Community Health Partnerships

1. Community Health Partnerships Gill McVicar

3. Demography “The most important policy issue facing European Governments over the next 50 years is how to cope with ageing populations……For Scotland the future is now……Its population is ageing faster and dying quicker than any other industrialised nation.” The Scottish Report – Scotland the Grave (2003)

4. Capacity Capability Health inequalities Contracts, MMC, EWTD Ageing population 18 week RTT Financial position Other initiatives Projects/targets Long Term Conditions Collaborative Mental Health Collaborative Shifting the balance of care Our Iceberg

5. WANT TO CHANGE V HAVETO CHANGE

6. Partnership for Care • “New Community Health Partnerships, more accountable to local communities, better matched with Social Work services and better able to represent local interests within NHS Boards”

7. Partnerships will…. • Ensure patients and a broad range of healthcare professionals are fully involved • Establish a substantive partnership with Local Authority services • Have greater responsibility and influence in the deployment of resources by NHS Boards • Play a central role in service redesign locally

8. Act as a focus for integrating health services, both primary and specialist at local level • Play a pivotal role in delivering health improvement for their local communities

9. Better Health Better Care-CHPs • Key to delivery • Partnership re emphasised • Broader range of delegated resources • Greater flexibility in decision making • Integrated resource framework – joint commissioning, collaborative contracts, budgets devolved to local level • Extend responsibility and accountability

10. Expectation of CHPs • Shift the balance of care • More local services • Improve access • Waiting times – new targets • Manage demand • Reduce unnecessary referrals to specialist services • Provide better community care services

11. Specialist Services Ambulatory Care Referral Management Centres Community Hospitals Consultants in Community Nurse/AHP Consultants Specialist Roles in PC Hospital at home Intermediate care Community Rehab Demand management Case/Care Management Practice Access programmes Team approach Extended roles LTC Management Home Care access Seek out those Most at risk Promote/support Self care Better Information Early Intervention Text messages Mental Well being Community Learning Community Planning Health Improvement Culture Leisure Food Nutrition Community Development Community Resilience IT

12. Patients Local Authority Staff Voluntary Sector Public Communities Secondary Care Carers Primary Care Tertiary Care Independent Sector

13. Voluntary Independent Carers Primary Care Patient Community Specialist Care Local Authority

14. Web of connections and communications Integrated Teams Better Anticipatory care Whole system engagement ?Joint Standards Joint Inspection New flexible Training and learning opportunities Early intervention Right person Right place, Right time Right information Self care support Health Improvement New roles Information sharing Integrated Resource Framework Technology Leadership

15. Considerations • Staff • New roles, development opportunities • ££ • Partnership • Community • Time

16. Support to shift the focus? • Sensible governance and performance management v time consuming bureaucracy • Freedom to manage • Flexible training and education, quickly • Bust the barriers • Public awareness • Mutuality • Manage expectations

17. Anticipatory Principle • Collective imagination and discourse about the future • Image of the future guides current behaviour • Project ahead – horizon of expectation • Bring future powerfully to present (mobilise) • Inquire in ways that serve to refashion anticipatory reality (Cooperider et al, Appreciative Inquiry, 2000)

18. …a time for bold imaginings, thinking the unlikely, doing the unreasonable. Charles Handy