Achieving greater efficiency in services for older people in Wales

Achieving greater efficiency in services for older people in Wales PowerPoint PPT Presentation


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The Proposition. We will build together a model of best practice in Wales that demonstrates best use of resources for Older PeopleThe model will be built through a combination of understanding the data on the cost and shape of local services and a dialogue with each councilA visit will be arranged

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Achieving greater efficiency in services for older people in Wales

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1. Achieving greater efficiency in services for older people in Wales John Bolton - Consultant JRFB Ltd

2. The Proposition We will build together a model of best practice in Wales that demonstrates best use of resources for Older People The model will be built through a combination of understanding the data on the cost and shape of local services and a dialogue with each council A visit will be arranged with each council where we can build on good practice examples and look to help with locally identified issues The final publication will be a document for Welsh Authorities about welsh Authorities – it will focus entirely on best practice and evidence based practice The work will be led by John Bolton supported by the Institute for Public Care and sponsored by SSIA

3. Basics of efficiency in Adult Social Care We must look to deliver quality services at the lowest possible cost We must look to help people regain or attain independence, outside of social care services, wherever this is possible. We must aim to share services with local partners – either neighbouring local authorities or with health partners or both together, where this offers the best solutions. We will help people to use their own resources wherever this is feasible. We will no longer offer subsidies for services for those who through a means test can demonstrate they can afford to pay for those services.

4. People choose less dependent options: this is typically more cost effective

5. Keeping People out OR reducing the costs of care Reducing demand – re-ablement, intermediate care, recovery, helping towards independence and work The balance between Nursing Care/Residential Care The balance between residential care and community based solutions The role of the Review Prevention? Low level services?

6. Spend on Residential Care

7. Spend on Domiciliary Care

8. Assessment and Care Management

9. Spend on Residential and Nursing Care

10. More work to do on: Unit Costs Health data that impacts on social care data (admissions from hospital to residential care)

11. Cost effective interventions Cost effective interventions – Housing Models, Telecare Expensive and Cheaper models of community support vs residential care Systemic models of care Collective procurement Talking with Providers

12. Unit Costs - Procurement Costs of in-house Residential Re-ablement Procurement of Residential Care e.g. Challenge in the Learning Disability Sector and spot purchasing Dialogue with Providers – learn from them what works best

13. Maximising Income Income collection - subsidising costs of care vs full charging Self-funders vs assess and charge

14. Health and Social Care Evidence suggests joint governance not the solution alone BUT Intermediate Care – challenges for Health Reduce acute admissions of frail elderly by 30% Reduce use of Community Hospital beds Shared services joint projects single assessments Good health care - health interventions that reduce demand for social care – Incontinence – Urinary Infections Stroke - Falls prevention Podiatry- Dentistry

15. Role of Housing 40% of costs of residential care Extra Care Options of Models Supported Housing Options Supporting People and Floating Support

16. Personal Budgets Are these cost effective? Using community based solutions Do you commission for personal budgets?

17. Technology and Telecare Paperless office, Remote working Telecare and Telehealth Virtual contact.

18. Transformed Care System

19. Benefits Realisation First time resolution Minimum number of steps to resolve

20. What are you trying to achieve? Reduce demand Reduce levels of demand Reduce unit costs Reduce costs of packages Reduce staffing Creative care

21. The check list Are we sucking people in or keeping people out? Use of Resources Profile Cost effective packages of care in the community Staffing Structure Joint with Health Personal Budgets and creativity Housing Options Intermediate Care & Reablement – keeping people out Telecare – keeping people safe Maximising income Unit Costs – In House Unit Costs – Spot Purchase Remote working

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