The document discusses the potential benefits of adopting a "one budget" approach that fully integrates health and social care budgets in the UK. Key points include:
- Integrating budgets could end cost-shifting between health and social care, incentivize preventative social care, and allow services to be commissioned based on integrated outcomes rather than artificial divisions.
- Challenges include ensuring resources aren't just pulled back to hospitals, determining personal budgets under a single system, and adapting regulations for integrated providers.
- Health and wellbeing boards could provide local governance structures but may require primary legislation to fully implement a single budget approach.
The document discusses the challenges facing the UK's social care system due to a rapidly aging population. It notes that the number of older people needing care is expected to rise significantly in coming decades. The social care system is fragmented and underfunded, leading to unmet needs for many older adults. Integrating health and social care, increasing personalization and prevention, and reforming funding mechanisms are presented as important strategies for creating a sustainable system to care for the growing number of older citizens.
Public presentation on what the future integration of health and social care may look like in Kent, based on the principles of Kent County Council\'s medium term plan, Bold Steps for Kent.
Case studies of healthcare in singapore and britainscaree-w
The approach to healthcare in Singapore today involves shared responsibility between the individual, government, and community. The individual takes responsibility through Medisave contributions from their salary, which can be used to pay for healthcare costs. The government subsidizes healthcare services and provides additional support through Medifund for those unable to afford care. The community contributes through voluntary organizations that run healthcare facilities funded by the government.
The document outlines a plan called Better Care Together, which aims to transform health and social care services across Leicester, Leicestershire and Rutland over the next 5 years. It was produced through collaboration between local NHS organizations and councils to address issues like a growing and aging population, workforce challenges, quality of care concerns, and financial pressures. The plan proposes moving more services into the community, improving access to primary care, integrating health and social care, reducing unnecessary hospital admissions, and specializing acute hospital services across fewer sites. Local residents are invited to provide input to help shape the detailed options that will be developed and formally consulted on in the future.
Workshop D Work-care reconciliation in different welfare systems - Liberal De...Care Connect
Policies for carers in the Australian liberal welfare state
Prof Sue Yeandle, Director, CIRCLE (Centre for International Research on Care, Labour and Equalities), University of Leeds
Carers and Work-Care Reconciliation International Conference
University of Leeds, 13th August 2013
The document summarizes creative employee benefit options for nonprofit agencies. It discusses statutory benefits like disability, workers compensation, and unemployment insurance that employers must provide. It also discusses options for health and dental plans, retirement plans, voluntary benefits, and cafeteria plans that nonprofits can offer employees. The presentation aims to help nonprofits understand and select beneficial and cost-effective employee benefit options.
The document discusses the challenges facing the UK's social care system due to a rapidly aging population. It notes that the number of older people needing care is expected to rise significantly in coming decades. The social care system is fragmented and underfunded, leading to unmet needs for many older adults. Integrating health and social care, increasing personalization and prevention, and reforming funding mechanisms are presented as important strategies for creating a sustainable system to care for the growing number of older citizens.
Public presentation on what the future integration of health and social care may look like in Kent, based on the principles of Kent County Council\'s medium term plan, Bold Steps for Kent.
Case studies of healthcare in singapore and britainscaree-w
The approach to healthcare in Singapore today involves shared responsibility between the individual, government, and community. The individual takes responsibility through Medisave contributions from their salary, which can be used to pay for healthcare costs. The government subsidizes healthcare services and provides additional support through Medifund for those unable to afford care. The community contributes through voluntary organizations that run healthcare facilities funded by the government.
The document outlines a plan called Better Care Together, which aims to transform health and social care services across Leicester, Leicestershire and Rutland over the next 5 years. It was produced through collaboration between local NHS organizations and councils to address issues like a growing and aging population, workforce challenges, quality of care concerns, and financial pressures. The plan proposes moving more services into the community, improving access to primary care, integrating health and social care, reducing unnecessary hospital admissions, and specializing acute hospital services across fewer sites. Local residents are invited to provide input to help shape the detailed options that will be developed and formally consulted on in the future.
