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South Ayrshire Reshaping Care event October 20 th 2011

South Ayrshire Reshaping Care event October 20 th 2011 What was said in June 2009 & progress since then Jean Hendry - Health Care Manager NHS Ayrshire and Arran. Headlines from 2009…. Headlines from Older People’s Vision event – June 2009. THE BLOOMING GOOD LIFE!. CARE TAILORED FOR YOU!.

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South Ayrshire Reshaping Care event October 20 th 2011

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  1. South Ayrshire Reshaping Care event October 20th 2011 What was said in June 2009 & progress since then Jean Hendry - Health Care Manager NHS Ayrshire and Arran

  2. Headlines from 2009…

  3. Headlines from Older People’s Vision event – June 2009 THE BLOOMING GOOD LIFE! CARE TAILORED FOR YOU! PERSONALISED SERVICES DESIGNED BY YOU! OLDER PEOPLE ON THE MOVE! SOUTH AYRSHIRE SCOOPS AT THE FIRST CARE OSCARS HOSPITAL IN YOUR OWN HOME!

  4. ON LINE SERVICES AVAILABLE IN AYR HIGH STREET – Older people & their carers can get access to the full range of health, social care and voluntary services at the press of a button SOUTH AYRSHIRE VOTED THE BEST PLACE FOR OLDER PEOPLE TO LIVE IN SCOTLAND PRIMARY CARE STRATEGY A SUCCESS AS AYR HOSPITAL BECOMES CENTRE OF EXCELLENCE FOR TELE-REHABILITATION A LIBRARY OF CHOICE

  5. Re-ablement and care at home You said… • To nurture Re-ablement and care at home, all services need to work together and commit to change: • support people to be as independent as possible, • simplify and aligning systems and processes • provide flexible and responsive services,

  6. Re-ablement and care at home – you said • develop a joint service with pooled resources • make best use of new technologies, • invest in staff development • recognise informal roles and the substantial roles of carers and the service recipients themselves.

  7. Re-ablement and care at home – what we have put in place so far… DVD Case Study…

  8. Anticipatory Care You said… To support anticipatory care we need better upstream approaches, easily accessible information on services, more locally based interventions with easier points of access and better connections to other linked services such as leisure. We need patients to assume more responsibility for their own health and care and to work in partnership with them to develop health improvement and self-management programmes. Services should be better integrated, for example, day care.

  9. Anticipatory care – what we have put in place so far… DVD Falls Case Study

  10. Telehealth and telecare You said… • integrate telehealth and telecare into new service models (for example, for Falls Management) • provide adequate infrastructure to enable the technology to be rapid, effective, reliable and supported • raise awareness of the potential of telecare/telehealth • focus on opportunities at the new Girvan Community Hospital that could be used to demonstrate effective technologically based services.

  11. Telehealth and Telecare– what we have put in place so far… DVD Case Studies…

  12. Supporting carers You said… • Value the role of carers by involving them in service provision and service changes • provide a range of supports (including training, information and advice, social opportunities and better forms of respite) • recognise that carers’ needs differ widely • ensure professional staff are aware of the needs of carers.

  13. Supporting carers – what we have put in place so far… DVD Case Study

  14. Supporting those living with dementia You said… • Identify the early signs of dementia quicker • Provide early intervention to slow disease onset • Improve early care planning • Provide more staff training • Involve service users and carers in planning support needs • Use technology, • Supporting the 3rd sector providers • Create specialist multi-disciplinary teams with potential to increase support available in people’s own homes.

  15. Supporting those living with dementia– what we have put in place so far… • Increased GP early diagnosis • Range of supports for family and carers • New Nursing liaison posts with Care Homes • Provide more staff training through use of additional South Ayrshire based training post

  16. Communication and Consultation You said… Communication, communication, communication! • Vital • Invest in it • Get out there! • Tailor to the different needs • Use plain English, free of jargon • short and snappy • Use local newspapers.

  17. Communication and Consultation You said… • Single points of contact • Really value people’s opinion! • Be honest and transparent • Run a large stakeholder event at County Buildings • Develop local ‘champions’ • Address cynicism – engage with hearts and minds • Develop open and two-way channels of communication • understand each other’s roles • Manage expectations

  18. Communication and consultation - what we have put in place so far… • Events (such as this!) • Change Fund events - consultation in January, VASA event • Presence and inputs into other event • 4 Newsletters and basic summary guide • Good use of existing arrangements in place (like PPF) • Change Fund support for Community Development, South Ayrshire Senior’s Forum • Some pan-Ayrshire information materials developed • Plan for new service directory by January 2012

  19. Delegates highlighted that older people should not be seen as burdens and service recipients, but rather as community members who have contributed and will contribute greatly to their neighbourhoods and who want to live active and fulfilled lives – embed into the vision for the future!

