To receive a presentation on the funding and resources available for Corporate Plan Priority 2 – “Enable all adults to live healthy, long and fulfilling lives”. This will include updates on the Better Care Fund, the model for Day Opportunities and how the social care precept is being used.
Minutes:
The Panel received a presentation on the funding and resources available for Corporate Plan Priority 2.
Beverley Tarka, Director, Adult Social Services, commenced the presentation by explaining that the vision for Priority 2 (P2) was to enable all adults to live healthy, long and fulfilling lives. The Panel was informed the P2 Transformation Programme supported this vision by driving the delivery of MTFS savings, with an overall strategy to maximise the independence and wellbeing of residents and managing future demand for services and associated budgets. It was noted that work in this area involved working with key stakeholders and building on evidence from across the sector and was informed by the Design Framework for Integrated Health and Care.
Ms Tarka went on to provide information on the following:
- The P2 budget for 2017/18, totalling £95.4 million
- The total budget for adults social care, totalling £80.5 million
- Care packages by provision, totalling £63.1 million
- Care packages by age and primary support reason
In terms of the social care precept, the Panel was informed that the precept had been levied at 3% in 2017/18 with a total value of £2.7 million. The Panel was informed that this money would be used to protect social care services and the Council would improve outcomes for people by working in close partnership with the NHS in order to enable all adults to live healthy, long and fulfilling lives. It was noted that the Council would use the precept to develop a sustainable adult health and social care system through the following projects: Prevention; Stronger in Communities; Intermediate Care; Operations and Commissioning; Market and Brokerage. Further information was then provided on each project.
John Everson, Assistant Director, Adult Social Services, advised that Haringey’s Design Framework for Health and Social Care set the foundations for full integration of health and social care by 2020. In response to questions, Mr Everson outlined the importance of the Better Care Fund (BCF) and highlighted both achievements and areas for improvement following a review of work carried out during 2016/17.
BCF Review 2016/17 –
|
Achievements |
Areas for Improvement |
|
More support for people with dementia through dementia navigators |
Increase impact on non-elective admissions |
|
Over 1600 people discussed in multi-disciplinary teleconferences to improve their health and social care packages |
Increase referrals into Locality Team |
|
Successful falls prevention workshop across Haringey, Camden and Islington |
Work with frequent callers to London Ambulance Service / frequent attenders at A&E |
|
Implementation of an Advanced Care Planning Facilitator in care homes supporting end of life |
Increase the scale of Discharge to Access across all hospitals |
|
Expansion of Rapid Response providing urgent health and social care within 2 hours, 7 days a week |
Improve non-emergency patient transport and medication on discharge from hospital |
|
Successful implementation of simplified discharge pathway from hospital led by reablement, being used as a model across NCL |
Develop further work to support health and wellbeing in care homes |
|
Implementation of reablement flats in Protheroe House – winning national housing award |
Develop demand and capacity plans for intermediate care |
|
180 patients supported to self-manage their Long Term Conditions via “Expert Patient” type groups |
Build capacity of organisation to deliver information, advice and guidance |
|
Approved funding for Local Area Coordination |
Supporting the attitudes, behaviours and culture to embed integrated working |
|
Secured funding for an Integrated Digital Care Record Across NCL |
Implement an Integrated Digital Care Record |
Moving forward, the Panel was informed that national guidance for the BCF had not been published and that as a result plans for 2017/18 had not been finalised yet. The following points were considered:
- Targets for BCF Outcomes
- The fact 24 different services received funding and that all previous BCF services would continue to be commissioned following a service review and prioritisation
- The fact that four national conditions for the BCF had been met i.e. a jointly agreed plan; maintenance of social care; funding out of hospital services; and managing transfers of care.
In response to questions about the Health and Wellbeing Board, the Panel was informed that the BCF maintained rigorous and inclusive governance arrangements.
Charlotte Pomery, Assistant Director, Commissioning, provided an update on Day Opportunities Transformation. In addition, and following an invitation from the Chair, Mary Langan, Autism Partnership Board, Learning Disabilities Partnership Board provided an update on developments at Ermine Road Day Centre, including some of the challenges faced by service users and carers.
In setting the scene, Ms Pomery commented that the challenge for day opportunities, in order to deliver MTFS savings, was to transition out of a buildings based service model and to improve day services for people with dementia and learning disabilities. It was noted that the vision was to develop a decentralised, hyper-local, highly connected community resource and a responsive marketplace that connected people with the things they wanted to do.
The Panel was reminded that an initial co-production workshop had highlighted a need to focus on:
- Developing the day opportunities market – having more providers to support people’s needs
- Testing Care Navigation – working with users to help them make the right choice to meet their needs
- Making the most of the Haynes and Ermine Road as community hubs
- Making sure people can find information that they need about day opportunities
With this in mind, Ms Pomery went on to outline work that had been done in relation to market development, care navigation, developing community hubs, and access to information. The following points were noted:
- Market development
o The work that had taken place with the community sector and private suppliers in order to gauge capacity and to increase choice for service users
o The setting of clear expectations concerning fees and quality as part of externally commissioned provision
o The development of a Day Opportunities Provider Quality Assurance Framework
- Care navigation
o The use of support plan meetings to bring as much information as possible about different options to help service users navigate the market
o Once support plans had been completed, Brokerage had worked to identify services to meet identified outcomes
o All transitions had been completed and 6 week reviews had taken place
- Haynes and Ermine Road Hubs
o The Hub Service Specification which had been developed through Co-production Groups
o The appointment of Hub Managers
o The development of a new model on both sites
- Access to information about day opportunities
o The work that had taken place to improve and refine Haricare in order to make it easier to use and more user-focused
o Options for a new digital offer which would bring together assessments, information, advice, guidance and local knowledge
During the discussion the Panel was informed that a number of lessons had been learnt. For example, navigating lots of different options could be complex and that matching outcomes to the provider offer was very personal. In addition, work was needed to facilitate participation in “universal” activities such as leisure activities. The Panel went on to consider next steps for the project, including:
- The fact that the hubs at the Haynes and Ermine Road would be piloted in house for 6 months before a decision on a future provider was taken
- The work that would continue to develop a range of opportunities in the community, including improved access to universal services
- The monitoring of day opportunities provision, including externally commissioned services under the Quality Assurance Framework
- The need to capture user and carer feedback in order to help address gaps in the market
- Using intelligence from quality assurance in order to support market development
- Work to expand the use of Personal Assistants
- Developing work with the Dementia Action Alliance on access to universal services
In response to questions, the Panel informed that consideration would also be given to introducing a Dynamic Purchasing System for Day Opportunities Providers.
The presentation concluded with an update on the Priority 2 Performance Dashboard. It was noted further information about the Dashboard could be found online via: http://www.haringey.gov.uk/local-democracy/policies-and-strategies/building-stronger-haringey-together/p2
AGREED:
(a) That the presentation outlining the funding and resources available for Corporate Plan Priority 2 be noted.
(b) That an update on Haringey’s Design Framework for Health and Social Care be considered by the Panel at its next meeting (10 October 2017).