?
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What has this led to?
• Heath and Wellbeing Strategy – People, Place, Outcomes
• Lead responsibilities for delivering strategy shared between partners
• CCG Plan • Developing a shared commitment to asset based
approaches to community engagement• All council directorates and portfolio holders committed
to demonstrating how their areas maximise peoples life opportunities
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How do we Maximise the Life Opportunities of People in
Coventry?
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Top Tips
• Don’t say it is a health issue• Start with a co-design model for working
with communities and interest groups• Role of Public Health is to act as a catalyst
– delivery needs to be owned by everyone
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Background to Dementia Gateways in Dudley
Dr David Hegarty & Andrea Pope-SmithDudley Metropolitan Borough Council
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New approaches to Troubled Families
Sarah NormanWolverhampton City Council
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Building Relationships &
Changing BehaviourTroubled Families
Sarah Norman – Chair Regional Troubled Families Network
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"If you always do what you've always done, you'll always
get what you've always got."
Henry Ford?
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Information Sharing Whole family working Difficult conversations Intensive
What we need to do differently
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“Dedicated workers dedicated to families” Family Intervention Programme Model Key worker model Are “stand alone models” a lost opportunity
to change the way all agencies work with Troubled Families? Vz
Will key workers working in existing agencies be able to work sufficiently differently?
Stand Alone vz integrated models
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“These workers have a distinct working style seen as the key to success consisting of dogged persistence, the ability to challenge values and behaviour, clear honest, authoritative and assertive working styles and a real understanding of the family”
Practical “hands on” support, modelling behaviour, teaching “on the job”
What is the best way to build a family intervention workforce?
Is this a new profession?
New breed of worker?
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Most LAs in the West Midlands have located Troubled Families in Children’s Services
Many of the Parents have mental health, substance misuse or learning disabilities.
Contributions also possible from YOTs, Family Nurse Partnerships, Tenancy Sustainment
Aspects of the approach may be relevant to working with adults without children
Is Troubled Families a Children’s service?
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Funding only available for three years What is the legacy strategy?
◦ Demonstrate savings achieved?◦ Embedding in the way existing services work?
Evidence Base How does your legacy strategy impact on
what you need to do now?
Legacy
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Lunch & networking12.30-1.30pm
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Peter HayWest Midlands ADASS
Wendy SaviourNHS Commissioning Board
Making it work in the West Midlands
Sue IbbotsonPublic Health England
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The role of the NHS Commissioning Board
in the West Midlands
Wendy Saviour,Director,
NHS Commissioning Board Birmingham, Solihull and the
Black Country Area Team
14 March 2013
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The NHS Commissioning Board• NHS CB combines a single national operating
model with local focus and implementation
• Mandate and Constitution drive our agenda
• Improving outcomes for patients at the heart of everything we do
• Partnerships essential – within and outside the NHS
• We will support and develop CCGs so that they can be the best they possibly can be
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Nationwide Organisation, Local Presence NHS Commissioning Board
• Central team – main base Leeds, small presence in London
• Four Regional Teams (part of the Operations Directorate) – we are part of Midlands and the East
• 27 Area Teams (ATs) – commissioning high quality primary care services, supporting and developing CCGs, assessing and assuring performance, direct and specialised commissioning, managing and cultivating local partnerships and stakeholder relationships, inc representation on health and wellbeing boards
• Three Area Teams in the West Midlandso Birmingham, Solihull and the Black Countryo Arden, Herefordshire and Worcestershireo Shropshire and Staffordshire40
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Local Area Team (LAT)Common LAT functions:
• CCG development and assurance
• Emergency planning
• Resilience and response
• Quality and Safety
• Partnerships
• Reconfiguration
• System Oversight
• Key local partner of Health and Wellbeing Boards
41
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Our purpose
• Improve health outcomes and quality
