Adult Services Stakeholder Conference

1. Building Better Support for Carers | The Adult Services Stakeholder Conference | 19 November 2013 Building Better Support for Carers | The Adult Services Stakeholder Conference | 19 November 2013 Building Better Support for Carers | The Adult Services Stakeholder Conference | 19 November 2013 Welcome to the Adult Services Stakeholder Conference Councillor Robert Evans Care Services Portfolio Holder London Borough of Bromley robert.evans@bromley.gov.uk Share your thoughts: #BASSCquestion Share your thoughts: #BASSCquestion

2. Building Better Support for Carers | The Adult Services Stakeholder Conference | 19 November 2013 A changing landscape of reform, challenge and opportunity Terry Parkin Executive Director Education, Care and Health Services London Borough of Bromley terry.parkin@bromley.gov.uk Share your thoughts: #BASSCquestion

3. Building Better Support for Carers | The Adult Services Stakeholder Conference | 19 November 2013 The current health and social care system • The health and social care system is an evolving system • There was a new important piece of law from the Government last year - the Health and Social Care Act 2012 • This created many changes in the way services are provided and bought, these are in addition to many other changes over the last couple of years • The Government is planning more changes through the Care Bill, which is likely to become a new law in 2014 and need to be put in place by April 2015 • So what changes have we have seen in health and care services in Bromley? Share your thoughts: #BASSCquestion

4. Building Better Support for Carers | The Adult Services Stakeholder Conference | 19 November 2013 Changes in the health care system since 2010 Expected changes 2014 2010 2012 2013 2015 2011 Buying services Provision of services Public Health Provision of services also through others, such as: Buying services Health and Wellbeing Board Public Health Provision of services through other organisations, such as: Voice of users Buying services Public Health Provision of services through other organisations, such as: Health and Social Care Act 2012 Care Bill is expected to receive Royal Assent Changes from the Care Act 2014 to be in place

5. Building Better Support for Carers | The Adult Services Stakeholder Conference | 19 November 2013 Constraints of the current financial situation • The Council has reduced its budget by £57 million since 2010 • The Council now estimates that it has to save more than £60 million between 2014 and 2018 • This is because of: • a reduction in funding from the Government; • the rising costs of buying things, including placements; • the increasing number of people using services; and, • the increasingly complex needs of service users. Share your thoughts: #BASSCquestion

6. Building Better Support for Carers | The Adult Services Stakeholder Conference | 19 November 2013 The increasing needs of local people (1) A growing demand for services relating to: • our resident older population, growing faster than the national average and many have complex needs relating to dementia, physical frailty and disabilities, with: • an increase of 6.8% in the number of residents aged 65 and over by 2016 • an increase of 2.5% in the number of residents aged 85 and over by 2016 • our residents experiencing mental health issues will increase by 4.5% by 2016 and 9.3% by 2020 • our residents with learning disabilities will increase by 4.6% in 2016 and 9.2% in 2020 • our resident young people with learning disabilities who are moving into adulthood is also increasing • our residents with physical disabilities will increase by 10.4%by 2020 Share your thoughts: #BASSCquestion

7. Building Better Support for Carers | The Adult Services Stakeholder Conference | 19 November 2013 The increasing needs of local people (2) A growing demand for services relating to: [cont’d] • a sharp increase in the number of households presenting as homeless • and, although the Council works with such households and its partners to do all it can to prevent a household losing their home, there is a considerable financial impact of the sharp and continuing trend • the impact of the benefit cap and welfare reforms which is expected to place additional cost responsibilities on the Council as part of meeting its housing responsibilities • the costs are expected to increase by £4m for 2013-14 and 2014-15 Share your thoughts: #BASSCquestion

