Common themes feedback - WM Peer Challenge

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by Eddie Clarke

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Common themes feedback - WM Peer Challenge

  1. 1. Common Themes - from the mini challenges 4 April 2014 1
  2. 2. What’s Working Well? (1)  Stability in the Top Team plus link up of commissioning and operations  Sustaining financial control and performance  Using the Safeguarding and use of Resources toolkits  Integration with Public Health  Strong political leadership and support, with vision of being a commissioning Council  Creating a culture where personalisation is the norm – Making it Real focus  Community interest vehicle for DH pilot on social work  Robust provider voice 2
  3. 3. What’s Working Well? (2)  Relationships with Health and a good HWBB  Integrated community team for avoidance of hospital admissions  DToCs improving with 7 day working  All age approach to disability  Safeguarding with positive peer review and new Ind Chair  MoU on sub-regional working  Workforce Plan and MPS  Rural areas/service location  Programme management approach 3
  4. 4. What are the Key Challenges? (1)  Elected Members  Safeguarding  Commissioning Model/diversity of the market  Pace and scale of change – keeping people with us  Recruitment  Budget reductions of 8% in one year, 28%/30% over next 3 years, further £7m to find  Use of technology for advice and information 4
  5. 5. What are the Key Challenges? (2)  Adding Children’s Services into the Directorate  Poorly performing Children’s Services in People Directorates  CCG leadership not strong  Building an early help system/demand reduction  DToCs with poor acute provider  Number of younger adults in rh/nh  Imagining new models of care – not even thought of by anyone yet! 5
  6. 6. What are the Key Challenges? (3)  Performance dreadful – data?  Need a more active voluntary and private provider sector  Large number of self funders  Care Bill implementation 6
  7. 7. What are the Main Areas for Improvement? (1)  Safeguarding – reassurance that systems and records are in place  Care Bill – market development  Corporate change programme  Integration with the NHS  Driving out/down costs  Financial audit of DPs – not all the money has been needed  Referrals not high but complexity is 7
  8. 8. What are the Main Areas for Improvement? (2)  CHC reduction of £25m to £10m with costs transferred  Joining up the commissioning vision with CCGs  Delivering alternatives to rh/nh care when having to make significant savings  Modernising in-house services  Quality of care homes for younger adults – need to stimulate the market  Personalisation has stalled  Need “doing” plans, not strategies 8
  9. 9. What are the Main Areas for Improvement? (3)  Risk averse social work model  Support for Carers and new model  MH Social Workers being brought back into the Council  Telecare  Market shaping re housing market  Developing an evidence base of what works eg reablement  Community asset building 9
  10. 10. What has been the Progress on the BCF? (1)  Related to QIPP with NHS providers receiving no growth – created a NHS cash pot for the BCF  Some money secured for implementing the Care Bill, but not demographics  Focus on whole system re-design and whole system events  4 workstreams: MH, Dementia, Reablement, and reducing hospital and care home admissions  BCF instead of £2m Council growth 10
  11. 11. What has been the Progress on the BCF? (2)  7% reduction in delayed bed days  Tensions between CCGs when across LA border  MH and LD commissioning  Issue of targets – no evidence they are deliverable  Happy with BCF outcome  Agreed to develop a risk sharing protocol 11
  12. 12. What Would Assist you to Move Forward?  Political appetite and leadership development  Sharing of Care Bill planning  Sharing of BCF plans  Joint work with neighbouring Councils on reducing care home numbers for younger adults, and improving quality  Pooled approach to high cost expenditure placements  Learning from areas that have come out of health integration  Work on Social work culture change  Work on Advice and Information development 12

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