• Clinical leadership and engagement
• Patients and the public to have more choice and control over their care and services
• Innovation and transformation
• Equality and the reduction of inequality in access to healthcare
42
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Our role• Allocate resources to CCGs
• Support and hold to account CCGs
• Direct commissioning responsibility for:
oPrimary care
oSpecialised services
oPublic Health, Military and Offender health services
• Strategic, clinical and professional leadership across Local Area
• Clinical Networks and Senate43
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Clinical Networks and SenateNHS Outcomes Framework
Senates [12]
Strategic Clinical
Networks
Local Professional
Networks
Operational Delivery Networks
Other Local
Networks
“The conscious and guiding intelligence”
“Engines for change and improvement across complex care systems”
“Gathering frontline knowledge and expertise”
“Mapping patient pathways to ensure access to specialist support”
“15 AHSNs: Masters of science and evidence based practice”
Multi-professional
i.e. Cancer; CVD; Maternity and Children’s; Mental Health / Dementia / Neurological Conditions
i.e. Pharmacy; Eye health; Dental
e.g. Adult Critical Care; Neonatal Intensive Care; Trauma; Burns; Paediatric NM; Paediatric IC
e.g. Academic Health Science Networks, Research Networks
Annual national priorities from the NHSCB Medical and Nursing DirectoratesAll supported by Improvement Body and Leadership Academy
NHSCB Network Support Teams (AT-based)
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45
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The West Midlands Clinical Senate
NHS Outcomes Framework
Senates [12]
“The conscious and guiding intelligence”
Multi-professional
“The Senate, an assembly of some three hundred of Rome’s great and good, generally acknowledged - even by those not in it - to be both the conscience and the guiding intelligence of the Republic. Membership of this elite was determined not automatically by birth but by achievement and reputation…..
“This gave to the Senate’s deliberations immense moral weight, and even though its decrees never had the technical force of law, it was a brave or foolish magistrate who chose to ignore them”
Holland; Rubicon (London, 2003) p37.
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The West Midlands Clinical Senate: Key Relationships
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The West Midlands Clinical Senate: Council and Assembly
The Senate Council :• Experienced and credible clinical chair - Dr David Hegarty • Core multi-disciplinary ‘steering’ group of between 20–30• Responsible for the formulation and provision of independent strategic clinical
advice to CCGs, the NHS CB and HWBs• Considers objective data and information, views and opinions from a broad
range of experts and others invited through the ‘Assembly’
The Senate Assembly:• Diverse multi-professional forum providing the Council with ready
access to experts from a broad range of health and care professions, invited through the Chair, as required
• Membership to encompass a wide range of clinical professions, the ‘birth to death’ spectrum of NHS care, and the five domains of the NHS Outcomes Framework.
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The West Midlands Strategic Clinical Networks
Strategic Clinical Networks
“Engines for change and improvement across complex care systems”
i.e. Cancer; CVD; Maternity and Children’s; Mental Health / Dementia / Neurological Conditions
SCNs will operate for cancer; cardiovascular; maternity and children; mental health, dementia and neurological conditions from April 2013.
A model through which professionals and organisations will come together, working across boundaries to:
deliver programmes of continuous quality improvement
contribute to the achievement of outcome ambitions for patients, and benefit population health, where there is a need for whole system or collective improvement endeavour.
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SCN Oversight Group
50
West Midlands SCN Oversight Group
Cancer SCN Steering Group
Cardiovascular SCN Steering
Group
Maternity & Children SCN
Steering Group
Mental H, Dementia & Neuro Conditions SCN
Steering Group
SCN sub-groups / task and finish groups together with
county specific groups / local implementation teams
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Core Membership of SCN Oversight Group
51
Acute CEO Representative
Area Team Medical Directors
Mental Health CEO representative
Specialised Commissioning Director
Commissioning COO representatives for each
county
Patient Representation
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Thank You
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Table discussion:
1. What do we need to do at which level – locally, sub-regionally & across West Midlands ?
2. What have we got to build on ? What have we got to share ?
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Action Planning & Next Steps
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[email protected] @richardatkf
Slides, videos and other materials from the day will be available at www.iewm.net/making-it-work