8. Building Better Support for Carers | The Adult Services Stakeholder Conference | 19 November 2013 Local priorities • The Health and Wellbeing Board agreed 9 priorities for the Borough’s first Health and Wellbeing Strategy from 2012 to 2015: • Anxiety and Depression • Children Referred to Children’s Social Care • Children with Complex Needs and Disabilities • Children with Mental & Emotional Health Problems • Dementia • Diabetes • Hypertension • Obesity • Supporting Carers Share your thoughts: #BASSCquestion

9. Building Better Support for Carers | The Adult Services Stakeholder Conference | 19 November 2013 Local service developments • We are working on a number of key service developments to help us manage the challenges • Many of these are being managed in partnership with a number of other organisations • You will hear about some of these in the workshops, such as: • The proMISE Programme for improving integrated care, especially for those with long-term conditions • The Welfare Reform Programme for improving the experience of people in Bromley who need to access benefits, especially the most vulnerable ProMISE stands for: Proactive Management of Integrated Services for the Elderly Share your thoughts: #BASSCquestion

10. Building Better Support for Carers | The Adult Services Stakeholder Conference | 19 November 2013 A changing landscape of reform, challenge and opportunity Paul White Programme Director: ProMISE Bromley Clinical Commissioning Group (CCG) paul.white@bromleyccg.nhs.uk Share your thoughts: #BASSCquestion

11. Building Better Support for Carers | The Adult Services Stakeholder Conference | 19 November 2013 The financial challenges • We are expected to achieve more than £50 million efficiencies between 2013 and 2016. This is against a backdrop of: • increasing demand for urgent and unplanned hospital services (A&E and emergency admissions) • major problems at South London Healthcare Trust which was technically declared ‘bankrupt’ and dissolved in October • an increasingly older population with multiple long-term conditions and complex support needs • addressing other health and social care challenges identified as priorities by the Health and Wellbeing Board Share your thoughts: #BASSCquestion

12. Building Better Support for Carers | The Adult Services Stakeholder Conference | 19 November 2013 Bromley CCG’s vision for healthcare Bromley CCG is a new GP led NHS commissioning organisation and we have developed a vision for the future of healthcare in Bromley: • Better Health: improve health outcomes and reduce health inequalities across Bromley • Better Care: transform the landscape of healthcare, by developing partnerships, leading to an integrated healthcare system with improved access and quality • Better Value: create a sustainable health economy reinforced through collaborative working Share your thoughts: #BASSCquestion

13. Building Better Support for Carers | The Adult Services Stakeholder Conference | 19 November 2013 General practice at the heart General practice is at the heart of everything we do and is key to the delivery of our six transformational programmes of work: • Planned care • Unscheduled care • ProMISE / Long term conditions • Mental health • Children, young people and maternity • Primary care Share your thoughts: #BASSCquestion

14. Building Better Support for Carers | The Adult Services Stakeholder Conference | 19 November 2013 What we will deliver • Better outcomes for patients diagnosed with mental health problems, including dementia • Better informed patients with more access to self care and self management (especially those with long term conditions) • Improved services overall for people with long term conditions through proactive care planning • Fewer emergency admissions for over 65s – reducing demands for emergency beds • Better support for people in the final year of life Share your thoughts: #BASSCquestion

15. Building Better Support for Carers | The Adult Services Stakeholder Conference | 19 November 2013 The ProMISE programme People tell us that, where possible, they prefer to receive care at - or closer to – home, with support to live as independently as possible. We will change the way that care is provided for local people, working proactively to integrate care and services around the individual and their carers through: • informed and involved patients, able to have a say in their care - making their own lifestyle choices, setting their own goals and working in partnership with service providers • predicting risks and care planning for people with complex needs and long-term conditions, typically people aged 65+ • services working better together to identify people's needs, support them to remain healthy, and bring improvements to their experience of care Share your thoughts: #BASSCpromise

