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Working Together

Working Together. Tim Crayford Maggie Atkinson John Dixon. Dr. Tim Crayford. President, ADPH Director of Public Health & Medical Director, Croydon NHS Primary Care Trust. Central Government. ‘Our Health, Our Care, Our Say’ DH 2006

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Working Together

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  1. Working Together Tim Crayford Maggie Atkinson John Dixon

  2. Dr. Tim Crayford President, ADPH Director of Public Health & Medical Director, Croydon NHS Primary Care Trust

  3. Central Government • ‘Our Health, Our Care, Our Say’ DH 2006 To ensure there is more visible local leadership on health and wellbeing, particularly on public health issues such as childhood obesity, smoking rates and health inequalities. It is important that the local authority lead member for adult social services is able to influence the commissioning decisions of health and social care bodies, and drive action to reduce health inequalities by engendering systematic partnership working between NHS bodies, local authorities and other partners, for example through greater use of joint appointments, pooled budgets and joint commissioning. We want to see health and social care services delivered seamlessly around the needs of patients, families and carers, and local partners able to work together in tackling the wider causes of social exclusion, worklessness, and vulnerability

  4. Our Health, Our Care, Our Say • New powers for Scrutiny (APHR) • Jointly appointed DsPH • LDPs to become more aligned with LAAs

  5. NHS view on commissioning PPI

  6. Strong and prosperous communities …by engendering systematic partnership working between NHS bodies, local authorities and other partners, for example through greater use of joint appointments, pooled budgets and joint commissioning. We want to see health and social care services delivered seamlessly around the needs of patients, families and carers, and local partners able to work together in tackling the wider causes of social exclusion, worklessness, and vulnerability …local authorities will now be under a statutory duty to (establish) Local Involvement Networks (LINks) formal arrangements for Directors of Public Health to be jointly appointed and held jointly accountable by the chief executives of local authorities and PCTs

  7. Strong and prosperous communities • statutory partnership for health and well-being under the LSP • Strengthened role for LA Scrutiny esp. in relation to the DPH and the APHR • A new Lead Member at local authority executive level, whom we will expect to play a leading role on local health and well-being partnerships • LAAs strengthened

  8. Pulling it all together Annual Public Health Report (HEAs) LSP LAA 6 Domains of Choosing Health JSNA

  9. JSNA DPH JSNA DASS DCSS

  10. Care Services Ideal Need Demand Want

  11. Efficient delivery Need Demand Want

  12. Current Care Services Need Demand Want

  13. Wellness needs? Need Demand Want

  14. Challenges: Joint DPH Appointments • Variable interpretation • Clearly the right direction • Need to remain NHS-based • ?account via the LSP

  15. Challenges: JSNA Information • Accessing it • Pooling it • Analysing it – mapping it • Presenting it in a JSNA • Sharing our experiences with it

  16. Dr. Maggie Atkinson President, ADCS Director of children’s services, Gateshead Metropolitan Borough Council

  17. Children’s Services: integrated! • We are charged with being outcome focused ...... • not process obsessed or stuck in old models ...... • Which means a focus on addressing and narrowing gaps and taking out inequalities • We are REQUIRED to work together: Health's NSFs, Every Child Matters, Our Health Our Care Our Say • ...And my friend, Mrs Cannybody.

  18. Who’s she? • She lives on Ubiquity Street, Anytown, Everyshire, in social housing, on the minimum wage • She's a single parent and a busy woman • She wants to ask one person for help, guidance, advice on public services and get a straight answer: • where to go • what to do • how to get support • She wants her family to be healthier and better placed than she is • She is not interested in who pays your wage, or mine • She's interested in ......

  19. Good ante-natal, maternity and post-natal care for herself • Advice on her baby, her older child, her teenage stepchild's smoking, drinking and risk taking lifechoices • Advice on lifestyles, when  finances are tight and diet, fitness, exercise • Advice on stress:  hers and others'...  and on stopping smoking • She wants us to .....

