Design Framework for Integrated Care
The council and its partners have ensured a system that focuses on people at risk of losing their independence and declining health. Haringey’s Design Framework for Integrated Care has produced significant improvements in the effectiveness of operations, improving residents’ health and wellbeing and a transformed reablement services now responds within 24 hours of a resident’s discharge from hospital. In 2016-17, there were 849 residents who benefited from a reablement intervention, compared with only 459 the previous year. It facilitated, on average, 10 discharges a week since March 2017 to date, reducing the time residents spend in hospital and saving two to three bed days each time.
Hull City Council
Integrated Health and Care
Hull is the UK’s third most deprived city and is predicted to see a 17% increase in the elderly population by 2030. Life expectancy is lower than average and the incidence of long-term conditions is high. People tend to seek support late in their disease progression, resulting in a reliance on secondary care services and a need to raise health expectations and support self-care. Residents said they would rather stay in their homes and have care and support that encourages self-resilience and independence. The council and its partners have agreed joint health and social care objectives to encourage this approach and sustain services for the future.
Kensington & Chelsea RBC, Hammersmith & Fulham LBC, Westminster City Council and Central & North West London NHS Foundation Trust
Community Independence Service
Covering three boroughs and three acute hospital sites, the service receives 1,000 referrals a month. In the past five months it has avoided 987 admissions, meeting a Better Care Fund target, and 65% of residents who pass through the reablement service attain complete independence afterwards. The service offers a community-based rapid nursing and therapy service providing assistance within two hours to avoid A&E admissions and rehabilitation and reablement to give residents maximum ability to remain in their own homes. It has seen a 96% satisfaction rate and its work has cut adult social care expenditure through greater use of reablement.
Changing Health and Social Care in Tandridge
Although a district, Tandridge resolved to take a leadership role in health and social care, with a ‘customer first’ approach joining the dots between local health care and private and voluntary sector providers. It offers an identification and referral service to improve safety and support for victims of domestic abuse, which teaches professionals how to effectively identify and support any individual suffering from abuse. Tandridge’s Wellbeing Prescription is a free service to residents who have a need which is not medical and instead focuses on their health and wellbeing. Such is the demand, there is an eight week waiting list and funding partners have offered enhanced financial support.
Torbay and South Devon FT & Torbay Council
Torbay and South Devon FT and Torbay Council
In October 2015, the coming together of acute and community health and social care services in Torbay resulted in an integrated care organisation that has listened to feedback from local people about how they want to experience health and social care services. The organisation is improving people’s experience by providing care that feels co-ordinated and person-centred and gives users more say in decisions and supports them to manage their health and wellbeing. More than £200,000 has been invested in voluntary sector wellbeing co-ordinators in every locality, and the intermediate care team has expanded by 60 staff, helping more people to stay at home.
Tower Hamlets LBC
Tabard Court Forensic Service
Tabard Court Forensic Service is a specialist supported housing project that helps service users to safely move from secure forensic psychiatric and residential services to independent community living. Tower Hamlets had a fragmented, costly forensic mental health pathway, prone to blockages, which was damaging to individual recovery and poor value. Tabard Court Forensic has created a safe, consistent and continuous pathway to recovery by providing intensive accommodation-based support to 19 men aged 18-74, with mental health challenges. It has successfully reduced out-of-borough placements, length of stay in secure mental health services and promoted community reintegration of service users.
Vale of Glamorgan Council
Increased pressures on health and social care services has resulted in Vale of Glamorgan Council and Cardiff & Vale Health Board taking a joint, whole-system approach to reablement and encouraging elderly and infirm people to be independent. The launch of The Bay reablement unit in November 2015 provides a tailored package of support for those whose requirements fall in the grey area of hospital and home care. The Bay helps people to avoid unnecessary hospital appointments and provides a bridge between hospital discharge and home for those who require additional time in a supportive environment. Basing care on need rather than location has yielded annual savings of some £500,000.
Wakefield and its NHS partners sought to reduce the length of hospital stays with timely support for people to return to their own home and regain skills they had lost. An improved community reablement service has been created and has proven a vital component in improving quality of life, and reducing the need for care and support services. There were 1,047 individuals referred to the reablement team from September 2016 to August 2017, 42% of whom were fully reabled and required no further social care services. The 341 people who needed further support required fewer visits towards the end of their care packages.
A word from the award’s sponor
iMPOWER is proud to be the sponsor of the 2018 LGC award for Health and Social Care. The interface where these sectors meet is rightly a national priority, and the awards provide a valuable opportunity to highlight the most innovative and effective work being undertaken to improve outcomes for local citizens. While we wait for the latest green paper, it is inspiring to see so many in the sector seizing the initiative and pushing ahead with improvements within their communities.
Helen Briggs, chief executive, Rutland CC
Vanessa Reeve, assistant director, iMPOWER
Steve Rumbelow, chief executive, Rochdale BC
Rob Tinlin, non-executive director, NHS Digital