Workshop D Work-care reconciliation in different welfare systems - Liberal De...Care Connect
Policies for carers in the Australian liberal welfare state
Prof Sue Yeandle, Director, CIRCLE (Centre for International Research on Care, Labour and Equalities), University of Leeds
Carers and Work-Care Reconciliation International Conference
University of Leeds, 13th August 2013
The document summarizes creative employee benefit options for nonprofit agencies. It discusses statutory benefits like disability, workers compensation, and unemployment insurance that employers must provide. It also discusses options for health and dental plans, retirement plans, voluntary benefits, and cafeteria plans that nonprofits can offer employees. The presentation aims to help nonprofits understand and select beneficial and cost-effective employee benefit options.
2 Barnet LINk presentation 2011 Mathew KendallFlourishing
The document provides an overview of adult social services in Barnet, including the challenges they face, the services they provide, who they support, how eligibility is determined, and their vision for the future which focuses on prevention, personalization, and partnerships.
These slides were used as part of a talk for Sheffield Health Watch on the idea emerging from NHS England that the future direction of NHS reform will be the creation of Accountable Care Organisations (ACOs)
Long-term care: Integrating health and social care - Albert Veraart, NetherlandsOECD Governance
This presentation was made by Albert Veraart, Netherlands, at the 6th Meeting of the Joint OECD DELSA-GOV Network on Fiscal Sustainability of Health Systems, held at the OECD Conference Centre, Paris, on 18-19 September 2017
Sample Report on International Healthcare policy By Global Assignment HelpAmelia Jones
Sample Report on International Healthcare policy By Global Assignment Help.This report is prepared to analyze the formation of healthcare policy in an international context and discussed contemporary issues in International Healthcare policy.
Workshop D Work-care reconciliation in different welfare systems- Liberal Dem...Care Connect
Policies for carers in the Australian liberal welfare state
Dr Trish Hill, Senior Research Fellow, Social Policy Research Centre, University of New South Wales, Australia
Carers and Work-Care Reconciliation International Conference
University of Leeds, 13th August 2013
HFG Presentation on Designing Benefits Packages in EPCMD Countries at 2015 US...HFG Project
Presentation titled "A tisket, a tasket, is MNCH in your benefits basket?" given at 2015 USAID Global Health Mini-University held March 2, 2015.
Session description: Design of the benefits package "who gets covered for what services" can make or break efforts to expand universal health coverage to end preventable maternal and child deaths. The ideal benefits package will consider the local burden of disease, improve economic efficiency, achieve equity, and be politically sustainable. Poorly designed benefit packages cost too much, cover services benefiting only a subset of the population, or risk political backlash.
This session presents the benefits packages for Ending Preventable Child and Maternal Death (EPCMD) countries, and the technical and political factors that influence their design. Participants will do an exercise to look at these factors for a sample of countries grappling with the trade-offs for benefit design to address the needs of poor mothers and children.
This document summarizes a white paper from the Actuaries Institute on retirement incomes in Australia. Key findings include:
1. The superannuation system is generally doing what it was designed to do but will not deliver a comfortable retirement for all.
2. The least wealthy sections will continue to rely entirely on the Age Pension for a modest lifestyle. Younger cohorts will be marginally better off.
3. The average taxpayer subsidy via the Age Pension will reduce for future retirees due to the Superannuation Guarantee. This will partly offset rising costs of the Age Pension.
Chris Ham: introduction to the Health and Social Care Act and integrationThe King's Fund
Chris Ham, Chief Executive at The King’s Fund, gives an introduction to the Health and Social Care Act with a particular focus on integration. He explains what is meant by integration, looks at good practice case studies and outlines the duties of Monitor, the NHS Commissioning Board, clinical commissioning groups and health and wellbeing boards.
