Health and care
Bath & North East Somerset Council
The council and the clinical commissioning group in Bath and North East Somerset have carried out an ambitious review of community health and care services built on the findings from extensive engagement with local people and professionals. It is a pioneering example of how the new models of care, advocated in the NHS Five Year Forward View, can be delivered. From 1 April 2017, a single prime provider will co-ordinate more than 200 different community health and care services, working with clusters of GP practices to deliver improved health and wellbeing outcomes for more than 200,000 people.
Hertfordshire’s ‘Adults With Complex Needs’ project is a two-year pilot seeking to create a way of working that is more preventative, intensive and better supports adults with complex needs. Scoping work revealed there were 20 local individuals who used £1.5m of public services in two years without sustained improvement to their lives. A multidisciplinary team, to which people with complex needs can be referred, has been formed with the involvement and funding of the police, clinical commissioning groups and the county and district councils. This project seeks to generate data that proves that this way of working represents a better way of spending across the public sector.
Leeds City Council
The NHS Five Year Forward View made integration of the workforce and use of new technology central to transforming services. Leeds has brought these overlapping opportunities together through collaborative system change, enabling its health and care practitioners to build skills and confidence in the digital domain, safely share information to improve patient experience and to develop a ‘one workforce’ approach. Through these partnerships an overall strategy is embedding technology at the heart of health and care.
Leicester City Council
Leicester City Council and Leicester City Clinical Commissioning Group have worked in partnership to create an integrated urgent care and discharge pathway. This has led to a dramatic reduction in delayed transfers of care at a time when rates are rising nationally. The integrated offer cuts across primary care, community health and social care with rapid interventions. Its focus is: ‘Why not home: why not today?’ As a result they are avoiding unnecessary hospital admissions or getting people home from hospital quicker. This work has radically changed the culture and ethos of the local system.
Rochdale’s intermediate tier service provides intensive support – at home and in community beds – to people who are at risk of an emergency hospital admission, who need extra support on discharge from hospital or who need extra support to retain independence. It has reduced the number of emergency hospital admissions and helped keep people independent. It is delivered by a partnership between the NHS, Rochdale MBC, the third sector and carers, and supports about 2,000 people per year.
Rutland CC shares the growing national challenge of delivering sustainable, high-quality adult social care services to an ageing population with restricted budgets. It developed social care services using system leadership approaches, with safeguarding, prevention and personalisation at the heart. The aim is to empower people to retain choice and control, enabling them to live healthier, more active lives in their communities, maximising their wellbeing and independence, and preventing and postponing the need for care. Rutland restructured adult services into three multidisciplinary services, each of which connects with a wider set of partners and services, creating an integrated system.
Tower Hamlets LBC
Tower Hamlets LBC and Tower Hamlets Clinical Commissioning Group jointly developed the Tower Hamlets Mental Health Accommodation Strategy and adopted it in 2011. The strategy outlines plans for developing supported accommodation and residential care for people with mental health problems. It sets out plans to remodel the existing in-borough mental health supported accommodation schemes to provide support and rehabilitative accommodation as a viable alternative to residential care. The strategy focuses on the principle that service users should be supported in the most independent setting, as close as possible to their home and community.
Worcestershire’s patient flow centre has successfully provided a link between the Worcestershire Acute Hospitals NHS Trust, Worcestershire Health and Care Trust, Worcestershire Clinical Commissioning Group and Worcestershire CC to deal with capacity and demand issues. The centre, staffed by triage nurses, social workers and admin staff, collates all information about service capacity across the local health and social care system. Discharge referrals are triaged by the clinical team and the needs of each individual matched with the most appropriate discharge pathway, with a focus on discharges to the home.
Steven Mason, chief executive, Northumberland CC
Ray James, director of health, housing and adult social care, Enfield LBC
Philip Simpkins, chief executive, Bedford BC