Expo is the most significant annual health and social care event in the calendar, uniting more NHS and care leaders, commissioners, clinicians, voluntary sector partners, innovators and media than any other health and care event. Expo 15 returned to Manchester and was hosted once again by NHS England. Around 5000 people a day from health and care, the voluntary sector, local government, and industry joined together at Manchester Central Convention Centre for two packed days of speakers, workshops, exhibitions and professional development. This year, Expo was more relevant and engaging than ever before, happening within the first 100 days of the new Government, and almost 12 months after the publication of the NHS Five Year Forward View. It was also a great opportunity to check on and learn from the progress of Greater Manchester as the area prepares to take over a £6 billion devolved health and social care budget, pledging to integrate hospital, community, primary and social care and vastly improve health and well-being. More information is available online: www.expo.nhs.uk

1. Integrated Personal Commissioning
Ian Dodge,National Director, Commissioning Strategy, NHS England
Ray James,President,ADASS
Zoe Porter, Head of Delivery, IPC & Personal Health Budgets
Graeme Niven, Chief Finance Officer, NHS Hartlepool & Stockton CCG
Jo Fitzgerald, Director, peoplehub
JeremyTaylor, Chief Executive, National Voices

2. IPC: an overview
Zoe Porter, Head of Delivery
IPC & personal health budgets

3. Integrationand empowerment is a fundamentalresponse to future
health & social care challenges
“There is broad consensus on what the future needs to be. It is a future that
empowers patients to take much morecontrol over their own care and
treatment. It is a future that dissolves the classic divide, set almost in stone
since 1948, between family doctors and hospitals, between physical and
mental health, between health and social care, between preventionand
treatment.”
Five Year Forward View, 2014

4. Who for?
• Children and young people with complex needs, including
those eligible for education, health and care plans.
• People with multiple long-termconditions, particularly
older people with frailty.
• People with learning disabilities with high support needs,
including those who are in institutional settings or at risk of
being placed in these settings.
• People with significant mental health needs, such as those
eligible for the Care Programme Approach or those who use
high levels of unplanned care.

5. To achieve what?
• People with complex needs and their carers have better quality
of life and can achieve the outcomes that are important to them
and their families through greater involvement in their care, and
being able to design support around their needs and circumstances.
• Prevention of crises in people’s lives that lead to unplanned
hospital and institutional care by keeping them well and
supporting self-management as measured by tools such as ‘patient
activation’ – so ensuring better value for money.
• Better integration and quality of care, including better user and
family experience of care.

6. The core elements of IPC

7. The IPC sites
• Barnsley
• Cheshire W & Chester
• Luton
• Hampshire
• Portsmouth
• South West
• Stockton-on-Tees
• Tower Hamlets
• Lincolnshire

8. IPC demonstrator sites

9. Key programme enablers:
critical questions and components of delivery support

10. National outputs of the IPC delivery support
programme
• Standard replicable models on key components of Integrated Personal
Commissioning
• Broader expertise on the active ingredients necessary for local and national
success
• Evidence of impact through a robust national evaluation
• A cohort of leaders from across the system who can share and influence
• Stories that clearly show the benefits and what can be achieved told by people
and the professionals that support them
• Clearly identified policy and legislative issues being addressed
• A delivery programme to support roll out

11. ‘We stand on the cusp of a revolution in the role that patients – and
also communities – will play in their own health and care.
Harnessing…this renewableenergyis potentiallythe make it or
break-itdifference between the NHS being sustainableor not.’
Simon Stevens

12. Mitchell’s story
2008-2015
Jo Fitzgerald,peoplehub Director

13. Personal health budget milestones

14. Mitchell’s personal health budget started in
September 2008
What changed?
• Designed support around Mitchell; no longer ‘one size fits all’
• Recruitedand trained our own staff team (band3/4)
• Designed a comprehensive training plan
• Greater choice, control and flexibility
• Changed relationship with health professionals

15. Mitchell transitioned to NHS Continuing Healthcare
in May 2010
• Mitchell now funded via NHS CHC
• No disruption to Mitchell’s support
• Able to retain existing arrangements and staff team

16. Mitchell’s health deteriorated in 2013
resulting in frequent ICU admissions
• Staff worked in partnership with ICU staff; learnt new skills
• Increasedconfidence and resilience
• Early discharge from ICU; discharge directly from ICU to home
• Built excellent relationships with ICU staff

17. End of life planning - 2015
• Built on relationships with ICU staff: good conversations, shareddecision-
making
• Excellent/efficient communication – e-mail link with lead ICU/respiratory
consultant
• Developed a robust emergency management plan and end of life plan
• Mitchell had a good death on 18th March, 2015

18. Integrated Personal Commissioning in
Stockton-on-Tees
Graeme Niven, Chief Finance Officer

19. Importance of co-production
Joint bid between:
• Catalyst
• Hartlepool and Stockton-on- Tees CCG
• North Tees and Hartlepool Foundation Trust
• Stockton-on-Tees Borough Council
Reinforcingexisting local partnership work

20. Our cohort
• Financial model based on people over 65 years of age with a Long Term
Condition
• Initially focus on respiratory pathways
• AGE UK Teesside coordinating community engagement
• Referrals to include ‘seldom heard’ groups, ensure we’re representative of
the whole community
• Cohort to influence a bottom up approach to developing IPC in Stockton

21. Our approach
IPC Stocktonexplaining their work to engage with participantsto
build the programmefrom the bottomup at the IPC Leadership
event 9th June 2015.

22. Here’s where it fits in
• Momentum Pathways
• Personal health budgets
• Personalisation
• Better Care Fund
• Peer Support Groups
• Foundation Trust’s year of care modelling

23. Making it happen
• Strong local Voluntary, Community & Social Enterprise Sector (VCSE)
• Development of peer support networks
• One care plan
• Non-traditional route of administering personal budgets being explored

24. Patient story
AGE UK:
• Mrs D referred into Better Health, Better Wealth
• Socially isolated
• A number of Long Term Conditions
• Finds it difficult to contact different clinicians
• Prefers direct contact with Age UK
• Unhappy with ‘prescribed’ care plan
• Now in receipt of a PHB
• Combining health and social care budgets would overcome her
current concerns, giving her choice and control over her care
package and one point of contact.

25. Next steps
• Information Governance-explicit consent
• Linked data sets
• Financial model will aid conversations
• Utilise evaluation tools, e.g. Outcome Star and POET
• Market Development Session
• Inform commissioning process

26. Questions for the panel