Ageing: Fiscal implications and policy responses -- Mirko Lichetta, United Ki...OECD Governance
This presentation was made by Mirko Lichetta, United Kingdom, at the 6th Meeting of the Joint OECD DELSA-GOV Network on Fiscal Sustainability of Health Systems, held at the OECD Conference Centre, Paris, on 18-19 September 2017
This document provides a practical agenda for policymakers and local authorities to better target public services to individuals' needs. It focuses on five domains: 1) Using data segmentation and sharing to gain deeper insights into diverse population needs; 2) Designing services around individuals rather than predefined models; 3) Examples of personalizing services in practice; 4) Mainstreaming preventative approaches; and 5) Effective partnerships. The report aims to point to achievable innovations that can be replicated across localities to improve commissioning and service integration without major structural reforms or new resources.
The document discusses rural health challenges in North East LHIN, a region covering 400,000 square kilometers in Northern Ontario. The region has a dispersed population of 560,000 people that is declining and aging. Compared to provincial averages, the region has higher rates of smokers, heavy drinkers, obesity, and chronic disease. There is also a shortage of health care professionals. The region is served by over 200 health service providers across several sub-regions.
This document discusses the care economy in Australia from a gender perspective. It finds that in 2009-2010, women undertook 21.4 billion hours of unpaid care work equivalent to 11.1 million full-time positions. The imputed value of this unpaid care was $650.1 billion or 50.6% of GDP. Paid care work accounted for $112.4 billion and 1.8 million jobs. Both paid and unpaid care disproportionately burden women and contribute to the gender pay gap. The document calls for policies and services to better support and value both paid and unpaid care work.
Innovative social enterprise, rural health, India Infrastructure Report 2014Poonam Madan
It is a moot issue just how much time and resources can get used up by social entrepreneurs in seeking public partnerships to scale their work, while it would be in the interest of the nation for governments to examine, identify and work with them.
1200 colm henry voluntary hospital forum final draft may 2015investnethealthcare
This document discusses several challenges facing the healthcare system including health inequality, the changing role of hospitals in Ireland and internationally, and the push toward integrated care due to demographic factors. It notes that hospitals are increasingly expected to work more closely with primary care, social care, and community services to provide coordinated care across settings. Internationally, some healthcare systems like Kaiser Permanente in the US have reduced costs by emphasizing preventive care and shifting care delivery out of hospitals when possible. The growing elderly population is also increasing cost pressures on healthcare systems.
The significance and function of accountable care organizationsPhilip McCarley
This paper provides a discussion and detailed analysis of the development, performance, and importance of Accountable Care Organizations as a vital component of health care reform from the time of the passage of the Affordable Care Act in 2010 through early 2015.
FINAL PRESENTATION_SPECTRUM GENERATIONS- In a Post ACA World Brett Seekins
This document summarizes a leadership summit on healthcare for the elderly that discussed various programs and models for delivering long-term care services. Key topics included Medicare and Medicaid funding challenges, person-centered planning, home and community-based services, care transition programs, patient-centered medical homes, community health workers, accountable care organizations, behavioral health homes, aging resource centers, livable communities, PACE programs, and the need for collaboration between health systems, community organizations, foundations, and state government to address the growing long-term care needs with limited new resources.
The document summarizes the history of healthcare reform efforts in the United States from the early 20th century to the present. It discusses key proposals and legislation over time including those under Theodore Roosevelt, Harry Truman, John F. Kennedy, Lyndon B. Johnson, Richard Nixon, Jimmy Carter, and Barack Obama. It also outlines provisions and goals of the 2010 Affordable Care Act related to expanding coverage, improving the healthcare workforce, lowering costs and improving quality, and how the act is funded. Finally, it discusses the development of the patient-centered medical home model as a joint solution to transform primary care delivery.
The fiscal sustainability of long-term care and its impact on health systems ...OECD Governance
This presentation was made by Tim Muir, OECD, at the 4th meeting of the Joint DELSA/GOV-SBO Network on Fiscal Sustainability of Health Systems, held in Paris on 16-17 February 2015.
