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ARE THERE ANY LESSONS FOR US FROM A ‘CARE TRUST PLUS’?

ARE THERE ANY LESSONS FOR US FROM A ‘CARE TRUST PLUS’?. ‘Making Partnerships Work in Health & Local Government’. Peter Melton PEC Chair, North East Lincolnshire Care Trust Plus 14 February 2008. AIMS OF THE CARE TRUST PLUS.

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ARE THERE ANY LESSONS FOR US FROM A ‘CARE TRUST PLUS’?

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  1. ARE THERE ANY LESSONS FOR US FROM A ‘CARE TRUST PLUS’? ‘Making Partnerships Work in Health & Local Government’ Peter Melton PEC Chair, North East Lincolnshire Care Trust Plus 14 February 2008

  2. AIMS OF THE CARE TRUST PLUS • Create and develop a formal key strategic partnership between the Local Authority and Local NHS • Drawing on respective strengths in order to deliver improved and accelerated outcomes • Adopting a holistic and integrated approach for those residents with the most complex needs • A Children’s Trust for whole population

  3. THE KEY ASPECTS OF THE CARE TRUST PLUS • Transfer Adult Social Care Commissioning responsibilities and budget from LA to NHS • Transfer Social Care Provision (LD, Adult Care, Intermediate Care, Mental Health) from LA to NHS • Transfer Public Health Directorate and responsibilities from NHS to LA • Transfer NHS community child services from NHS to LA which leads the Children’s Trust

  4. DRIVING PRINCIPLES OF THE CARE TRUST PLUS • Align Accountability with Responsibility • Deliver integrated services and decision making • Deliver holistic services and decision making • Bringing services and decision making as close to the patient, user, carer or citizen as possible • Balancing the rights and responsibilities of the individual and wider community

  5. STRATEGIC EXAMPLES OF HEALTH AND SOCIAL CARE IMPROVEMENT • Integrated review of home care services aligned to commissioning group plans • Re-commissioning GP OOH services to form an integrated health and social care provider • Re-aligning of health and social care teams to the four commissioning groups to support SAP and MDT working • Aligning PBC and Social Care budgets to support joint planning at individual and population level • Open Door • Open Mind, The Willows, Tukes • Joint Strategy and investment in LD

  6. OPERATIONAL EXAMPLES OF HEALTH AND SOCIAL CARE IMPROVEMENTS • Monthly MDT case planning meetings • Monthly commissioning group meetings • Reduced emergency hospital admission rate • Reduced residential care home admissions • Commissioning group plans around elderly, mental health, children and health improvement

  7. EXAMPLES OF IMPROVEMENT HEALTH AND TACKLING INEQUALITIES • Established a LA portfolio holder for Healthier Communities • Formulated jointly owned health inequalities action plan • Health inequalities adopted as a top 6 LA priority • LA investment in alcohol and tobacco control, reducing harm in the workplace • Health Impact Housing Strategy • Re-fresh teenage pregnancy strategy • Sports and active recreation strategy • LEGI • Social Marketing to reduce delayed cancer presentations • Neighbourhood renewal areas, housing, police aligned to commissioning groups

  8. EXMAPLES OF IMPROVEMENTS IN CHILD SERVICES • Moving towards a health and well being model of care • Shifting focus of delivery from practice to community and children’s centres • Common IT solution • Early support programme • Changing role of Health Visitors and School Nurses • LAPs and children’s centres aligned to commissioning groups

  9. ADDED VALUE OF CARE TRUST PLUS APPROACH • Management cost savings • Accelerates resolution of interface restraints to delivery • Positive cultural change • Constructive tension and challenge • Accelerated delivery of LAA • Greater workforce opportunities and satisfaction • Redressing ‘democratic deficit’

  10. CARE TRUST PLUS – THE FUTURE • Expanding health and social care provider teams to include secondary care, third sector and private • Commissioning group plans expanded to become ‘Mini LSPs’ leading to ‘Mini LAAs’ • More individual commissioning • Key local private businesses becoming more active partners of community leadership • Parents agreeing joint annual well being plans with the Care Trust Plus for each child

  11. ENABLERS TO THE CARE TRUST PLUS • Geography • Co-terminosity • Leadership • Strategic Fit • Clinical Engagement & PBC • Robust Legal Framework • Performance Agreements • Governance • Financial Parity • FeSC

  12. ISSUES IN ESTABLISHING A CARE TRUST PLUS • Scepticism / Trust • Risk aversion • Change fatigue • Change management capacity • Timing • Practical barriers • Perceived loss of control • Untested

  13. CONCLUSIONS • Initial local and external evaluation positive • Created boost to joint strategic directions • Brings complimentary skills • Creates a more robust system to balance the rights and responsibilities between individual and community • Redresses the balance between ‘looking out’ and ‘looking up’ • Creating ‘empowered communities’ • ?Transferable • Questions: peter.melton@nelctp.nhs.uk

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