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Call to Action

Call to Action. Andy Layzell Chief Officer. Pressures in the NHS The money Transformation Fund Where we are heading Implications for the Voluntary Sector. Over the last 10 years: 50% increase in GP consultations 35% increase in emergency care admissions

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Call to Action

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  1. Call to Action Andy Layzell Chief Officer

  2. Pressures in the NHS • The money • Transformation Fund • Where we are heading • Implications for the Voluntary Sector

  3. Over the last 10 years: 50% increase in GP consultations 35% increase in emergency care admissions 50% increase in procedures undertaken A&E Departments under pressure ‘The worst winter I can remember’ Pressures in the NHS

  4. What causes the pressures? Combination of factors: • Demographic change • 25% of the population with a long term condition (70% of expenditure) • Poorly joined up services between primary, secondary and social care • Technical advance

  5. The money • Tightest period of funding in the last 50 years of the NHS • NHS funding has declined in real terms and is below the level of 2009/10. • Growth in real terms funding likely to cease after 15/16 • Inflation of 2-3% per year still expected to impact on the costs of delivering health services • Investment of £18m in Social Care by 15/16 (Integration Transformation)

  6. SDCCG Estimated productivity Challenge 2014-2019

  7. Quality • Quality suffers when systems are under pressure • Too many people in hospital • People not supported to retain their independence in the community • Too many people entering long term care too early or without proper assessment

  8. Requires open dialogue with the public, providers and stakeholders about the future of the NHS Each CCG to develop 5 year commissioning plans by June 2014 To include use of the Transformation Fund ‘A Call to Action’

  9. The ‘Integration Transformation Fund’ • Aim is to encourage integration, but no new money • £18m for SDCCG (3% of total funding) • Focuses on preventing hospital admissions and facilitating discharge • Explicit about impact on acute services • In the context of huge financial pressures on local authorities

  10. Where are we heading? • Acute trusts working more closely together in strategic partnerships • Community services working closely with primary care and social care to deliver integrated services • Primary care developed as a robust provider of a wider range of local services • Care Homes developed as strategic partners in the local health and social care economy • Mental health provision integrated with community provision • Some shift from medical to social models of care

  11. Assumptions • The acute sector stops growing • The evidence base around integration

  12. Integrated Care – Where are we now? • Health and social care teams working locally with practice populations of 20-25,000 • Focus on the elderly and people with a Long Term Condition • Single Points of Access • Local teams have access to a range of support services (therapies, specialist teams, local beds, community physicians etc)

  13. Integrated Care – what comes next? • Expansion of community approach to include mental health and links to local community networks • More modern, flexible community estate, with beds available locally to Community Support Teams • In-reach support to Care Homes • Shared information • Services available 7 days a week

  14. Our priorities are still the same …. • Urgent care • Mental health • Children • Planned care • Primary care • Long term conditions • Frail and elderly older people

  15. …But our model of delivery focuses on integration Self Help Advice, information & Advocacy Social Capital Social philanthropy Primary/ Community Delivered locally Early Intervention Prevention Rehabilitation Community Care Primary/ Community Health at “district” level Intermediate Care Social Work Out of hospital Specialist Services Specialist Hospital Care Care Homes • Primary care as key part of community services • Same model works for most client groups • Potential development of a Public sector Offer • Development of social capital • What are the public’s responsibilities in this model?

  16. Implications for the Voluntary Sector • Funding will reduce • Public sector will rationalise its working with the voluntary sector • There will be opportunities • Prevention • Social capital • Has to integrate with the Public Sector • What is the voluntary sector ‘offer’ to the statutory sector?

  17. Thank you

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