Better Care Together is a partnership between NHS organizations and local authorities in Leicester, Leicestershire and Rutland to plan and deliver changes to health and social care. It aims to provide more support in the community to meet the needs of an aging population, improve outcomes, and address a projected £400m funding gap. The plan has input from professionals, patients, and the public. It will see greater integration of health and social care services and a shift away from hospital-based care to more community services over the next 5 years, though details are still being developed and changes may take longer to fully implement.
What offers more choice? Budgets or human rights?shibley
My talk on how best to deliver choice in English dementia strategy - through the market, e.g. personal budgets, or international law, e.g. human rights.
2 Barnet LINk presentation 2011 Mathew KendallFlourishing
The document provides an overview of adult social services in Barnet, including the challenges they face, the services they provide, who they support, how eligibility is determined, and their vision for the future which focuses on prevention, personalization, and partnerships.
These slides were used as part of a talk for Sheffield Health Watch on the idea emerging from NHS England that the future direction of NHS reform will be the creation of Accountable Care Organisations (ACOs)
Long-term care: Integrating health and social care - Albert Veraart, NetherlandsOECD Governance
This presentation was made by Albert Veraart, Netherlands, at the 6th Meeting of the Joint OECD DELSA-GOV Network on Fiscal Sustainability of Health Systems, held at the OECD Conference Centre, Paris, on 18-19 September 2017
Sample Report on International Healthcare policy By Global Assignment HelpAmelia Jones
Sample Report on International Healthcare policy By Global Assignment Help.This report is prepared to analyze the formation of healthcare policy in an international context and discussed contemporary issues in International Healthcare policy.
Workshop D Work-care reconciliation in different welfare systems- Liberal Dem...Care Connect
Policies for carers in the Australian liberal welfare state
Dr Trish Hill, Senior Research Fellow, Social Policy Research Centre, University of New South Wales, Australia
Carers and Work-Care Reconciliation International Conference
University of Leeds, 13th August 2013
HFG Presentation on Designing Benefits Packages in EPCMD Countries at 2015 US...HFG Project
Presentation titled "A tisket, a tasket, is MNCH in your benefits basket?" given at 2015 USAID Global Health Mini-University held March 2, 2015.
Session description: Design of the benefits package "who gets covered for what services" can make or break efforts to expand universal health coverage to end preventable maternal and child deaths. The ideal benefits package will consider the local burden of disease, improve economic efficiency, achieve equity, and be politically sustainable. Poorly designed benefit packages cost too much, cover services benefiting only a subset of the population, or risk political backlash.
This session presents the benefits packages for Ending Preventable Child and Maternal Death (EPCMD) countries, and the technical and political factors that influence their design. Participants will do an exercise to look at these factors for a sample of countries grappling with the trade-offs for benefit design to address the needs of poor mothers and children.
This document summarizes a white paper from the Actuaries Institute on retirement incomes in Australia. Key findings include:
1. The superannuation system is generally doing what it was designed to do but will not deliver a comfortable retirement for all.
2. The least wealthy sections will continue to rely entirely on the Age Pension for a modest lifestyle. Younger cohorts will be marginally better off.
3. The average taxpayer subsidy via the Age Pension will reduce for future retirees due to the Superannuation Guarantee. This will partly offset rising costs of the Age Pension.
Chris Ham: introduction to the Health and Social Care Act and integrationThe King's Fund
Chris Ham, Chief Executive at The King’s Fund, gives an introduction to the Health and Social Care Act with a particular focus on integration. He explains what is meant by integration, looks at good practice case studies and outlines the duties of Monitor, the NHS Commissioning Board, clinical commissioning groups and health and wellbeing boards.
