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IMPROVING OUTCOMES AND SUPPORTING INNOVATION. Dr Margaret Whoriskey Director, Joint Improvement Partnership Board. A Scottish Approach to Public Service Reform. Prevention – decisive shift: Reduce future demand by preventing problems arising or dealing with them early on.

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Improving outcomes and supporting innovation

IMPROVING OUTCOMES AND SUPPORTING INNOVATION

Dr Margaret Whoriskey

Director, Joint Improvement Partnership Board


A scottish approach to public service reform
A Scottish Approach to Public Service Reform

  • Prevention – decisive shift: Reduce future demand by preventing problems arising or dealing with them early on.

  • Partnership – Bringing public, third and private sector partners together with communities to deliver shared outcomes that really matter to people.

  • People – We need to unlock the full creativity and potential of people at all levels of public service, empowering them to work together in innovative ways. We need to help create ways for people and communities to co-produce services around their skills and networks.

  • Performance – To demonstrate a sharp focus on continuous improvement of the national outcomes.


Our 2020 vision
Our 2020 Vision…

By 2020 everyone is able to live longer healthier lives at home, or in a homely setting.


Health social care integration
Health & Social Care Integration

  • Underpinned by Legislation:

    • nationally agreed outcomes;

    • Healthier

    • Independent Living

    • Positive experiences and outcomes

    • Carers are supported

    • Services are safe

    • Engaged workforce

    • Effective resource use


Principals defining outcome focused approach
Principals/Defining Outcome Focused Approach

Understand outcomes as the impact or end result of support and/or services on a person’s life:

BUT start by defining expectations and outcomes with the person

Focus on strengths and capacities more than deficits

Identify the person’s role as well as other people in their life and services

Outcomes can be measured both for the individual and for the service as a whole

Believing that the participation of the person is core to practice


What do we mean by outcomes
What do we mean by outcomes?

The “So what?” question – if we have provided support or service to someone, what did that achieve? Did the person benefit and how do they see it?

This requires both the services, and the person themself to think through together what matters and how it can be best achieved.

The big challenge is to develop what we often do well at the individual level to be the basis of our whole organisational approach – keeping people and what they want at the heart of everything we do. We refer to this as a personal outcomes approach.



“Most older people (89.5%) do not receive ‘formal’ care in NHS continuing care, a care home or a home care service organised by social work agencies.”


Reshaping care integration in action
Reshaping Care: Integration in Action care in NHS continuing care, a care home or a home care service organised by social work agencies.”

10 Year National Programme 2011-2021

£ 300 million Change Fund 2011 - 2015

32 Partnership Change Plans agreed by:

NHS: primary, acute and mental health services

Local Authority: social care and housing

Third sector

Independent sector

Reshaping Care and Integration Improvement Network to support partnerships to transform care


Reshaping care pathway
Reshaping Care Pathway care in NHS continuing care, a care home or a home care service organised by social work agencies.”


The change fund and rcop
The Change Fund and RCOP care in NHS continuing care, a care home or a home care service organised by social work agencies.”

  • 2012/13– CF built on current initiatives and developments - Only 1-2% of total spend

    • build on wide range of other innovative work underway

    • early reflections on Joint Commissioning

  • 2013/14 – Joint Commissioning Strategies with a 10 year horizon to shift the balance of care

  • Change Plans as lever to change :

    • Investing to maximise improvements in outcomes

    • Maximising potential for resource shifts by bridging to new service models

    • Investing to lever otherwise inaccessible resources


  • Going forward joint strategic commissioning
    Going Forward: Joint Strategic Commissioning care in NHS continuing care, a care home or a home care service organised by social work agencies.”

    • “all the activities involved in assessing and forecasting needs, links investment to agreed desired outcomes, considering options, planning the nature, range and quality of future services and working in partnership to put these in place.”

    • First iteration prepared for 13/14 focusing on older people

    • Will be a legislative requirement from 2015 onwards for all adult care groups

    • National support programme launched

    • http://www.jitscotland.org.uk/action-areas/commissioning/


    Joint commissioning plans
    Joint Commissioning Plans care in NHS continuing care, a care home or a home care service organised by social work agencies.”

    Increasing focus on dementia

    Post diagnostic support

    Focus on Physical environment , housing, adaptations, telecare

    Training for all

    Anticipatory care

    Reablement


    What needs developed
    What needs developed care in NHS continuing care, a care home or a home care service organised by social work agencies.”

    Need for better integration across mental health, older people services and support

    More focus required on post diagnostic support

    Support for care homes

    8 Pillars – needs to be integrated in wider work

    Dementia friendly communities

    More opportunities for telecare

    More recognition and support for carers


    Learning from demonstrators
    Learning from demonstrators care in NHS continuing care, a care home or a home care service organised by social work agencies.”

    Communication tool app for phones and tablets for people with dementia

    Care and repair

    Perth and Kinross open access memory clinic and disinvestment from community hospital beds to alternative NHS services in the Strathmore locality

    Midlothian family group conferencing initiative and detailed IRF work with primary care

    North Lanarkshire dementia cafe work (for which they have received an award); reminiscence initiative re football; dementia friendly community work in Motherwell involving local traders and other statutory agencies; outreach from day care work.

    Housing initiative with all sites

    Reablement


    Supporting innovation at scale
    Supporting Innovation at Scale care in NHS continuing care, a care home or a home care service organised by social work agencies.”


    Expanding range of telecare equipment
    Expanding Range of Telecare Equipment care in NHS continuing care, a care home or a home care service organised by social work agencies.”

    Wristcare

    Locator

    Medication Reminder

    Wayfinder

    Epilepsy sensor


    A useful enabler
    A useful enabler… care in NHS continuing care, a care home or a home care service organised by social work agencies.”


    In five years to 31/3/2012, 325 users of the Renfrewshire Care 24 telecare service had dementia; over 30% of all users. The Service has provided a range of equipment including door contacts, pressure mats and bed monitors, operates a Responder service in the event of an alarm being triggered and has a specific dementia pathway; all with the aim of keeping these vulnerable people safely at home.


    The Renfrewshire Telecare service estimated 114 hospital and 88 care home admissions were avoided by this group because of telecare.


    For more info

    For more info: 88 care home admissions were avoided by this group because of telecare.

    @jitscotland

    www.jitscotland.org.uk

    [email protected]


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