An Introduction to Integration

Lance Gardner Chief Executive Officer

Care Plus Group

The Journey So Far

• 2006 Primary Care Trust (PCT) merges announced

• 2007 North East Lincolnshire PCT legal Agreement with North East Lincolnshire Council (NELC)

• Care Trust Plus (CTP) born September 2007

• All adult services to CTP

• Children's Provider services to Council

• Health and Wellbeing to Council

• Care Plus became ASC (Adult Social Care) Provider

Care Plus Group

• We are a Social Enterprise

• Fully integrated health and social care provider

• 720 staff [815]

• 50:50 split

• £23.5 million [£26 million]

• 156,000 population

Some of our Services

• Intermediate tier• Community nursing• Home care• Specialist nursing• Drug and Alcohol intervention programme• Employability• Meals on wheels• Day services

“The Provider of Choice”mission statement

Care Plus Group -a Community Benefit Society• Every member of staff is an owner

• For the benefit of more than just the members

• Social objectives

• Can be an charity

• We have an asset-lock

• 1 member, 1 vote

CARE PLUS GROUP

Care Plus Board3 Execs – 4 NEDs

Council of Governors8 staff, 2 Councillors, 1 GP, 3 Customers, 1 Volunteer

Advisory Committee 25 members

CARE PLUS GROUP

Care Plus(operating Division)815 members approx

Volunteer constituency 250

‘Customer’ constituency 250

So what’s different?• More freedom to act• Different relationship with commissioners• Broader roles• More opportunities to work with staff from

across the Society• Sense of ownership• If things don’t work we are empowered to

change them

Key Preceptors for Change• SHMI• Keogh Review• ‘Healthy Lives Healthy Futures’• 7 day services• We are all ‘not for personal profit’• Ultimately there is a lot less money available• ‘Why are there 6 separate providers?..........• The status quo isn’t an option because it isn’t

sustainable

“The role of the hospital is to support the community not the

other way round”

Winter incentive scheme• 5 stretch targets:• 4 Hour A&E waits 95% • Limit Delayed Transfers of Care• increase the utilisation of ambulatory Care • To maximise intermediate tier beds /reduce

hospital beds compared to the winter 2012/2013

• Maintain patient satisfaction

Achieving this through…..• GP in the front of A&E  7/7 9.00am – 5.00pm• Social workers in at the weekend • Home care provider available 24/7 • 16 seater bus and driver available to all• Home equipment store open at weekend• Rapid response nurses in A&E and on wards• Commissioning 12 ‘step up’ beds in high quality care

homes locally

CPG

CCL

‘NICE’

LINCs

Proposed JV [3]

New JV

DPOWH

NAViGO

St Andrews

CCL

LINCs

CPG

focus

Benefits• Increased provider autonomy• Better for customers• Easier to implement new pathways• Potential economies of scale• Consistent messages• Strength in numbers• Increased understanding and trust

Risks• Perceived loss of identity• Perceived risk to individuals roles• Accusation of monopoly• Concentration on building

partnerships rather than effective delivery

Key Questions….• Do we really trust each other?• What is the priority - the community or

the company?• What will it cost?• Would we transfer any staff?• Would we share senior posts?

A person is the most important person in our community. They are not an interruption to our

work, they are the purpose of it. They are not an outsider in our system, they is a part of it. We are not doing a favour by serving them, they are doing us a favour by giving us an opportunity to do so.

Mahatma Gandhi