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Community Foundation Trusts: Challenges & Opportunities for Partnership lorimer@btconnect.com. PARTNERSHIP - A WELL KNOWN PHRASE?. No Because….. Yes if……. CHALLENGE, OPPORTUNITY & IMPERATIVE. Improving Chronic Disease, DH, Jan.2004
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Community Foundation Trusts: Challenges & Opportunities for Partnershiplorimer@btconnect.com
PARTNERSHIP - A WELL KNOWN PHRASE? No Because….. Yes if……..
CHALLENGE, OPPORTUNITY & IMPERATIVE • Improving Chronic Disease, DH, Jan.2004 • Our Health Our Care Our Say, DH, Oct. 2006 • Strong and Prosperous Communities, DCLG, October 2006 • CSR October 2007
IMPROVING CHRONIC DISEASE • e.g. Arthritis, Diabetes, Stroke Asthma, Respiratory • 80% of GP consultations • 60% of hospital bed days • Arthritis: Residential & Nursing Home Costs = £130m. (2004) • Those over 65 with a LTC will double every 10 years (OHOCOS, 2006) • Over 85 in need of Residential Care to double by 2020 (OHOCOS, 2006)
OHOCOS • Health, Prevention &Well Being • Better Access to Primary & Community Services • Support for People with Long Term Conditions • Care Closer to Home • Choice & Individualisation, • Commissioning Led • Mixed economy Market
STRONG AND PROSPEROUS COMMUNITIES • Single Performance Framework (April 2009) • Mandatory LAA with Financial Incentives • Statutory LSP process to deliver LAA • Provider Involvement in Local Priorities • Named Organisations e.g. FTs to cooperate in agreement and delivery of objectives • Increased Accountability to OSC (JSNA) • CAA to assess risks to service and capacity to be in partnership (to deliver LAA) DCLG, 2006
CSR? • ‘Growth and efficiency ‘for public services -Plan for ‘out of hospital care’ • 4% growth year on year to £110 blln • Social Care for Adults to £2.6 blln • Support to carers £190 m – 1.5 blln • 3% of those over 65 (with 2 or more unplanned admissions) = 35 % of all unplanned admissions and: • 76% were not known to District Nurses and 66% to Social Care (Evercare
SERVICE OPPORTUNITY • Population and locality v Care Group Response • Case Finding – at risk and resource control • Prevention Design & Criteria for Service • Currency for R & S I and Outcomes • Integrating delivery response
AGENCY OPPORTUNITY • Streamlining transactions • Maintaining market and stability (critical mass) • Resource sharing & utilisation incl. estate • Joint Venture including Community Venture with Third Sector Acute and CIC • Partnership Tools (S.75 and S.10) • S.75 to ‘gate keep’ alongside Contracting Out
SCOPE OF SERVICESS75 Contracts: £5 blln + CTs & S10 • Mental Health Assessment, Care Management, Nursing, Day Care, Placements & Packages • Learning Disabilities including Housing related services • Older People and complex care • Children pre school, prevention, at risk, including specialist services and therapies
SCOPE Contd. • Long Term Conditions • Urgent Care and Out of Hours Care • Intermediate Care • Reablement • Equipment • Drugs and Alcohol • Productivity Metrics
BENEFITS & EXPERIENCE • Integrated Assessment • Rapid response • Completed Packages of Care • Strategic Focus • Market ‘Place’ and Place Shaping • Recovery and Social Inclusion • Recruitment, Retention , Morale
LOCAL HURDLES • Management Experience • Finance & Fears, Risk, Control • Development of an Agreement • Technical e.g. VAT and Charging • Operational Milestones & Currency • Control Management or Partnership Gain Culture
“ NOT SUITABEL FOR FTs” • FOUR POINTS OF ACCOUNTABAILITY: • Healthcare Commission/CSSCI/MHAC (Quality and Performance) • Monitor (Terms of Authorisation) • Patients and Public (OSC AND FT Members) • PCT and LA (via legally binding contracts)
THE FOUNDATION TRUST • Legally Constituted, Well Governed, Financially Viable (via Business Plan): • List Partnerships and Joint ventures • Rules, Structures, Protocols and Process • Assumptions and Risks (understood) • S31 ‘Contract’ and Requirements • Contract to be ‘relied upon’ within the Model Contract?
REFERENCES • Integrated Care Network – Guidance, Register and Case Studies on Integration http://www.icn.csip.org.uk/ • DCSF Better Outcomes for Children Services - Guide http://www.everychildmatters.gov.uk/strategy/planningandcommissioning/jointfunding/ • Primary Care & Children - Literature Review http://www.primarycarecontracting.nhs.uk/uploads/childrens_services/childrens_services_literature_review.pdf
REFERENCES • Audit Commission – A Fruitful Partnership: • http://www.auditcommission.gov.uk/reports/ACREPORT.asp?CatID=&ProdID=A190CA25-7A7E-47D1-BCAB-373A86B709C0 • Audit Commission: Governing Partnerships: • http://www.audit-commission.gov.uk/reports/AC-REPORT.asp?CatID=&ProdID=A190CA25-7A7E-47D1-BCAB-373A86B709C0
REFERENCES • Improving Chronic Disease Management: • http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4075214 • PBC /LA Case Studies • http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4139630