Ageing: Fiscal implications and policy responses -- Mirko Lichetta, United Ki...OECD Governance
This presentation was made by Mirko Lichetta, United Kingdom, at the 6th Meeting of the Joint OECD DELSA-GOV Network on Fiscal Sustainability of Health Systems, held at the OECD Conference Centre, Paris, on 18-19 September 2017
This document provides a practical agenda for policymakers and local authorities to better target public services to individuals' needs. It focuses on five domains: 1) Using data segmentation and sharing to gain deeper insights into diverse population needs; 2) Designing services around individuals rather than predefined models; 3) Examples of personalizing services in practice; 4) Mainstreaming preventative approaches; and 5) Effective partnerships. The report aims to point to achievable innovations that can be replicated across localities to improve commissioning and service integration without major structural reforms or new resources.
The document discusses rural health challenges in North East LHIN, a region covering 400,000 square kilometers in Northern Ontario. The region has a dispersed population of 560,000 people that is declining and aging. Compared to provincial averages, the region has higher rates of smokers, heavy drinkers, obesity, and chronic disease. There is also a shortage of health care professionals. The region is served by over 200 health service providers across several sub-regions.
This document discusses the care economy in Australia from a gender perspective. It finds that in 2009-2010, women undertook 21.4 billion hours of unpaid care work equivalent to 11.1 million full-time positions. The imputed value of this unpaid care was $650.1 billion or 50.6% of GDP. Paid care work accounted for $112.4 billion and 1.8 million jobs. Both paid and unpaid care disproportionately burden women and contribute to the gender pay gap. The document calls for policies and services to better support and value both paid and unpaid care work.
Innovative social enterprise, rural health, India Infrastructure Report 2014Poonam Madan
It is a moot issue just how much time and resources can get used up by social entrepreneurs in seeking public partnerships to scale their work, while it would be in the interest of the nation for governments to examine, identify and work with them.
1200 colm henry voluntary hospital forum final draft may 2015investnethealthcare
This document discusses several challenges facing the healthcare system including health inequality, the changing role of hospitals in Ireland and internationally, and the push toward integrated care due to demographic factors. It notes that hospitals are increasingly expected to work more closely with primary care, social care, and community services to provide coordinated care across settings. Internationally, some healthcare systems like Kaiser Permanente in the US have reduced costs by emphasizing preventive care and shifting care delivery out of hospitals when possible. The growing elderly population is also increasing cost pressures on healthcare systems.
The significance and function of accountable care organizationsPhilip McCarley
This paper provides a discussion and detailed analysis of the development, performance, and importance of Accountable Care Organizations as a vital component of health care reform from the time of the passage of the Affordable Care Act in 2010 through early 2015.
FINAL PRESENTATION_SPECTRUM GENERATIONS- In a Post ACA World Brett Seekins
This document summarizes a leadership summit on healthcare for the elderly that discussed various programs and models for delivering long-term care services. Key topics included Medicare and Medicaid funding challenges, person-centered planning, home and community-based services, care transition programs, patient-centered medical homes, community health workers, accountable care organizations, behavioral health homes, aging resource centers, livable communities, PACE programs, and the need for collaboration between health systems, community organizations, foundations, and state government to address the growing long-term care needs with limited new resources.
The document summarizes the history of healthcare reform efforts in the United States from the early 20th century to the present. It discusses key proposals and legislation over time including those under Theodore Roosevelt, Harry Truman, John F. Kennedy, Lyndon B. Johnson, Richard Nixon, Jimmy Carter, and Barack Obama. It also outlines provisions and goals of the 2010 Affordable Care Act related to expanding coverage, improving the healthcare workforce, lowering costs and improving quality, and how the act is funded. Finally, it discusses the development of the patient-centered medical home model as a joint solution to transform primary care delivery.
The fiscal sustainability of long-term care and its impact on health systems ...OECD Governance
This presentation was made by Tim Muir, OECD, at the 4th meeting of the Joint DELSA/GOV-SBO Network on Fiscal Sustainability of Health Systems, held in Paris on 16-17 February 2015.