16. Building Better Support for Carers | The Adult Services Stakeholder Conference | 19 November 2013 An example of proactive care planning Mr Walker - a 67 year old man with type two diabetes. He is an overweight heavy smoker. His’ GP used ‘risk stratification’ to identify him as a high risk patient and referred him for assessment by one of our Community Matrons, Roberta. Roberta recognised that Diabetes Management was an issue and referred John to the community Diabetic Nurse Specialist. Through proactive care planning with John, his Diabetic Nurse Specialist, Mr Walker has now been encouraged to stop smoking and given help to lose weight by attending the ‘Fit for Life’ programme run by Age UK Bromley & Greenwich. This year he has had his first flu jab and an annual check for Diabetic Retinopathy (which can lead to blindness). He gets regular reminders about appointments from his Patient Liaison Officer, Sue, and visits from Roberta, his Community Matron to monitor his progress. Mr Walker also now gets text messages sent to his mobile phone every week, through the FLO simple telehealth system, helping him to monitor his own weight through agreed targets. Share your thoughts: #BASSCquestion

17. Building Better Support for Carers | The Adult Services Stakeholder Conference | 19 November 2013 End of Life Care with St Christopher’s • St Christopher’s Group will deliver an enhanced service from December • New 24 hour coordinated care centre • Increasing their caseload by 800 • Supporting those patients and their families in their final year of life • Coordination of care packages across the system to enable patients who choose to die at home to do so with support, dignity and respect Share your thoughts: #BASSCpromise

18. Building Better Support for Carers | The Adult Services Stakeholder Conference | 19 November 2013 Why are we here today? • To look at the results of the Carers Survey and through the workshops to enable you to help us build new structures for support around long term conditions • To hear your views about how we are doing and your suggestions for improvement • To ensure that together we build better support for carers in the future Share your thoughts: #BASSCpromise

19. Building Better Support for Carers | The Adult Services Stakeholder Conference | 19 November 2013 Learning about the needs of the people who live in Bromley:The Joint Strategic Needs Assessment(JSNA) Agnes Marossy Consultant in Public Health London Borough of Bromley agnes.marossy@bromley.gov.uk Share your thoughts: #BASSCquestion

20. Building Better Support for Carers | The Adult Services Stakeholder Conference | 19 November 2013 What is the JSNA? • The purpose of the JSNA is to identify the current and future health and wellbeing needs of the people of Bromley so that we can plan the right services for the next 5 to 10 years • It is not about the needs of individuals, but about the needs of the population • It should identify groups where needs are not being met and that are experiencing poor health outcomes Share your thoughts: #BASSCquestion

21. Building Better Support for Carers | The Adult Services Stakeholder Conference | 19 November 2013 Where can you find the JSNA? • The JSNA can be found on the Bromley MyLife website:http://bromley.mylifeportal.co.uk • It is within the ‘Health and Wellbeing’ section Share your thoughts: #BASSCquestion

22. Building Better Support for Carers | The Adult Services Stakeholder Conference | 19 November 2013 Who is Involved? • The JSNA is a document which is developed in partnership • It includes representatives from: • London Borough of Bromley • Public Health (the Director of Public Health and Consultant in Public Health) • Adult Social Care • Children’s Social Care • Education • Environment and planning • Housing • Strategic support • Bromley Clinical Commissioning Group • Healthwatch Bromley • Community Links Bromley • The Voluntary Sector Strategic Network Share your thoughts: #BASSCquestion

23. Building Better Support for Carers | The Adult Services Stakeholder Conference | 19 November 2013 What is in the JSNA? Populations of Interest Older people People with a learning disability People with a physical disability &/or sensory impairment People with mental health issues End of life care Children and young people Carers and young carers Substance misuse Alcohol People who use emergency health services frequently The People • The population of Bromley: numbers and types of people • The health of people in Bromley The Places where People live • Ward health profiles • Housing Share your thoughts: #BASSCquestion

24. Building Better Support for Carers | The Adult Services Stakeholder Conference | 19 November 2013 How Can You Get Involved? You can contribute your views via: • Healthwatch Bromley • Community Links Bromley • The Voluntary Sector Strategic Network We want you to be involved! Share your thoughts: #BASSCquestion