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Integrated care programme PowerPoint Presentation
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Integrated care programme

Integrated care programme

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Integrated care programme

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  1. Integrated Care: Integrated Community Services for AdultsCath DomanHead of Community Health CommissioningProgramme Lead Integrated CareNHS Airedale, Bradford and LeedsLyn SowrayAssistant DirectorAdult and Community ServicesBradford Metropolitan District Council

  2. Integrated care programme • Delivering the vision for integration • Transformation of health + social care in the District • Integration of community services clustered around GP practice/s • Services working as a single team for each locality • Risk stratification of locality population

  3. In simple terms, it’s… …whatever the person needs following (or to prevent) acute care or long-term dependence • Reablement • Rehab • Recuperation • Return to optimal health + wellbeing

  4. The visionRight careright placefirst time Joined up services to enable people to regain and keep their optimal health, well-being and independence

  5. The health economy • Need for new models of care delivery • Funding gap • Shift from hospital to community requires greater capacity and productivity in community services • Growing demand/population requires a preventative approach • Increased capacity to prevent needs escalating • Better case management across partners to reduce bureaucracy, duplication, risk Adapted from slide by Nick Morris BDCT

  6. The Partners Commissioners • NHS Airedale, Bradford and Leeds • Emerging Clinical Commissioning Groups • BMDC • NYCC (for Craven) Providers • Bradford District Care Trust • Bradford Teaching Hospitals • Airedale NHS FT • Bradford Metropolitan Borough Council • Voluntary and Community Sector • North Yorkshire County Council

  7. Integrated functions • Community nursing • Intermediate care services • Community therapy services • Long-term conditions management • Long-term support and care • Rehabilitation and reablement • Associated support services - VCS • Opportunities to include MH + LD services

  8. The programme Mental health and dementia Enable

  9. Dr Tom Downes 2008

  10. Timescale: 2-3 years Practices putting in proposals now • 2011/12 Transfer + achieve consensus Transfer of community services and development of strategy • 2012/13 Change Early wins: test-sites across District of teams working together, common criteria, assessment and records, enablement working alongside therapy and community nursing • 2013/14 Polish + make it stick 111, pooled budged, single management, health + social care services delivered from community-based hubs

  11. Warden Discharge team CMHT GP Introducing Mrs Jones… District nurse Housing grants Community Matron Physio podiatrist Out-patients Equipment services Social worker OT Practice nurse Social services OT Home care Heart doc Diabetes doc MATS BDCT BMDC InCommunities BTHFT ANHSFT VCS GP

  12. Discussion and questions