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Better Care Fund Feedback from Westminster Briefing event 10 th June 2014

Better Care Fund Feedback from Westminster Briefing event 10 th June 2014 . Centre for Public Scrutiny Speakers Ian Bainbridge: Deputy Director, People Communities and Local Government DOH Olwen Dutton: Bevan Brittan LLP Georgina Craig: Chair, NHS Alliance People Powered Health Network

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Better Care Fund Feedback from Westminster Briefing event 10 th June 2014

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  1. Better Care Fund Feedback from Westminster Briefing event 10th June 2014

  2. Centre for Public Scrutiny • Speakers • Ian Bainbridge: Deputy Director, People Communities and Local Government DOH • Olwen Dutton: Bevan Brittan LLP • Georgina Craig: Chair, NHS Alliance People Powered Health Network • Professor Tom Downes: Clinical Lead for Quality Improvement. Sheffield Teaching Hospitals NHS Foundation Trust.

  3. Centre for Public Scrutiny Overview • Ian: BCF – what, why and a little on • where we are now. • Olwen: The Care Act and BCF • Georgina: Community led commissioning • Tom: Discharge to Assess – an integrated approach

  4. Centre for Public Scrutiny • Better Care Fund: • We all know why – last six months of life, affordability, demography, demand • 14 pathfinders: http://www.icase.org.uk/pg/dashboard • Negative press: • ‘Health and care integration could prove too costly for the NHS’ • ‘Better care Fund plans are weak but integration is key to Quality’ • NHS ‘concerns’ • High expectations

  5. Centre for Public Scrutiny • By 2018 Integration the norm. • Doing nothing is not an alternative • Finland – the inefficiencies in our system • Huge variation across the country around key areas such as transfer and re-ablement – not the acceptable face of localism. • Challenge to the role of the HWB Board • Sign off integration plans • Engaging providers • Concerns re more demand and more obligations – financially unsustainable • Concerns re eligibility criteria – ‘trying to get the words right to ensure nil cost impact but local variability will mean there may be winners and losers, hope flexibility will resolve this’ • Concerns re the new responsibilities around carers: • Levels of demand unknown

  6. Centre for Public Scrutiny • Need for whole system thinking • Everyone needs to make the shift - from hospital to community and prevention. • Public Health centre stage: • Skills around understanding the evidence base and how to gather evidence of success. • Prevention – move from intervention at crisis stage to earlier intervention and advice for living well, empowerment and healthy communities

  7. Centre for Public Scrutiny • Challenges: • Organisational survival • Divided governance • Perverse incentives • Complexity • Concerns: • Noted but going ahead • Looking at plans and their feasibility – some will receive more support (September)

  8. Centre for Public Scrutiny • Getting commissioning right - ‘experience led commissioning,’ involve the front line workforce. • Involving Providers • Role for Overview and Scrutiny? • New ways of working – Social Impact Bonds, mutual, seeding co-production • Design for outcomes • Design in good outcomes for staff wellbeing – if the workforce is not supported then the patient experience will be poor. • Involve everyone – Sheffield ‘discharge to assess’ • Calculate the value • Structural integration is not important – collaboration is

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