  20. see the person, not the episode or the casework • ask her to tell her story once, • safely share and use what she tells us • keep our promises that we can help • think wellbeing and wellness, and • plan services around helping her attain them • join up to support her and her family, and MEAN IT! • not make her second guess or be clever or articulate to get what's needed

  21. Circle of exchange Lead Practitioner(s) Nurses Advisers, mentors Circle of participation Teachers, tutors Outreach workers Places of worship scouts brownies guides Cadets etc Dinner supervisor Circle of friendship Police And support officers grand father grand mother Social worker People next door Circle of intimacy Fire fighters Football or other sports clubs best friend Mum, Dad, carer, brothers & sisters others at home Lollipop person Aunt or uncle Nanny or childminder People in the park Godparent Doctors, health workers cousin Community wardens Class mates Step sibling Parents’ friends Education Welfare Service Community of neighbours Learning support assistant Other children in school Shopkeepers Librarian Therapy services Baby sitter, Child minder Educational Psychologist

  22. John Dixon President, ADAS Director of Social & Caring Services,West Sussex County Council

  23. Inequalities and Well-being –Working TogetherJohn DixonExecutive Director of Adults and Children, West Sussex County Counciland President, ADASS

  24. Adults’ Services – A Changing Role • Life Chances of Disabled People – Opportunity Age • Independence, well-being and Choice – Our Health, Our Care, Our Say • Safe and Prosperous Communities • Place Shaping and The rise of well-being • Shift in relationship between state and citizens • 100% of population and personalisation • DASS’s huge assimilation of roles

  25. DASS: Joined Responsibilities 50% - Housing 40% - Crime Prevention Regeneration Safer Communities Neighbourhood Services 25% - Culture, Leisure, adult learning Most - Health 10% - Children’s as DCS

  26. All our Tomorrows - Revisited Professional gift relationship Specialised interventions Resource Intensive Targeted help to individuals Support to Communities Infrastructure for Community development and self-help Sustainability Customer in control

  27. Infrastructure for citizens to support informed safe choices & to help providers Housing/Accommodation/Supporting People Public Health Community Health Transport Access to Employment/Workforce Social Inclusion Lifelong Learning Community Safety Regeneration Leisure & Recreation opportunity

  28. Effective Joint Commissioning • All about patient/care pathways • Best mix for patients of health/social care/3rd sector input • From self-care to tertiary care • Choice and control – from professionals to users/patients • Transferring activity & finance within care pathways: the ‘5% plus’ test • Joining the two commissioning frameworks • Achieving - user satisfaction - clinical outcomes - reconfiguration - financial sustainability

  29. Personalisation, Eligibility & The Green Paper on Care & Support • It’s about Social Justice as much as funding • Need to agree principles of new settlement first • Rethink dependency and contribution: • The two groups : those currently eligible for state funding : those outside of the state net • Those currently funded: not much longer affordable : to be given control • Those not now funded : more than half the population • Transparency and eligibility • Some help for everyone, and more for those who need it most • Public knowledge and affection: NHS vs. social care • The weakest link in the welfare state: assurance for old age and disability? • Affordability and £1.1trillion – insurance risk capping?

  30. World Class Commissioning and Putting People First • Comprehensive understanding of the needs of everyone in the community • Planning in partnership with users and carers for services to meet agreed outcomes through improved choice and control • Work with providers and Third Sector to develop services for independence and well-being • More intelligent and responsive procurement of services to improve outcomes. • Ensure individual purchasing is as near to the person as possible • Improving evaluation of service provision as a return on investment • Need to join up governance, leadership, basic skills and knowledge • Need for workforce development • Practice based commissioning – focus on needs of communities – links with local government – social care and children’s services with acknowledgements to Mark Britnell

  31. ADASS Business Unit Local Government House Smith Square London SW1P 3HZ Tel: 020 7072 7433 Fax: 020 7863 9133 EMAIL:team@adass.org.ukWEB:www.adass.org.uk

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