Beverly Hone Assistant Director – Strategy & Commissioning & Jessie McArthur

1. Use of Resources Summit14 December 2009Workshop C: Partnership with Health – the East Sussex POPP programme Beverly Hone Assistant Director – Strategy & Commissioning & Jessie McArthur Head of Policy & Service Development

2. Local ‘enablers’ • Joint Commissioning Strategy for Older People and Partnership Board • All Plans aligned to ‘direction of travel’ • Good use of JSNA • Mechanisms for ‘Whole Systems’ developments • Accountability to older people (3500 forum members)

3. Local barriers? • History of difficult relationships eg high DTCs • Complex picture re preventative developments – causal links and benefits accrual • Securing resources for community investment (resisting the ‘pull’ into hospitals) • National policy context

4. Partnerships for Older People Projects (POPP) A £60m national fund from the DH, awarded to 19 sites in 2006 (and 10 more in 2007) to test and evaluate, innovative approaches that sustain prevention work for older people “Innovation, the prevention & well-being agenda, and partnership”

5. “Independence First”The East Sussex programme • £3.2 million 2 year partnership between older people, local health, social services and community services. • Grant funding ended in June 2008, and services now fully integrated • Why this programme? • Local issues – large older people population and known gaps esp. Mental Health • Targeted prevention • Long-Term Conditions

6. Independence First aims • Improve the care, quality of life & wellbeing of older people • Help older people maintain their independence • Support sustainable shifts in resources from acute to community care • Increase support for people with long term conditions • Maximise effective partnership with the voluntary sector • Test service innovation

7. Independence First services 12 services improving the health & wellbeing of older people most at risk of going into hospital or a care home – Specialist & Community-based Specialist Services • Enhanced response (ASC) – rapid access home care • Duty & Assessment - extended hours • Falls prevention • Medicines management • Rapid response (health) • Memory assessment • Extended hours community mental health • Paramedic practitioners

8. Community services • ICES Direct – rapid access simple equipment • County Connect – simple inter-agency referral • Bathing advice & information • Navigator service – info + practical support • handyperson services • wellbeing, carer and transport grants (prototype personal budgets) • aids and equipment

9. Measuring success • Service use data • Case studies • Quality of life surveys • Staff, public and stakeholder surveys • Service user interviews • Economic impact • Whole System indicators

10. Outcomes Over 12,350 people accessed services funded by Independence First (July 06 – March 09) Economic appraisal suggests by avoiding more expensive care options, the POPP specialist services have returned £3 for ever £2 spent for reinvestment in health and social care. Even after formal closure, performance sustained or improved!

11. Quality of life Quality of life survey suggests that while peoples’ health status remains stable they: • Feel more confident • Knowledgeable about their condition and where to get information • Able to manage their condition • Modest improvement in perceived quality of life • Self reported decrease in use of emergency care

12. Before After Example of Outcome reporting 6 month Before & After Navigator service user survey results Sample of 70 in March 2008

13. ASC performance improvements

14. Health service indicators

15. Improving equity

16. Improving equity

17. Older people’s involvement • Commissioning services • POPP Reference Group • Service Champions • Service user interviews • Facilitating focus groups – Anchor staying put Charter Mark

18. Tools to share • End of POPP programme report • Monitoring and evaluation toolkit • Older people involvement toolkit • Just released: National POPP evaluation, incl. 4 generic business cases for preventative interventions

19. Learnings to sharere Partnership work • Directly engage with older people (co-production) • Use evidence base/good practice for design • Clearly define and resource projects • Use partners effectively - Health and VCS (and beyond) • Good performance tools

20. Learnings to sharere Partnership work cont. • Agree your approach to joint investment/sustainability: • Close alignment to commissioning plans – cautious exposure to non-core business • Proven reductions in emergency care usage but not released spend from acute provision ie be realistic • Use an Investment/Disinvestment tool

21. Does this approach scale-up to support further integration? Yes (we think!) Our next step – Integration Plan for Health, Social Care & Wellbeing • ‘Big Ticket’ items – Intermediate Care/re-ablement, Dementia, LTC, etc • ‘Add Value’ items – Quality of Life and personalisation • ‘Efficiency’ items – commissioning resource and back office

22. Contacts beverly.hone@eastsussex.gov.uk 01273 482586 jessie.mcarthur@eastsussex.gov.uk 01273 481141