Macclesfield 16th July

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Last Modified 15/07/2013 12:57 GMT Standard Time
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Integrating Care in Eastern Cheshire
Doc ID
Strategic Plan
Public Engagement
Event
Macclesfield, 16 July

LastModified15/07/201312:57GMTStandardTimePrinted
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1
Agenda
TimeObjective
‘10Welcome and intros
„25International case examples
„30Vision of integrated care
‟50Look and feel of integrated care
Next steps „5

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Thank you for joining us on the continuation of our journey
toward Caring Together in Eastern Cheshire
1
2
3
July - August September - DecemberJanuary - June
Objectives • Informing strategic plan
• Helping to design the
look and feel of the
integrated care model
• What is most important
to change
• Informing vision of 4
pillars
• Understanding how
care is currently
experienced
• Informing and assessing
the business case
• Providing input and
feedback on
implementation plans
Agreed
actions/
next steps
• Building the four pillar
vision
• Communicating plans
• Incorporating input into
design of integrated
care services
• Amending and improving
business case based on
feedback

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Objectives for today
Today’s session aims to:
1. Feedback what we have heard from
previous engagement events
2. Update you on where we are on the
journey toward integrated care
3. Push forward thinking on tangible
aspirations for integrated care
4. Review international best practice on what
care could be provided under integrated
care, and how it could be delivered

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Agenda
TimeObjective
„10Welcome and intros
‘30Vision of integrated care
Next steps „5

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As a reminder, there is a strong case for change for integrated
care in Eastern Cheshire
SOURCE: Caring Together PIDs; Interviews ECCCG and stakeholders; McKinsey analysis
Coping with an
ageing
population
Fragmented
services across
rural area
Severe
financial
challenges
• A population older than the England average
• The fastest growing population of over 65s
and over 85s in the North West
• A declining number of informal carers
• Dementia morbidity significantly above the
national average
• Hospitals still at the centre of much
of the health care provision
• A rural geography meaning many people struggle
to access services
• Poor infrastructure, with IT systems unable to
access single patient records
• £12-15 million per year needed for next 5 years
• £36m savings needed over next three years
• Local Authority and CCG amongst lowest
funded in country
• Acute trust needing a 6.9% CIP
• Mental health and community services in the
lowest national quartile for investment
These factors have
strongly affected your
relationship with the
health system
We are keen to address
these challenges
through Caring
Together

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What we heard on patient experience. . .
SOURCE: Participate Ltd. engagement report
“There is a lack of
integration within
organization, let alone
across organizations”
Patient
experience“I want
simple, accessible
information about my
own care, through a
single point of
contact”
“Staff are overworked and don‟t
have the time or opportunity to
develop a personal relationship
with patients”
“We want more care in
the community so that
we can keep our
independence”
“Sharing of the necessary
patient information does not
always happen because of a
lack of communication”
“We waited 2 years for
a referral to the right
specialist. I don‟t want
my son to be constantly
in hospital”

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What we heard on clinician experience. . .
“There are too many
teams and too little
information on what they
do” Clinician
experience
“Patient experience and
outcomes should be a
driving force”
“There is too much
fragmentation. We need a
better dialogue between
primary and secondary
care providers”
“Many individuals come to our
service in a crisis situation and are
already known to other services.
Sharing information and getting
support in these situations is
essential”
“We need better
communication and IT
systems that can speak to
each other”
“I do not know who I am supposed to be
talking to. It would be easier if there was
one person or one department to
handle everything involving the patient”
“There is a lack of
understanding, and
perceptions of
organizations that may
not reflect the reality,
especially about the
voluntary and
community sectors”
“Providers are willing to
co-operate, but work
pressures, poor
communication and a
lack of technology
sometimes get in the way”
SOURCE: Participate Ltd. engagement report

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Based on your input, our vision centres on four pillars
SOURCE: Caring Together: A Framework for Designing, Planning and Delivering a New Integrated Health and Social Care Model for Eastern Cheshire;
1:1 Interviews
Pillar 1: The empowered
person
• Individuals empowered
and supported to take
responsibility for and
manage their own health
• Support provided by
network of community
and voluntary providers
• Key interventions include
health prevention and
promotion, screening,
community exercise,
short term assessment
and signposting and
expert patient
• Universal and town
based (0-5 miles)
Pillar 2: Community
provided care
• Fully integrated multi-
professional team
providing community-
based care centred
around patients with a
single line of
accountability
• 24 hour care anchored in
GP practices
• Key interventions include
single assessment for
health and social care,
case management/
coordination, specialist
input and carers support
• Targeted and town
based (0-5 miles)
Pillar 3: Local specialist
care
• High quality specialised
care delivered at scale
within a reasonable
distance from people‟s
homes, including health
and social care beds
• Acute specialists and
community teams work
in partnership to address
patient needs
• Key elements include
general hospital
services, rapid discharge
team and daycase
centre
• Complex but local (15
miles)
Pillar 4: Regional
specialised care
• World class specialist
centres delivering
highest standards of
care at scale
• Highly-trained specialists
delivering complex
care, often using
advanced technologies
in regional specialist
centre
• Specialist may require
travel (up to 30 miles)
Precise interventions yet to be established/finalised – with focus on more investment in pillars 1 and 2

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Agenda
TimeObjective
’50Look and feel of integrated care
Next steps „5

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Group exercise – What does this mean to you?
Based on the areas for
improvement that you
have identified, think
about what an improve-
ment would look like in
practical terms
Write your ideas on post-
its and stick then on your
group‟s poster
In groups, spend
20 minutes discussing
what changes you would
like to see on a day-to-
day basis, if the issues
identified were resolved

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Agenda
TimeObjective
‘25International case examples
Next steps „5

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Gallery Walk – integrated care case examples
Read the posters and
think about what
elements you like about
the case examples
Put a sticky dot on
anything you particularly
identify with
Take 20 minutes to walk
around the room
We will then spend
30 minutes in
groups, discussing our
vision for integrated care

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Group exercise – Our vision for integrated care
What is our vision for
integrated care?
Going back to the four
pillars of our vision, piece
together the elements you
liked from the case
examples, along with the
feedback from our
discussions on what
integrated care would
look like to you
In groups, use the posters
to write down your ideas
for how integrated care
could look

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What are you willing to commit to over the next few months to
help drive integrated care forward?
Alexi Ness – Clinical Project Manager
To discuss/share and champion Caring
Together in the projects I work on, and
with the people I work alongside
Helen Weston – community Matron
Share principles of Caring Together
through workstreams of integrated
care/neighbourhood teams. Attach logo
to emails
Paul Bowen – GP chair
I‟ll ensure I allow the aspirations set out
by the Clinical Commissioning Group to
motivate the rest of the programme into
action/progress. We need to be sure the
progress of service design keeps up with
the promises of the campaign
Andrew Tester – Health and Wellbeing
Officer Plus Dane Group
1. Attach the link onto the bottom of my
emails.
2. Work with Comms Group to raise
awareness in the neigh-bourhood we
serve (internal and external)
3. Share with partners I work with

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Agenda
TimeObjective
Next steps „5

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How might this change your personal thinking and actions in the
near future?
1
2
This week Next 6 months
Using the wall poster, let‟s create a group
commitment board for both time horizons

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Examples of previous personal commitments

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Next steps
• We can all contribute to communicating the
vision and getting the word out about Caring
Together
• We will take your input today and incorporate
them into our plans for designing integrated
care services
• We look forward to reviewing our initial plans
with you at our next meeting (August)

Macclesfield 16th July

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Macclesfield 16th July