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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1. Achieving greater efficiency in services for older people in Wales John Bolton - Consultant
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 –
Expensive and Cheaper models of community support vs residential care
Systemic models of care
Talking with Providers
12. Unit Costs - Procurement Costs of in-house
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
Good health care - health interventions that reduce demand for social care –
Incontinence – Urinary Infections
Stroke - Falls prevention
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,
Telecare and Telehealth
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
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
Joint with Health
Personal Budgets and creativity
Intermediate Care & Reablement – keeping people out
Telecare – keeping people safe
Unit Costs – In House
Unit Costs – Spot Purchase