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Andrew Archibald presentation


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Andrew Archibald presentation

  1. 1. Improving Outcomes and Improving Efficiency 25 January 2011 - London Total Place Project – Older People Andrew Archibald – Dorset County Council
  2. 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. 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. 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. 5. Community services A – ( B +C) = Y Alternatives to Hospital Care - Care Closer to Home <ul><ul><li>Rapid / crisis response </li></ul></ul><ul><ul><li>Reablement / Rehabilitation </li></ul></ul><ul><ul><li>Clinical triage </li></ul></ul><ul><ul><li>End of Life Care </li></ul></ul><ul><ul><li>Case finding and management </li></ul></ul><ul><ul><li>Expanded role of GP’s – “GP’s as providers as well as referrers” </li></ul></ul><ul><ul><li>Falls prevention and management </li></ul></ul><ul><ul><li>Direct access Community Hospital beds </li></ul></ul><ul><ul><li>Telecare / telehealth </li></ul></ul><ul><ul><li>Extra care housing and other options </li></ul></ul><ul><ul><li>Intravenous therapies </li></ul></ul><ul><ul><li>Virtual Wards </li></ul></ul>
  6. 6. Long term policy <ul><li>A – (B+ C ) = Y </li></ul><ul><li>Ageing Well </li></ul><ul><li>Three building blocks; </li></ul><ul><ul><li>Information, advice and support; </li></ul></ul><ul><ul><li>Community Development; </li></ul></ul><ul><ul><li>Neighbourhood / Locality working. </li></ul></ul>
  7. 7. Long term policy <ul><ul><li>Exploration of personalised commissioning and integrated personal budgets; </li></ul></ul><ul><ul><li>Policy decisions not to fund long term care home placements alongside a comprehensive set of services such as reablement and carers support; </li></ul></ul><ul><ul><li>Need for more radical approaches to collaboration eg. shared housing, family placements, neighbourhood and community care; </li></ul></ul><ul><ul><li>Ideas sit in the context of current policy development. </li></ul></ul><ul><li>We still need a shock to the system </li></ul>
  8. 8. Developments In Dorset
  9. 9. What will assist us to work in new ways? <ul><ul><li>Reduction of bureaucracy and processes </li></ul></ul><ul><ul><li>Streamlining of management structures and greater authority to act </li></ul></ul><ul><ul><li>Integrated computer system </li></ul></ul><ul><ul><li>Redefining of management and practitioner responsibilities: </li></ul></ul><ul><li>Budget Management & Performance </li></ul><ul><li>Professional Development </li></ul><ul><ul><li>Workforce Development </li></ul></ul>
  10. 10. How will we be working in new ways? <ul><ul><li>Alignment …Co-location…Integration </li></ul></ul>
  11. 11. How will we be working in new ways? <ul><ul><li>Person Centred </li></ul></ul><ul><ul><li>Peer evaluation and audit evidence to develop practice </li></ul></ul><ul><ul><li>Greater responsiveness and consistency </li></ul></ul><ul><ul><li>Greater autonomy and accountability </li></ul></ul><ul><ul><li>Focus on outcomes based approach </li></ul></ul>
  12. 12. Contact details: [email_address]