Better Care Together is a partnership between NHS organizations and local authorities in Leicester, Leicestershire and Rutland to plan and deliver changes to health and social care. It aims to provide more support in the community to meet the needs of an aging population, improve outcomes, and address a projected £400m funding gap. The plan has input from professionals, patients, and the public. It will see greater integration of health and social care services and a shift away from hospital-based care to more community services over the next 5 years, though details are still being developed and changes may take longer to fully implement.
What offers more choice? Budgets or human rights?shibley
My talk on how best to deliver choice in English dementia strategy - through the market, e.g. personal budgets, or international law, e.g. human rights.
This document introduces the asset approach for improving community health and reducing health inequalities. The asset approach focuses on communities' strengths rather than deficits, viewing communities as having skills, knowledge, and social connections that can be mobilized. It emphasizes empowering communities and residents as co-producers of health rather than just recipients of services. The asset approach values what works well in communities and builds individual and community resilience. It can be used to refocus existing programs and requires practitioners to share power with communities. Specific local solutions may not be transferable, but the approach's principles of community empowerment can be replicated.
This document discusses the challenges of integrating health and social care services between local authorities and the NHS. It argues that while integration has been a goal for decades, there have been many missed opportunities to truly integrate services. The current policy landscape claims things will be different now, but the document expresses skepticism, noting the systemic failures and that proposed solutions often try the same structural approaches rather than changing institutional designs. It advocates considering outcomes before structures and focusing on relationships, leadership, and flexibility to shift resources locally rather than just coordinating separate services.
This document summarizes key changes brought about by two pieces of UK legislation: the Public Services (Social Value) Act 2012 and the Care Act 2014. The Public Services Act requires public bodies to consider social value and community benefit when awarding contracts. The Care Act reforms social care law by placing new duties on local authorities regarding adult social care, with a focus on well-being, prevention, integration, market diversity, and eligibility assessments.
This document discusses opportunities and challenges for community organizations in engaging with the changing healthcare environment for aging populations. It outlines how community organizations are well-positioned to innovate through person-focused care, mitigate financial risk for healthcare entities, help transition patients through different care settings, and support end-of-life needs. However, key challenges include engaging healthcare partners who have different cultures, financially aligning, sharing data, and translating awareness of opportunities into concrete actions through organizational reinvention. The document provides strategies for community organizations to build partnerships and their business case for engagement.
This document discusses changes to health and social care in the UK and their potential impact on the Jewish community. It notes that individuals will receive personal budgets to spend on care rather than money going to organizations. This may lead clinical groups to signpost people to cheaper non-Jewish providers. However, over-relying on non-Jewish care could threaten the viability of Jewish providers. The document recommends educating the Jewish community about communal assets and resolving to promote Jewish care through an information campaign.
The document provides an overview of Ontario's health care system. It discusses how the Ontario government operates under a Westminster system with a Liberal minority government led by Premier Dalton McGuinty. It outlines the roles of the Ministry of Health and Long-Term Care and Local Health Integration Networks in developing health policy and overseeing service delivery. It also describes how physicians and hospitals are major private providers that receive public financing in Ontario's mixed public-private system.
The document discusses the establishment of a Health and Wellbeing Board in Leicestershire County Council to promote integration between health and social care services. It outlines the board's purpose and statutory responsibilities. The board has identified 8 initial priorities related to public health issues like smoking, obesity, and care for older people. It is currently in a shadow period to engage stakeholders and refine its substructures before becoming a statutory committee.
EU regulation of health services but what about public health?tamsin.rose
Highlights some of the issues with the planned approach by the EU to regulate healthcare services and social welfare services across Europe. Raises questions about public health and the importance of civil society (NGOs) as service providers and building social capital
NHS pathway towards an Integrated Care System.pptxMark Da Rocha
This presentation is about the milestone the NHS achieved here in the UK on 1st July 2022 on its roadmap to provide Integrated Care at a local level, nationally in the UK.
Mark Da Rocha is a Healthcare Projects specialist working in the NHS in the UK.
