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  • 1. Improving Outcomes and Improving Efficiency 25 January 2011 - London Total Place Project – Older People Andrew Archibald – Dorset County Council
  • 2. The vision A shared commitment to improving outcomes for older people at less cost by… ...reshaping secondary care and community services, a sustained investment in well being and prevention and more integrated commissioning and provision A brave step to deliver a shock to the system
  • 3. Implementing the vision A – (B+C) = Y A is the saving, by reducing the number of people avoidably receiving secondary care or long term residential care; B is the cost of meeting needs in alternative ways; C is cost of increased provision in well-being and early intervention; and Y is the reduction in overall expenditure.
  • 4. Diversion from “acute” care A – (B+C) = Y Reduction in unplanned admissions in acute care – 15% > 65 (£18m) Reduction in care home admissions
  • 5. Community services A – ( B +C) = Y Alternatives to Hospital Care - Care Closer to Home
      • Rapid / crisis response
      • Reablement / Rehabilitation
      • Clinical triage
      • End of Life Care
      • Case finding and management
      • Expanded role of GP’s – “GP’s as providers as well as referrers”
      • Falls prevention and management
      • Direct access Community Hospital beds
      • Telecare / telehealth
      • Extra care housing and other options
      • Intravenous therapies
      • Virtual Wards
  • 6. Long term policy
    • A – (B+ C ) = Y
    • Ageing Well
    • Three building blocks;
      • Information, advice and support;
      • Community Development;
      • Neighbourhood / Locality working.
  • 7. Long term policy
      • Exploration of personalised commissioning and integrated personal budgets;
      • Policy decisions not to fund long term care home placements alongside a comprehensive set of services such as reablement and carers support;
      • Need for more radical approaches to collaboration eg. shared housing, family placements, neighbourhood and community care;
      • Ideas sit in the context of current policy development.
    • We still need a shock to the system
  • 8. Developments In Dorset
  • 9. What will assist us to work in new ways?
      • Reduction of bureaucracy and processes
      • Streamlining of management structures and greater authority to act
      • Integrated computer system
      • Redefining of management and practitioner responsibilities:
    • Budget Management & Performance
    • Professional Development
      • Workforce Development
  • 10. How will we be working in new ways?
      • Alignment …Co-location…Integration
  • 11. How will we be working in new ways?
      • Person Centred
      • Peer evaluation and audit evidence to develop practice
      • Greater responsiveness and consistency
      • Greater autonomy and accountability
      • Focus on outcomes based approach
  • 12. Contact details: [email_address]