Better Care update note from Anthony Kealy, Programme Director

11 December 2015
 

In this week’s note:  

  • Sign up for a webinar on information sharing to support integrated care
  • Request for examples of integrated care to share
  • Amended Section 75 regulations
  • Insight visits to Southampton and Sheffield
 

Sign up for webinar: information sharing to support integrated care
If you work as an integrated care programme lead, or lead on information governance or information sharing, you are invited to join an introductory webinar organised by the Better Care Fund support team, on Thursday 17 December from 10:00-11:30. This webinar will provide an overview of the new guidance and support available around the sharing of information to support integrated care.

The webinar will provide an overview of the new guidance and support available to local areas sharing information to support integrated care. It will:
  • Provide an overview of a new Information Sharing User Framework and resources developed through the Pioneer programme to provide guidance on information sharing for different aspects of integrated care
  • Introduce local areas to some of the key organisations supporting improved practices in relation to information sharing in integrated care (including the Local Government Association, Information Governance Alliance, the Better Care Support Team and the Centre of Excellence for Information Sharing)
  • Provide details of planned regional events in 2016 focusing on information sharing to support integrated care.
Sign up for the webinar here: https://attendee.gotowebinar.com/register/6965625335776860674
 

if you have any questions about the webinar or workshops please do not hesitate to get in touch with Emma Barugh (Project Manager) at emmabarugh@nhs.net

 

Request for examples of integrated care
Local areas tell us that they welcome opportunities to learn from how each other are implementing integrated care. The regional ‘Sharing and Learning’ events that Primary Care Commissioning (PCC) are running on behalf of the Better Care Support Team are an excellent opportunity to do that.

To help make these as useful as possible for each region, we would welcome any examples from local areas about any actions, programmes or schemes they’ve put in place that are making an impact at a local level.
 

Let us know about your successes – as well as any challenges you’ve overcome – so that we can help you learn from each other. Contact us at england.bettercaresupport@nhs.net or tell PCC directly at sean.fenelon@pcc.nhs.uk or charlotte.goodson@pcc.nhs.uk

 

Amended Section 75 regulations
The NHS Bodies and Local Authorities Partnership Arrangement Regulations underpin Section 75 arrangements of the NHS Act 2006. They set out which bodies can enter into partnership arrangements for health functions. In the last Parliament, the government consulted on the proposal to amend the regulations to allow CCGs and/or local authorities to pool budgets with NHS England to enable a wider and more integrated set of services to be commissioned from GP practices under a common set of contractual arrangements.

Generally responses to the proposal were positive as general practice has a significant role to play in the delivery of integrated care and many respondents felt that this was in keeping with the general direction of travel. The government therefore decided to make the amended regulations in Parliament and they will come into effect on 1st April 2016. The regulations can be found here and further details on the analysis of the views of consultees and the government response can be found at by clicking on this link.
 

It should be noted that the change is permissive: areas can, but will not be expected to make use of this new flexibility.  Furthermore, overall accountability for the provision of core GP services will still be held by NHS England. The regulations stipulate that these partnership arrangements can only be used where they are likely to lead to an improvement in the exercise of the health function. To make use of this change, the regulations state that the partners would need to jointly consult those who would be affected.

The amended regulations also make two further changes:
  • In situations where CCGs and local authorities are required by legislation to enter into some form of partnership arrangement that they should no longer have to consult beforehand.  In short because this is burdensome and unnecessary, however, this does not extend to the situation outlined above where partners might voluntarily pool budgets for additional primary medical services.
  • The amended regulations take into account the abolition of the Audit Commission.
 

Update on Better Care Insight Visits: Luton and the Wirral
In the last week, the Better Care Support Team has Southampton and Sheffield as part of our Insight Visits programme. The Insight Visits are an opportunity for the national team to understand what local areas are doing well with regards to integrated care, and what national and regional support would be helpful to address their challenges.

 

Southampton visit
Last week we visited Southampton, where we were given the opportunity to attend a local stakeholder event focusing on the progress of the BCF and integrated care agenda in the last 18 months.

Local partners made use of the Better Care Planning and Evaluation Self-assessment Tool to engage a wide range of partners on the day, which included the local police, fire and voluntary services. The diverse turnout is testament to the high level of buy-in locally to Better Care as a crucial vehicle to improve public services in the city. Southampton are one of the highest pooling areas in the country, and it’s clear that local political leadership has played a significant role in galvanising support for the programme.
 

After the stakeholder event, we caught up with some of the senior HWB leads within Southampton.

The local integrated model in the city is based around cluster teams linked to GP practices, serving populations of 30-50,000.
 

We were particularly interested to hear about the success Southampton are finding with reducing DTOC rates – they attribute their significant reductions to a very effective discharge pathway that has considerable senior leadership involvement, including weekly monitoring. We also heard encouraging things about their rehab and reablement service.

Southampton are looking at a big picture when it comes to integrated services in the future, and are exploring how they can make the most of opportunities with prevention initiatives, the regional devolution bid, and using the high level of council-owned social housing as a lever for public health work. 
 

Sheffield
This week really was the week of the ‘mega poolers’ – Southampton and Sheffield are the two biggest poolers to their Better Care Fund. Sheffield have pooled a total BCF budget of £242m this year. Local clinicians, senior leaders and individual workstream leads led a series of really insightful presentations on the individual schemes underway in the city.

Sheffield is a coterminous area and has a well-developed foundation for integrated working, and local leaders have capitalised on this to develop really effective working partnerships.
 

This steady partnership has produced a really clear and well-defined programme of work, centred around:

  • Keeping people well: A really joined up approach combining community support workers, information sharing agreements with every GP practice, a central referral system, strong involvement and development of housing services, local community partnerships, and an evaluation partnership with Sheffield University.
  • Person centred care: We saw a really well developed approach to care planning, with strong GP engagement, and underpinned by use of patient activation measures.  
  • Active support and recovery: Sheffield have developed core service principles, and are pursuing the introduction of a provider alliance that will involve all the statutory bodies and the third sector.
Looking to the future, Sheffield have plans around a city regional devolution deal, and developing new models of care. Look out for some best practice examples we’ll be sharing in the near future – including a literature review that has informed their planning work, and the excellent care planning system we were shown.


This week
Our next update note will include summaries of our visits to Birmingham and Bexley. If you’d like any more information on the visits, please get in touch with Dan.Gocke@nhs.net.

Anthony Kealy signature

Anthony Kealy

Better Care Support Team Programme Director