  20. South Ayrshire’s approach to supporting change: (meets national guidance and evidence of what might support change and improved outcomes)

  21. S P O C Shifting the Balance of Care and Resources Fundamental to addressing the ‘demand’ within the health/social care system is an emphasis on community well-being and utilising universal services. This approach will be founded upon community development and asset based principles and will involve investment in community capacity building, supporting volunteering, developing a range of community services, supporting the third sector/community infrastructure, providing information and supporting carers. Hospital Based Services Acute/Specialist Care

  22. S P O C Shifting the Balance of Care and Resources • Change Fund investments • Community Development posts linked to hubs • Support for South Ayrshire Senior’s Forum • Community Directory + local directories • Community Transport • Carrick Centre Community Care room • Dementia bibliography • Access to IT for OP • Telephone Befriending • Carers support workers, health checks, support programmes Hospital Based Services Acute/Specialist Care

  23. S P O C Shifting the Balance of Care and Resources The approach, at the next ‘tier’ aims to sustain independence and promote self-management. This will include work to provide supportive physical and environmental infrastructure (including equipment and adaptations, telehealthcare, targeted falls interventions (eg ‘prehab’ through group exercise programmes), and strengthening co-creation approaches (for example, in relation to respiratory disease). An Ayrshire-wide approach to transform timeous access to equipment will be developed. Hospital Based Services Acute/Specialist Care

  24. S P O C Shifting the Balance of Care and Resources • Change Fund Investments • Falls pre-hab service (Invigor8) • Targeted Adaptations • Ayrshire-wide equipment access • Trusted Assessors training and capacity building Hospital Based Services Acute/Specialist Care

  25. S P O C Shifting the Balance of Care and Resources Geographical Rehabilitation and Enablement ‘hubs’ will focus on better co-ordinated re-ablement approaches. Additional capacity for ‘rapid response’ to older people with emergent health/care needs will also be linked to these ‘hubs’ as will additional community geriatric services. There will be strong links within the hubs, with Elderly Mental Health Services and other appropriate services including community pharmacy. Community Nursing and AHP teams will be configured to allow full support for the work of the hubs.. Falls prevention will also become a core part of all staff’s remit within the hub. Hospital Based Services Acute/Specialist Care

  26. Change Fund investments • Significant investment in Re-ablement approaches to allow to move to new model of working • Service hubs with Single Point of Contact • Premises investment to allow co-location • New Intermediate Care and Enablement Service (ICES) investment • Falls prevention linkage (eg TI triaging) • Additional AHP inputs • Girvan Community Hospital related work • Community Pharmacy investment including working with Carers and developing new Community based supports linked to hubs • Telehealthcare investment in equipment and capacity • IT investments (eg Community Nursing) S P O C Shifting the Balance of Care and Resources Hospital Based Services Acute/Specialist Care

  27. S P O C Shifting the Balance of Care and Resources Linked to the ‘hubs’ at the ‘Intensive support’ part of the model will be work supporting ‘enhanced complex care’ involving extended primary care services (Community Wards) that will target higher ‘tariff’ cases and will include additional dedicated GP and nursing capacity. The work of Managed Clinical Networks (particularly in relation to respiratory disease) will be strengthened to allow a better flow from acute to community based health care. Hospital Based Services Acute/Specialist Care

  28. S P O C Shifting the Balance of Care and Resources Linked to the ‘hub’ based work will be a concentrated work to improve the response to older people ’out of hours’ in evenings, overnight and at week-ends. This will involve telecare (alert) staff, out of hours nursing, ADOC, Scottish Ambulance Service and Rapid Response and will ensure more ‘joined up’ approaches together with additional capacity. (This will involve using existing staff resources smarter and building additional capacity for overnight support, respite and care. Hospital Based Services Acute/Specialist Care

  29. S P O C Shifting the Balance of Care and Resources The local dementia strategy work will be strengthened through additional specialist nursing capacity (who will link closely with the care home sector) and through additional training resource. Hospital Based Services Acute/Specialist Care

  30. S P O C Shifting the Balance of Care and Resources The whole system approach underpinned by robust change management. Change Fund plan will be underpinned by an outcomes based approach There will be robust monitoring and the outcomes will be directly linked to economic analysis through the Integrated Resource Framework with a view to ensuring sustainability subsequent to the existence of the Change Fund. Hospital Based Services Acute/Specialist Care

  31. Linking this together… Housing Social care Health Care Older Person Self Management Carer support Social support

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