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East North Herts Vanguard Compex Care Premium Webinar 12th October

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A copy of the 12th October WebEx which explained how the East & North Hertfordshire Care Homes vanguard is rolling out care home worker training across 92 care homes

This presentation covers:
• The Complex Care Premium, that serves to develop confidence and capability in care home staff to improve quality of care & reduce hospital activity across the system
• How the training for care home champions was developed and implemented
• Exactly what the Complex Care Premium is
• Prerequisites prior to roll out
• How it is being evaluated & impact to date

Published in: Healthcare
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East North Herts Vanguard Compex Care Premium Webinar 12th October

  1. 1. Hertfordshire Vanguard Complex Care Premium WebEx 12th October 2016
  2. 2. Michelle Airey, Recruitment and Integration Manager HCPA Paul Fenton – Programme Manager – vanguard CCG The presenters
  3. 3. Structure • The WebEx has 3 parts, including some polls and videos. Questions • Please post any questions in the Chat room through the WebEx • Between each part, we will go through the questions posed in the Chat room Afterwards • This WebEx is being recorded and will be uploaded onto YouTube • Slides will be uploaded onto Slideshare • An Evaluation survey will be sent out afterwards
  4. 4. Hertfordshire Development Delivery and Impact
  5. 5. Hertfordshire Development Delivery and Impact
  6. 6. 50 vanguards across the country 6 focusing on Care homes “One in six people aged 85 or over are living permanently in a Care Home. Yet data suggest that had more active health and rehabilitation support been available, some people discharged from hospital to care homes could have avoided permanent admission.” NHS Five year Forward View, October 2014  August 2015 = Won the bid to become a vanguard site
  7. 7. Enhanced GP care Supportive technology Care Home pharmacist Care Home Trusted Assessor Skilled Care Home staff Confident Staff Upskilling staff to feel more confident about supporting residents’ health & wellbeing Multidisciplinary Teams Support & advice from pharmacists, dieticians, geriatricians, mental health professional, doctors, therapists & nurses Rapid Response A range of services including a frailty vehicle delivering expert care, supported by tams of healthcare professionals, doctors and nurses Effective Technology GP access to patient information when they visit them in their care homes and data analysis Community linked geriatric team End of Life care Wrap around services
  8. 8. Time ScaleofIntegration 2004 2016 East and North Hertfordshire Journey Wheelchairs Mental Health DTOC fines pooled Better Care Fund Vanguard / Service Integration STP
  9. 9. QUALITY Unique Partnership Arrangement Memorandum of understanding Pick and mix options Strategic Alliances Negotiation for Outcomes
  10. 10. Raise standards of quality by sharing best practice NETWORK EVENTS WORKFORCE DEVELOPMENTMEMBERSHIP INFORMATION ADVICE & SUPPORT
  11. 11. Poll - Integration in locality between LA & CCG Rating Financial Projects Monitoring Commissioning Fully integrated Partially integrated Not at all Unsure
  12. 12. Hertfordshire Development Delivery and Impact
  13. 13. What is an advanced Pathway?
  14. 14. Champion Expectations
  15. 15. Enhanced GP care Supportive technology Care Home pharmacist Care Home Trusted Assessor Skilled Care Home staff Confident Staff Upskilling staff to feel more confident about supporting residents’ health & wellbeing Multidisciplinary Teams Support & advice from pharmacists, dieticians, geriatricians, mental health professional, doctors, therapists & nurses Rapid Response A range of services including a frailty vehicle delivering expert care, supported by tams of healthcare professionals, doctors and nurses Effective Technology GP access to patient information when they visit them in their care homes and data analysis Community linked geriatric team End of Life care Wrap around services
  16. 16. The Project The Problem Mandate Project Team Analysis Development Engagement Delivery Support Evaluation
  17. 17. Problem • Staff Pressure • Unplanned admissions • Transfer Delays • Poor Outcomes Mandate What can we deliver in Hertfordshire to reduce use of services, bridge the gap in funding between regular funding and CHC and keep residents in their home?
  18. 18. Building a Project Team Project manager Commissioning from Local Authority Integration Manager across LA and CCG Contracts Manager LA Quality Lead- CCG Providers Association
