Homecare within N. Ireland’s Integrated Health & Social Care Structures

1. Homecare within N. Ireland’sIntegrated Health & Social Care Structures An Overview Martin McGeady Head of Homecare Services

2. N. Ireland – Some Facts • Population 1.7 million • 5,400 square miles • 6 Counties • 26 District Councils • NI Assembly – devolved government since 1998

3. MAP OF NORTHERN IRELAND Northern Area Population 449,623 Area (Hectares) 435,567 Population Density 0.98 Moyle D.C. Coleraine D.C. Ballymoney D.C. Western Area Population 295,192 Area (Hectares) 484,080 Population Density 0.58 Limavady D.C. Derry D.C. Ballymena D.C. Larne D.C. Strabane D.C. Magherafelt D.C. Carrickfergus D.C. Antrim D.C. Newtownabbey D.C. Cookstown D.C. North Down D.C. Omagh DistrictCouncil Belfast D.C. Castlereagh D.C. Lisburn D.C. Dungannon D.C. Ards D.C. Craigavon D.C. Down D.C. Armagh D.C. Banbridge D.C. Fermanagh D.C. Newry & Mourne D.C. Southern Area Population 342,754 Area (Hectares) 318,768 Population Density 0.98 Eastern Area Population 671,579 Area (Hectares) 175,124 Population Density 3.80

4. N. Ireland Assembly • Power-sharing Executive since 2007, dominated by DUP & Sinn Fein • Health Minister – Edwin Poots, DUP • Health Committee – Joint Chair • Block grant determined by Westminster [Barnett Formula] allocated to priorities by the NI Executive • Policy and legislative authority in N. Ireland for almost all health and social care issues

5. Evolvement of N. Ireland’s Health & Social Care Structures • 1948 – 1972 Tripartite Arrangement • 1972 HPSS (NI) Order – 4 Boards • 1991 creation of 19 Hospital & Community Trusts • By 2000 NI had 48 H&SC Institutions • 2002 – 2007 review of Public Administration • 2012 – Today’s Integrated Structures

6. N. Ireland’s H&SC Structures

7. Roles & Responsibilities of the Various Bodies

8. Cont’

9. An Overview of Homecare in NI • Home Help – Home Care – Reablement • In-House (42%) : Independent Sector (58%) • Estimated 23,000 service users • 86% Service Users 65+ • Annual Spend £200m • Estimated 10,000 staff employed • 283 Providers* [likely less than 100] • Regulated since 2009 *RQIA – significant double counting of multiple site providers and supported living facilities

10. Integration in Action - ISD • Integrated Service Delivery • Formalised approach mid 2000’s • Standardised Approach [RPA] • Co-location [Health & Care Centres] • Overcoming professional and organisational boundaries • Fully [?] integrated multi-disciplinary working • Locality sensitive approach • Single Assessment Tool [NISAT] .

11. The Team • Locality Services Manager [WHSCT 2x Nurse,1xSW & 1xOT] • Primary & Community Care Co-ordinators [13 staff – professional mix] • Social Workers • Community Nurses • AHP’s – Aligned • Homecare – Aligned • Admin Support

12. ISD – The Benefits • Co-location • Improved Communication • Better understanding of each other’s roles • Easier Access to other professionals • Shared patient / client input • Single Assessment Tool • Improved Service

13. Actual or Virtual? • “Could do Better”! • Examples where staff are co-located but not necessarily integrated • Challenges – Facilities, other change processes • Good Examples

14. Best Practice • Dementia Team • Reablement • Community Rehabilitation

15. The Future • Transforming Your Care • Integrated Working Re-visited and Re-emphasised • Health & Care Centres • Importance of GP engagement

16. Any Questions???? Thank You! martin.mcgeady@westerntrust.hscni.net