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Vanguard – Enhanced integration with care homes and social care.

Vanguard – Enhanced integration with care homes and social care. Dr Dan Cowie Clinical Director Transformation April 2015. NHS England Vanguard sites.

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Vanguard – Enhanced integration with care homes and social care.

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  1. Vanguard – Enhanced integration with care homes and social care. Dr Dan Cowie Clinical Director Transformation April 2015

  2. NHS England Vanguard sites January 2015 NHS England invited organisations and partnerships to apply to become a Vanguard site for the new models of care programme including Enhanced heath in care homes This approach is seen as one of the first steps in delivering the NHSE Five Year Forward View through supporting improvement and integration of services

  3. More than 260 individual organisations and health and social care partnerships expressed an interest On the 10th March 2015 29 Vanguard sites were chosen Gateshead is one of only 6 enhanced health in care home sites

  4. New Models of Care • New ways of working: • Commissioning • Provision • Accelerated LEARNING + IMPROVEMENT • Working TOGETHER (design + delivery) • NG CCG + Gateshead LA • Stakeholders in SRG • Establish a model – reciprocal across England • Better Care, Better Health and Lower Cost • Leadership, relationships, large scale change • Embrace and believe it will work!

  5. Gateshead - New Model • Not about Care Homes (in isolation) • About health and Social Care integration • Cohort - Frailty spectrum • A new model for: ‘COMMUNITY BEDS and HOME-BASED CARE’

  6. Setting the scene • CARE HOME PROGRAMME • 206, 000 population • 9% increase in over people aged 85 years of age by 2030 • Over 1500 beds (community) • Started 2010 • 9.3% reduction in non-elective admissions (baseline 11/12)

  7. Case Management New Integrated Community-bed and home-based care model MCP + PACS New model of care Health + social co-commissioning Weekly locality-based ward rounds + Community-based MDT Case management/disease management Care-homes Twice weekly locality-based + community-based ward rounds Case/disease management/self care/promoting independence Short-stay beds Alignment of Intermediate + reablement+ home-based care teams + Home-based care teams Home-based care Disease management/self care/wellness/independence 24/7 Accountability + capitation-based funding RRR

  8. By 2016 – Community beds and home-based care? • Joined up commissioning • Joint/Co-commissioning • Providing joined up care • Provider Alliance Network • Commissioning joined up care • Outcome-based population commissioning • New Contractual Model: • Outcome-based contract • Payment-based alignment

  9. ONE BED - Joined up commissioning • ONE health and care BED – no distinction • Co-commissioning/lead commissioner • Better Care Fund vehicle

  10. One service - providing joined up care – PAN • PAN MODEL – merging and evolving • HYBRID – MCP and PACS • Primary Care led Organisation • Service Delivery • Borough-based • Locality-based • Person/home-based INCREMENTAL EXPANSION

  11. Gateshead’s Integrated Community-bed and Home-based care Service Provider Alliance Network Macro-integration (System) Meso-integration (Organisational) Normative Integration Micro-integration (Clinical)

  12. INCREMENTAL EXPANSION

  13. One Outcome - Commissioning Joined up care New Contractual Model • Type of Contract • Alliance /Lead provider plus • Outcome-based • High-value outcome measures (e.g. Quality) • Service integration measures (e.g. coordination and continuity of care) • Payment alignment • Outcomes + Integration • Client-needs = Unity of Currency (e.g. capitation) • Pathways - Bundle payment + cycle of care

  14. INCREMENTAL EXPANSION

  15. How will it work? • Clinical /Management engagement • Patient/public involvement • Local ownership • National Support

  16. Aligning the system 5year plan vision Health and Social care economy shifts: • Move to value (from effectiveness, quality, safety) • Move to culture (from structural redesign) • Move to population planning (from individual) • Move to collaborative system (from competitive provider landscape) • Move to the ‘£’ – stewardship of system resource (from unaccountable ownership)

  17. Next steps • Central Team Visit – May 5/6th • Finalising the 2 days – stakeholder day Wednesday 6th9 – 12 noon • Project plan: • Core Team • Commissioner and Provider – leads • Payment + Funding • Contracting/outcomes • PAN • Commissioning

  18. Any questions?

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