  19. 19. Analysis Collect baseline data Review baseline data What is a complex patient? 1. Dementia 2. Falls Prevention 3. Nutrition 4. Wound Management 5. Health Care - End of Life, Continence, Neurological and Respiratory
  20. 20. Development Timeline Characteristics Develop training Develop Job descriptions Develop exercise Programme Develop finances
  21. 21. Contracts and Payments Contract Training Payment Claiming Criteria Payment Schedule
  22. 22. Monitoring Admission HCS Quality CCG QualityPerformance Improvement
  23. 23. Poll - Localisation of Champions Please pick three champions from the list below, that you would consider the most necessary champions for your locality? •Activities and Wellbeing •Continence and Stoma •Dementia •Diabetes •End Of life Care •Falls •Medication •Neurological •Nutrition •Respiratory •Stroke •Wound Management
  24. 24. Hertfordshire Development Delivery and Impact
  25. 25. 2014 2017Dec 2015 Jun Sep Dec 2016 Jun Sep Dec Start engaging Training providers Start engaging Care Homes Sign up interested Care Homes Start reviewing & approving interested Care Homes Start Care Home contract amendments Premium starts to be paid Team meetings start Start internal training & mentoring Final Evaluation starts Pre Evaluation Training Post Evaluation Support visits Beyond the Armchair Engagement & mentoring Delivery and Engagement Timeline
  26. 26. 0 10 20 30 40 50 60 70 80 90 100 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 FallsRisk(%) CCP Home ID Average Falls Risk (Above 50% Attendance) Average Pre Score Average End Score
  27. 27. Internal Evaluation Impartial Feedback Service Pre and Post Course questionnaires Impact evaluation for each pathway Beyond the Armchair Exercise Behaviour Assessments Engagement Case Studies External Evaluation MedeAnalytics LSE
  28. 28. 90 91 92 93 94 95 96 97 98 99 100 Safe Responsive Caring Effective Well Led Example CCP Home KLOE's PERCENTAGE SATISFACTION GRAPH Satisfied April 2015 Satisfied April 2016
  29. 29. Champions Trained 126 champions trained Since April 2015… 22% care homes received training Complex Care Premium (CCP) Wave 1 Complex Care Premium (CCP) Wave 2 Key: 21 Health champions 21 Dementia champions 21 Wound champions 21 Nutrition champions 21 Falls champions 21 Engagement champions
  30. 30. Complex Care Framework Outcomes “This programme has enabled all of our staff to gain confidence and knowledge of our clients needs, improving our care standards, resulting in a reduction of ambulance call outs, A&E visits and admissions.” Mihir Shah, Burleigh House Residential Home
  31. 31. If we consider total A&E attendances per 100 resident population, and perform confidence interval tests, there seems to be some meaningful difference (1 s.d.) between our Wave 1 care homes and those that didn’t receive the training at October 2015 when the training completed. Training started Training finished A&E attendances per 100 Care Home population
  32. 32. Community Contacts Training • The wave 1 residents show a higher rate of community contacts than the non-wave residents. • The rate of community contacts has significantly increased since the training commenced to it’s highest level in Oct 2015.
  33. 33. Emergency Inpatient Admission Length of Stay Training • This indicator describes how many days on average were spent in hospital as an emergency admission by care home residents who were still in residency. • Following training, wave 1 residents spent less time in hospital than the non-wave residents. • Consistent with the fall in rate of admissions during this period.
  34. 34. Mental Health Admissions Training • Following the completion of the training, none of the wave 1 residents were admitted to a mental health provider. (From December onwards).
  35. 35. Lessons learnt Engagement Managers support Spread out training Ongoing support Levels of learning Volume of coursework
  36. 36. Building Blocks- Summary
  37. 37. Summary The Problem Mandate Project Team Analysis Development Engagement Delivery Support Evaluation The Problem Mandate Project Team Analysis Development Engagement Delivery Support Evaluation
  38. 38. Complex Care Framework training model 41
  39. 39. Questions?
  40. 40. Closing Thank you for your time today. Just one more thing… If you could complete the following short survey Add weblink
  41. 41. Find out more… Visit our website: www.enhertsvanguard.uk Follow us @... This WebEx will be published on… This slide deck will be shared on…

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