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Lessons learned on improving health and social care between PCTs and Local Authorities. A short presentation by Keith Skerman. Agenda. Background to discussion personal lessons recent national policy Cultural change + workforce
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Lessons learnedon improving health and social care between PCTs and Local Authorities A short presentation by Keith Skerman
Agenda • Background to discussion • personal lessons • recent national policy • Cultural change + workforce • Developing health + social care: joint commissioning + integrated provision • Governance in the care sector • Some technical issues
Personal Lessons Health + Social Care career – seamless service Joint approach LA/NHS as Director SS Swindon Interim in LAs + PCTs since 2005 – Lambeth, Aberdeen, Staffordshire, Milton Keynes, Luton NHS Workforce Review Team focus on integrated services
Recent Policy Background • DH World Class Commissioning (WCC) • PCT separation • NHS market development • DH Putting People First (PPF) • Personal budget + Personalisation agenda • Choice + control • 9 NHS DH guidance documents Nov 08-Jan 09 • NHS Operating Framework (incl. collaboration + competition) • Transforming Community Services • Safeguarding reviews • Adult + children • Care Quality Commission (CQC) starts April 09
Cultural Change & Workforce Focus on customers (patients, users, carers) Shift from “professional gift” to “in control” Care sector as key player in local economies Sustainable improvement + quality dependent upon investment in workforce Stepped approach to change associated with consistent focus on outcomes not process Choice + competition with joint commissioning
Developing Health + Social Care 1)Commissioning (WCC) – NHS focus upon market management + PCT separation for VFM - Joint commissioning issues with LAs led by NHS? Care pathway reviews, Patient experience, Security of supply versus Competition/choice 2)Provision – personalisation/choice impact upon health + social care, versus integrated services? - Impact of mixed NHS economy/ WCC procurement on patient outcomes, + workforce
Governance In The Care Sector • Coherence in community + political governance of care sector i.e. is there a thread from LSP/LAA to frontline services for health and social care? • Joint Commissioning accountability – officers with NEDs + Members, + with users/carers • Ownership and involvement in models of provision + innovation– NHS FT, PBCs, Social Enterprises, Direct Services, ?customer focus • Quality – user/carer experience + outcomes
Some Technical Issues Access to capital, + developing assets (such as property, ICT) in credit crunch Shared services for integrated care providers ICT support to users + carers for self assessment, brokerage, telecare/health Access to commercial expertise ( providers + commissioners procurement) in care market “Due diligence” techniques + support in new providers to support sustainable solutions