Presentation at the Voluntary Sector Forum June 30th 2016

1. Developing a New
Way of Working
for adult health
and social care in
Kingston
Voluntary Sector Forum
30th June 2016
KCC Design Team

2. Looking at the wider picture
• NHS Five Year Forward View (2014)
This sets out how the NHS needs to change over the next five years, given the opportunities that
science and technology offers patients, carers and staff, whilst also meeting a number of new
challenges: we live longer, with complex health issues, sometimes of our own making.
It also promotes a more engaged relationship with patients, carers and citizens so that we can
promote wellbeing and prevent ill-health.
• South West London Sustainability & Transformation Plan (STP)
Developed to meet the challenges faced across South West London as well as the national
requirements set out in the Five Year Forward View. The following prioritised clinical themes have
been identified;
- Prevention and early intervention
- Right care in the best place
- Acute configuration and clinical networking
- Efficiency and working together
• Kingston & Richmond Sustainability & Transformation Sub Regional Plan
Shared transformational programmes covering Primary care, Community health, Mental Health,
Planned care and Urgent emergency care.
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3. Looking at the wider picture
• Destination Kingston 2016 – 2020
A Council vision of services publicly organised, but not necessarily publicly
delivered, and a specific focus on;
- Improved direct engagement with residents and their communities
- Benefitting from the growth of the population as well as providing the
infrastructure to support it
- Managing a reducing budget in the context of greater demands
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4. The more detailed picture
Kingston Coordinated Care
- Asking people what was working and what
wasn’t (2014)
- Initial work streams;
Integrated Customer Journey
Active and Supportive Communities
Contracts and Commissioning
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5. New Ways of
Working
Commissioning and
Contracting
Joint Commissioning
Service – Phase 2
IT / Information
Governance
Designing the operating
model – functions, roles
and Structure
Organisational
development
Deliver procurement
process
Plan Procurement
Route
Develop specification
Integrated community
health /social care
pathway including OT
Home Care
Transformation
Kingston Coordinated Care Projects and Work Streams
Active and Supportive
Communities
KCC Finance Group
Model finances for joint
commissioning
Model benefits of KCC
Develop and monitor
financial arrangements
for S75 including BCF
Design Team
Action Learning
Kingston Care Passport
Interdependencies
Monitor KCC budget
Enablers
Develop commissioning
strategy
Strengthening individual
and community
engagement
Embedding support in
universal Services
Outcomes-based
commissioning of the
VCS

6. Decision-making
Supported by Kingston test via
Commissioning Support Board
Kingston Commissioning Board
(Commissioners)
Decision–making
Supported by Delivery Group
and Finance committee
Joint Commissioning
Service (Phase 2)
Commissioning &
Contracting
New Ways of
Working
Design Team Action Learning
Communications & EngagementFinanceICTHR & Workforce
•Whole Systems Leadership
•Influence and Steer
•Unblock barriers
•KCC progress reports
Governance
Enablers
Health and Wellbeing
Board
Estates
ProgrammeDecisionsProjectImplementation
KCC Programme
Delivery Group (PDG)
(Commissioners &
Providers)
KCC Finance
RBK Strategic
Committees
Kingston CCG
Governing Body
Kingston Coordinated Care Governance
Active and
Supportive
Communities

7. Design Team focus for 2016
Informed by the discoveries in 2015
Embedding the ‘New Way of Working’
The Essentials for Customers:
 Keeping the person at the centre
 The Golden Design Principles
 Value added – does it add value?
 It’s about capabilities not ‘bodies’
or organisations
 Understand, Plan, Do with the
person
The Essentials For Staff:
 Golden Ticket/Golden Fund
 All the information in one room
 DT must represent the whole
system
Ambassadorial Role:
Sharing the DT’s observations and
learning from the new ways of working
across the whole system
Action Learning:
Deploying the new way of working
across the system, using people’s stories
Identifying challenges and opportunities:
Acting as a customer intelligence layer for the
whole system. Identifying where there are
opportunities for quick initial wins and
marginal gains
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8. Ambassadorial Role -
Getting the Message Across
Mental Health
ASC
YH
KHFT
Voluntary
G.P's
Other
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Proportion of staff numbers ‘touched’ by DT

9. Action Learning has highlighted four key
themes to date
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Understanding the
Whole Person (IT)
Readiness and Ability to
Engage
Identify the capabilities
to Plan & Do with the
person
The Golden Ticket to use
existing capabilities
across boundaries

10. Identifying Challenges & Opportunities
•
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11. Proposed Next Steps
• Continue to win ‘Hearts & Minds’ across the
community
• Share learning with new initiatives and developments
• Influence how the New Way of Working can improve
people’s access to care
– GP Practices
– Ambulance Service
– Community Access
• Communicate the New Way of Working beyond the
care system
This is a multiple year transformation programme.
Current funding for the Design Team runs out end July, so
here are some collective observations….........
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12. Design Team collective observations
There is a real opportunity to make a difference, but it
is easy to underestimate the challenges in getting
traction on all the good ideas
• The power of people’s stories
• The power of meeting people face-to-face
• The influence of organisational culture and resistance to change
– The length of time things take to change (e.g. IT & Governance)
– New ideas are easily trampled on
• The system too often requires instant answers, quick wins and
ready made solutions
• Many small marginal gains will generate significant savings
People on the ground are really ‘up’ for this, but is the
system ready for change?
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