southern derbyshire ccg integrated care ccg & adult care view andy layzell southern derbyshire...

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Southern Derbyshire CCG Integrated Care CCG & Adult Care View Andy Layzell Southern Derbyshire CCG James Matthews Derbyshire County Council

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Page 1: Southern Derbyshire CCG Integrated Care CCG & Adult Care View Andy Layzell Southern Derbyshire CCG James Matthews Derbyshire County Council

Southern Derbyshire

CCG

Integrated Care CCG & Adult Care View

Andy Layzell

Southern Derbyshire CCG

James Matthews

Derbyshire County Council

Page 2: Southern Derbyshire CCG Integrated Care CCG & Adult Care View Andy Layzell Southern Derbyshire CCG James Matthews Derbyshire County Council

Southern Derbyshire

CCG

Adult Care Spend 2012/13

Page 3: Southern Derbyshire CCG Integrated Care CCG & Adult Care View Andy Layzell Southern Derbyshire CCG James Matthews Derbyshire County Council

Southern Derbyshire

CCG

What is Integrated Care?

Different perspectivesPerson

Seamless meeting of health and social care needs Physical, mental and social needs Support wrapped round person Personalised response reflecting our individuality

Organisations Continuum of care and support without gaps Single ‘pathway’ for person without inter-organisational

disruption Joined up investments

What it can look like Jointly provided services Jointly commissioned services Aligned services Integrated organisations

Page 4: Southern Derbyshire CCG Integrated Care CCG & Adult Care View Andy Layzell Southern Derbyshire CCG James Matthews Derbyshire County Council

Southern Derbyshire

CCG

Drivers for Integrated Care

Best experience and outcomes Demographic and associated pressures Potential for improved value for money National policies Care/support closer to home Health and Wellbeing Board and Strategy Technological Developments

Page 5: Southern Derbyshire CCG Integrated Care CCG & Adult Care View Andy Layzell Southern Derbyshire CCG James Matthews Derbyshire County Council

Southern Derbyshire

CCG

Obstacles to Integrated Care

Increased specialisation – especially in NHS Multiplicity of providers Professionals sensitivities Legal constraints eg insurance Competition rather than co-operation Organisational boundaries Organisational change

Page 6: Southern Derbyshire CCG Integrated Care CCG & Adult Care View Andy Layzell Southern Derbyshire CCG James Matthews Derbyshire County Council

Southern Derbyshire

CCG

Where have we got to so far?

Long history of joint commissioning, aligned investments and some joined up services and joint posts

New impetus: Integrated support for people with long term conditions Integrated approaches to avoid unnecessary acute hospital

admissions and delayed discharges Lead commissioning for carers and people with learning

disabilities Health and Wellbeing Board and Strategies County and City Leaders’ commitment across organisations

Page 7: Southern Derbyshire CCG Integrated Care CCG & Adult Care View Andy Layzell Southern Derbyshire CCG James Matthews Derbyshire County Council

Southern Derbyshire

CCG

Voluntary and Community Sector Role

Universal Advocacy, advice and informationSupport systems in communities

Targeted Prevention of requiring health and social care servicesSupport for people in their own homesSupport for carersSupport for people with specific needs

But …Define what you want to do and where it fitsCompetitive procurementLimited funding

.

Page 8: Southern Derbyshire CCG Integrated Care CCG & Adult Care View Andy Layzell Southern Derbyshire CCG James Matthews Derbyshire County Council

Southern Derbyshire

CCG

Andy

Andy Layzell

Chief Officer

Southern Derbyshire CCG

Page 9: Southern Derbyshire CCG Integrated Care CCG & Adult Care View Andy Layzell Southern Derbyshire CCG James Matthews Derbyshire County Council

Southern Derbyshire

CCG

“The worst winter I can remember”

“The worst winter I can remember”

This comment by Derby Hospitals

Medicine Division’s medical director and echoed by many senior consultant colleagues

Page 10: Southern Derbyshire CCG Integrated Care CCG & Adult Care View Andy Layzell Southern Derbyshire CCG James Matthews Derbyshire County Council

Southern Derbyshire

CCG

Doris is 85 and is taken to A&E after a fall one evening. The doctors in A&E have no clinical information about Doris but diagnostics tests indicate that some of her results are not normal. It is 10.30pm and with limited information about Doris’ normal health and her underlying conditions it is decided that there is no alternative but to admit her to hospital.

The following day the clinical team decide Doris can be discharged but there are concerns about her support at home. An assessment is organised but this takes several days to organise and meanwhile Doris is transferred to an acute ward due to pressure in the Medical Assessment Unit. During this time Doris has become slightly confused and has lost confidence, she has become more dependent on care staff and is anxious about going home.

Page 11: Southern Derbyshire CCG Integrated Care CCG & Adult Care View Andy Layzell Southern Derbyshire CCG James Matthews Derbyshire County Council

Southern Derbyshire

CCG

Where is the money spent?2010/11(provisional figures) (From

Nuffield Trust) “The worst winter I can remember”

Page 12: Southern Derbyshire CCG Integrated Care CCG & Adult Care View Andy Layzell Southern Derbyshire CCG James Matthews Derbyshire County Council

Southern Derbyshire

CCG

Principles for changing services in the NHS (1)

All services will be person-centred and will meet the needs of the person and their families or carers rather than meeting the needs of the system

We will provide care flexibly across all health and social care organisations by listening to, and understanding the person’s complete needs and meeting them by using all services and resources available.

We will challenge assumptions about the way we work and have the courage to make changes for the better that will improve the patient experience and obtain the best value for money.

Page 13: Southern Derbyshire CCG Integrated Care CCG & Adult Care View Andy Layzell Southern Derbyshire CCG James Matthews Derbyshire County Council

Southern Derbyshire

CCG

Principles for changing services in the NHS (2)

We respect and value the people who use and work in health and social care services in Derbyshire and we will invest resources to support the health and well-being of our communities.

We will actively seek and listen to the views of people who use and work in health and social care in Derbyshire so that we can plan and deliver services in partnership and be accountable to them.

We will support people to help them to make an informed choice about lifestyle and services and identify and provide extra support for those who need and want to make positive lifestyle changes.

Page 14: Southern Derbyshire CCG Integrated Care CCG & Adult Care View Andy Layzell Southern Derbyshire CCG James Matthews Derbyshire County Council

Dr Sheila Newport | Chair | Southern Derbyshire CCG

What we would like to share todayIntegrated Care

Page 15: Southern Derbyshire CCG Integrated Care CCG & Adult Care View Andy Layzell Southern Derbyshire CCG James Matthews Derbyshire County Council

Southern Derbyshire

CCG

Some of the Challenges

Low level support

Self management

Shared decision-making

Care Homes

Joined up consultation

Making the best use of scarce resource