Health and care
Health and care
One Croydon Alliance
The One Croydon Alliance comprises health, mental health, social care and voluntary organisations that have committed to improving the sustainability and quality of health and care services through integration. The alliance has already proven successful in integrating health and care services through implementation of the Living Independently for Everyone and integrated community network services. A return on investment review and service user feedback shows this.
Glasgow City Health and Social Care Partnership
Glasgow City Council has a statutory duty to assess people who present as homeless, or at risk of being homeless, and to provide ongoing support to people with highly complex and often challenging needs and behavioural profiles in similar circumstances. Through a collaboration with several stakeholders, Glasgow City Health and Care Partnership has adapted a Housing First model to respond more effectively and sensitively to homelessness issues in the city. It means rapidly rehousing people who are excluded from their community as a first, rather than last step. It is simple but radical, fundamentally challenging established practice.
Isle of Wight Council
Care Close to Home
The implementation of Care Close to Home has had a remarkable impact since April 2017. The area has seen a 48% reduction in permanent admissions into residential care for elders, a 50% reduction in delayed transfers of care, financial balance and the delivery of more than 10% savings to date, and transformed staff morale and motivation. New ways of working with health are resulting in the effective management of demand with the council’s partners in the voluntary and community sectors, providing a single integrated early help offer, while integrated locality teams support its at risk residents to stay living at home.
The Home First pathway was implemented because of increasing delayed transfers of care, attributed to the need for social care. This was causing not only delays in getting people out of hospital but also resulting in people not having access to the best outcomes and most appropriate care. Since the introduction of Home First, which has moved the functional assessment from the hospital setting to the person’s home, the council has seen a marked improvement in transfers, better outcomes for patients, an integrated way of working across health and social care, and vastly improved staff morale.
Widening support to carers
Carer crisis or tipping point were the most frequent reasons for a referral to the Lincolnshire Carers Service, requiring costlier and emergency support to both the carer and person cared for. This left carers unsupported, with worse outcomes socially and health wise prior to this point. Carers services can make the most difference to carer wellbeing and resilience the earlier they are involved. Using the improved better care fund, commissioners aimed to transform support to carers by improving early identification and early help, in collaboration with the charity Carers First, the local hospital trust leadership and other health providers.
Home Safe is a joint service between Northumberland CC and Northumbria Healthcare NHS Foundation Trust that brings together council social care staff and healthcare professionals, working with staff and volunteers from the British Red Cross as an integrated team at Northumbria’s specialist emergency care hospital. The aim is to combine expertise from each discipline to remove any organisational barriers leading to delayed transfers of care. The philosophy is to provide a seamless person-centred service that takes advantage of opportunities to innovate care delivery so people receive the right care from the right person in the right place.
Two Carers in a Car
The cost of delivering care throughout the night is one of the more expensive elements of adult social care. Shropshire Council has developed a bespoke night-time support service, Two Carers in a Car, to meet the challenge. It is a simple idea: two carers provide a flexible and responsive service to meet the needs of service users at night at less than a third of the cost of the previous service. The council has created a solution that gives the right support, at the right time. It does not create overdependence and it costs less money.
St Helens Council
St Helens Cares
St Helens Council is taking an innovative, place-based approach to addressing the challenge of cost and demand in its health and social care services. The St Helens Cares programme is a locally driven model that is imaginative and innovative, taking a whole community collaborative approach with local democratic stewardship through the people’s board. It is potentially of national significance, delivering real benefits to residents at the same time as achieving more efficient use of resources.
Integrated discharge and reablement
The integrated discharge planning and reablement places patients at the centre of what the council does, based on the vision that older people are best supported at home wherever possible. This minimises the time they spend in hospital and enables then to regain skills as quickly as possible. As a result, savings of £1.8m to £2.3m will be made, while delayed discharges have fallen by half. Care at home is now the default option for the NHS and social care. The council’s lessons inform models across the sustainability and transformation partnership and other local authorities developing reablement.
Lyn Carpenter, chief executive, Thurrock Council
Simon Edwards, director, County Councils Network
Sharon Kemp, chief executive, Rotherham MBC
Carole Mills, chief executive, Derby City Council