Contents

1. The Balance of Care Approach:Modelling complexity in services for older peoplePaul Forte & Tom Bowenwww.balanceofcare.com+44 7818 066653ORAHS 2010, Genoa, Italy, 19-23 July 2010

2. Contents • The Balance of Care approach: - whole system demand-supply modelling • An example of a telecare application: - model development and application - changing care pathways

3. Areas of strategic importance for health and social care • Organisational issues: • supporting partnership working; innovative connections; workforce development • Information issues: • sharing of data, information and intelligence; common definitions • People issues: • harnessing drive of health and social care professionals • facilitating client and carer engagement

4. The Balance of Care model High dependency Medium dependency Older People Low dependency

5. The Balance of Care model Acute care bed High dependency NHS Community nurse Physiotherapist Medium dependency Older People Occupational therapist Day care centre Local Authority Care assistant Low dependency Independent sector Care home

6. The Balance of Care model Acute care bed High dependency NHS Option 1 Community nurse Physiotherapist Medium dependency Older People option 2 Occupational therapist Day care centre option 3 Local authority Care assistant Low dependency Independent sector Care home

7. Balances to be struck… Care Professionals Non-Clinical Managers Health Services Social Services High Dependency Low Dependency

8. Developing a model for telecare • Support for social services to develop business cases for telecare in the wider context of the organisation and provision of local health and social services • Identification of potential increased cost effectiveness through: • reduced admission to long-term care homes • reduced cost of home care packages • savings to the NHS (eg. through reduced admissions to hospital)

9. Model demo here

13. Resource modelling for dementia services • Same model structure but adapted for a dementia patient classification and care options • Local application and costing • Support for joint strategic planning

14. Simplified Care Options

15. Potential Resource Requirements for Key Services

17. Category Label Intended Population Base Data Source for Telecare Valley Care home residents - not EMH Permanent care home residents over 65 supported by council (excluding Elderly Mental Health) England residents at 31-03-2004 / 150 Care home residents - EMH Permanent care home residents over 65 supported by council (Elderly Mental Health) England residents at 31-03-2004 / 150. Case management - frail older people Numbers over 65 receiving intensive home care (> 10 hours per week). These are assumed to be the people who would be included in case management schemes for frail older people. Based on England number receiving intensive home care (over 10 hours) at 31-03-2004 / 150. Other long term care needs Numbers over 65 receiving home care (5- 10 hours per week). These are assumed to be the people who require continuing social care support, but do not have chronic healthcare needs appropriate for case management. Based on England number receiving 5-10 hours of home care at 31-03-2004 / 150 Other low intensity needs Numbers over 65 receiving home care (< 5 hours per week) Other England low intensity home care (<5hrs per week) at 31-03-2004 / 150 Unsupported at home >65 Total resident population 65 years and over, not receiving a social care service England 2001 Census, resident population over 65, divided by 150, and net of estimated values for P1 to P5 inclusive. Category descriptions

18. Patient categories Meaningful groups of population >65 years for telecare planning purposes