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Making the DFG system Work

Making the DFG system Work. Francis Philippa. The Big Picture for us all. Shrinking Resource. Rising Demand. Local Freedom. Drivers for Change - Organisational. High satisfaction: Large no. of complaints! Long waiting times and growing waiting lists

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Making the DFG system Work

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  1. Making the DFG system Work Francis Philippa

  2. The Big Picture for us all Shrinking Resource Rising Demand Local Freedom

  3. Drivers for Change - Organisational • High satisfaction: Large no. of complaints! • Long waiting times and growing waiting lists • Disjointed access, process and accountability • Inconsistent in waiting times, in quality and customer experience across authorities and between tenures

  4. Drivers for Change - external • Increasing demand • Political pressure to reduce waiting times • Policy issues: • hospital discharge • community care • Falling resources (PSRG) removal 2011

  5. Best Summed up as: • 1. Takes too long • 2. Too many fingers in the pie • 3. No resilience – delays in one part affects all • 4. Often does not represent value for money • 5. Alternatives not always considered • 6. People resistant to change – we have always done it this way.

  6. Responses • Evolution; Sandwell • Lean Systems; Warwickshire and Norfolk • Radical redesign: Bristol • Outsourcing; Southend

  7. Response Characteristics • Re-design and simplification of processes, eliminating organisational and professional boundaries • Process designed around customer journeys • Outcome-based performance measures • Strong emphasis on diagnostics and triage at beginning – better training • Greater efficiency by reducing home visits and less hands-on contract management

  8. Common Features of the resultant Process • Single Point of Contact (with Specialist support) • Better information to customers • Forms of Triage (priority, type of work & necessary inputs) • Strong Assessment functions (Needs & Aspirations) • Framework agreements with standard specification • Stripped down bureaucracies, reduced hand-ons, joint visits • Trusted Assessors: OTs, HP, GO & caseworkers • Greater emphasis on simple solutions and self funding • Greater customer involvement

  9. Outcomes • Significantly reduced end to end process times • Sandwell reduced from 55 to 24 days ex assessment • Warks pilot 429days to 48 • Bristol reduced from 497 to 210 • Southend reduced from 260 to 133 • Increased capacity • Fewer people increase or maintain programmes • Budget goes further • People are happier

  10. However Significant challenges remainDFG Budgets are continuing to shrink

  11. The system often remains impenetrable

  12. Potential demand is continuing to rise • People’s expectations are rising • There is little guidance • More efficient DFG systems mean quicker spend • The position of RPs remains unresolved • Health remains largely disengaged

  13. Therefore......... If not a DFG then what else??????

  14. What Else? • Housing Option and Move on services • New & alternative forms of assessment • Handy Person Services (TA and minor adaptations) • Flexible & augmented Accessible Housing Registers • Adaptations protocols with RPs • Increased encouragement to self fund • Equity Release? • Further bundling up of services (integration & consolidation)

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