Changing the Practice Landscape. The Care Act: Implications for Practice. Glen Mason: The Care Act Delivery and Expectation.

1. The Care Act: Delivery and Expectation
21st November 2014
Glen Mason
Director of People, Communities and
Local Government
Department of Health
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DH – Leading the nation’s health
and care

2. Care and Support affect a large number of people
Many people need some extra care and support during their adult years to lead an active
and independent life. Three-quarters of people aged 65 will need care and support in
their later years…
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Who needs care? At age 65, what are your chances of
needing different types of care within your lifetime?
19 per cent of men and 34
per cent of women will
need residential care
48 per cent of men and 51
per cent of women will
need domiciliary care only
33 per cent of men and 15
per cent of women will
never need formal care
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3. 3
Drivers for Change in the English Care System
• Demographic pressure
• Unprecedented financial challenges
• Raising expectations
• Technological Change
• Systems failure eg: Mid Staffs Hospital and Winterbourne View
• A drive to integrate services
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4. 4
The Care and Support Act – our vision
We will change care and support in two fundamental ways:
1. The focus of care and support will be to promote people’s
independence, connections and wellbeing by enabling them to
prevent and postpone the need for care and support.
2. We will transform people’s experience of care and support, putting
them in control and ensuring that services respond to what they
want.
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A shift in the care and support system
From To
Repair
Focusing only on response after a crisis
Prevention
Acting earlier to prevent or delay needs
Fragmentation
Isolated services focused internally
Integration
Joined-up services working as partners
Paternal
State knows best
Personal
Person knows best
Exclusive
“Doing to”
Inclusive
“Doing with”
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6. Choice, control and quality
People have
clear
information
to make good
choices
about care
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People can choose
between a range of
high quality options,
or create their own
People
develop their
own care and
support plan
People’s
views are
heard and
help improve
services
People are in
control of
their own
budget
In the new, person-centred system...
i

7. 7
The Care Act is built around people
• People’s well-being will be at the heart of every
decision
• Carers rights on the same footing as those they care for
• Freedom and flexibility to encourage innovation and
integration
• Preventing and delaying needs for care and support
• Personal budgets giving people greater control over
their care
• Information and advice about the care and support
system
• New guarantees to ensure continuity of care
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8. 8
The Care Act is built around people
• Promoting the diversity and quality of the local care
market, shaping care and support around what people
want
• Ensure that no one goes without care if their
providers fails
• Puts adult safeguarding on a statutory footing for the
first time
• Young adults receive care and support during
transition
• Reforms what and how people pay for their care and
support
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Implementing the reforms: challenges ahead
• Funding: Estimates of additional costs arising from the reforms, and
sufficiency of baseline funding for social care.
• Links to Better Care Fund and integration which are a key part of delivery of
social care reform.
• Local authority readiness: Scale and complexity of the task facing local
authorities and the demands on capacity, and competition for attention.
• Need to maintain engagement in key areas of policy, regulation and guidance,
and consider further support needs for implementation.
• Communications challenge to ensure public awareness and local readiness
for reforms.
• IT – meeting the requirements of the Act but also the future challenge of
integration, shared records and customer access.
• Workforce – developing the skills, ensuring capacity, at the pace required to
meet local needs and respond to local challenges.
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10. Implementing the reforms: support offer
Financial clarity on the costs of the reforms
1. Work is jointly underway to better understand both the short and long term costs
2. Includes provision of models to use in financial planning, FAQs, and advice notes
3. Additional support and guidance has been provided to councils within each region
Information and tools to support planning for implementation
1. Major sets of information have been made available (e.g. draft regulations and guidance) or are
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about to be made available (e.g. timescales for the public awareness campaign and its resources
for local communication teams)
2. L&D resources and final versions of capacity planning tools will be published immediately
following the publication of regulations and guidance in mid-October
3. A range of products requirements identified by ADASS & DH policy leads to be available over
autumn and details for each product are being communicated to the sector
4. Additional support needs identified in Sep / Jan national stocktakes of readiness
Change capacity management
• £19m direct to authorities and £2.7m to establish 9 regional delivery partnerships for Care Act
implementation and BCF
• Exploring additional support at a regional level to address local capacity needs in relation to
L&D of the workforce
• Work planned to examine how best to manage the national asks of programmes such as Care
Act and BCF

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The Better Care Fund
Benefits of integrated care
Coordinated approach
Better use of resources
Organised around users
Services 7 days a week
Bring skills together around the user
Reduction in need to go to hospital
Better outcomes for users

12. 12
What is Government doing to support this?
The Better
Care Fund
June 2013
announcement:
£3.8bn to be
deployed locally in
2015/2016 on health
and social care
through pooled
June 2013
announcement:
£3.8bn to be
deployed locally in
2015/2016 on health
and social care
through pooled
budget
budget
arrangements
arrangements
Local authorities
and NHS Clinical
Commissioning
Groups must
agree a joint plan
to deliver better,
person-centred
care before
receiving funding
Local authorities
and NHS Clinical
Commissioning
Groups must
agree a joint plan
to deliver better,
person-centred
care before
receiving funding
Part of the £3.8bn
allocated to local
authorities includes
a payment for
Part of the £3.8bn
allocated to local
authorities includes
a payment for
performance
element to
performance
element to
incentivise ambition
and real change
incentivise ambition
and real change
Autumn
Statement
Autumn
Statement
December 2013:
Pooled budgets
December 2013:
Pooled budgets
will be an
will be an
enduring part of
framework in
future years
enduring part of
framework in
future years
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The Better Care Fund (BCF) narrative
The Better Care Fund (BCF) will accelerate the local integration of health and care services to
deliver better outcomes for people
NHS and social
care services are
now caring for
people with
increasingly
complex needs
and multiple
conditions.
There is consensus
that to respond to
this care should be
organised around
the person who
needs it, and that
person’s care team
should work
together to keep
them better for
longer.
DH – Leading the nation’s health and care
The Better Care
Fund is one of the
most concrete
steps ever towards
making this
change happen
everywhere. This
is the start and
pooled budgets
are here to stay.
Areas put in draft
plans in April, and
local areas are
now revisiting
these to make sure
they are as clear
and strong as
possible to kick
start the change
we need from next
April.
As ever with
system
transformation –
success depends
on the people
who are leading
it to make it
happen locally –
people taking bold
steps to move
away from their old
ways
The BCF has
accelerated and
made happen
conversations
that have never
happened before
about joint working
across agencies.
Now we want this
to happen
everywhere and
we are
committed to
support local
areas to achieve
this. Local areas
teams and local
government
regions will have a
crucial part to play.
It is challenging,
and will
undoubtedly get
harder before it
gets easier – but
we have seen in
small pockets the
immense value of
the prize for
patients, users,
families, carers
and staff.

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The Better Care Fund
Examples of where it’s happening
Greenwich – avoided 2000 patient admissions with a joint
emergency team
South Devon & Torbay – reduced physio waiting times from
8 weeks to 48 hours by bringing professionals together
Northamptonshire - targets have been exceeded by 14% on
preventing emergency inpatient admissions- targets on
preventing excess bed days exceeded by 4%
Tri-borough in London have produced new joint model to
help people manage chronic conditions
In Greater Manchester 10 local authorities and 12 CCGs
have joined forces to support a large scale reconfirguation
of hospital services

15. 15 DH – Leading the nation’s health and care

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Thank you and any questions?
Glen Mason
Director of People Communities and local Government
Department of Health
DH – Leading the nation’s health and care