The document discusses reducing health inequalities in the UK. It analyzes the coalition government's record, finding some positive steps but an overall lack of strategy and accountability. It examines current issues like measuring inequalities and the potential role of sustainability and transformation plans. The conclusion calls for a stronger focus on inequalities within place-based, integrated population health systems. The NHS is urged to maximize its potential to impact wider determinants of health and act as a social partner in local communities.
The presentation was a workshop at Evolve 2014: the annual event for the voluntary sector in London on Monday 16 June 2014.
The presentation was chaired by Shane Brennan, from Age Concern Kingston and looks at the changing context of public service commissioning.
Find out more about the Evolve Conference from NCVO: http://www.ncvo.org.uk/training-and-events/evolve-conference
Find out more about NCVO's work on volunteering: http://www.ncvo.org.uk/practical-support/volunteering
This document discusses expanding Shared Lives schemes through social investment. Shared Lives provides personalized care where carers share their lives and homes with those they support. The document finds that Shared Lives can provide significantly greater value for money than other forms of care, with average annual net savings of £26,000 per person for those with learning disabilities. Expanding one scheme by 75 placements could generate £1.5 million in annual savings once at full capacity. Barriers to expansion include lack of upfront funding and poorly developed incentives. The document proposes a Shared Lives Incubator to provide social investment and management support to overcome these barriers and enable expansion of Shared Lives at scale.
Q&A With Martin Farran - DASS for Liverpool CouncilScott Walker
Another great, and insightful Q&A session with Mr Martin Farran of Liverpool City Council.
Thanks again Martin for providing such detailed responses to my questions. I hope everyone enjoys reading it as much as I enjoyed asking the questions!
Governing for transformation report - WEBPaul Stanton
This document discusses governance challenges for Sustainability and Transformation Plans (STPs) in the UK National Health Service (NHS). It notes that while STPs aim to transform and ensure financial sustainability of the NHS, the centralized process and timelines have led to imperfect plans in many areas. It emphasizes that the scale and pace of local transformation through STPs must be determined by local needs and realities, not national targets. The document also cautions that priority on cost reduction targets could undermine collaboration and that limited capital funding may prevent implementation of plans requiring infrastructure changes. It concludes that STPs have largely focused on acute sector reconfiguration rather than comprehensive changes needed to better manage healthcare demand.
John Gillies: Health and Social Care Integration in Scotland 2018STN IMPRO
The document discusses health and social care integration in Scotland. It provides background on the Scottish population and healthcare system. The key goals of integration are to support people living independently at home, provide positive experiences of care, and design services around individual needs rather than organizational structure. Integration partnerships aim to improve outcomes such as quality of life, reducing inequalities, and supporting carers through coordinated primary, community and social care services.
Integrando los servicios sociales y sanitarios. Una vision desde la internati...Societat Gestió Sanitària
Ponencia a cargo del médico geriatra Marco Inzitari, director de Atención Intermedia, Investigación y Docencia del Parc Sanitari Pere Virgili, en el marco de la VI Jornada Right Care sobre Modelos avanzados en integración de servicios sociales y sanitarios, organizada por la Societat Catalana de Gestió Sanitària el 24 de mayo de 2019.
Similar to One budget, one care should the uk adopt a single health and care system (20)
October 29th, 2013
A public debate on the new radicalism emerging in UK housing policy.
Speakers at this event will include:
Ruth Davison, Director, Policy and External Affairs, National Housing Federation
Josh Miller, Senior Economist, RICS
Toby Lloyd, Head of Policy, Shelter
Matt Griffith, PricedOut
Chair: James Lloyd, Director, Strategic Society Centre
Twitter: #specialmeasures
“Build more homes” has become a universal political maxim, but few expect the UK’s housing shortage will be fixed during the next decade.
However, more stakeholders are now abandoning the notion that housing policy can be left to market forces, and a growing interest is observable in radical, unorthodox policy interventions to address the effects of housing under-supply on both households and the economy.
Recent examples of such ‘special measures’ proposed include:
A ‘cap’ on annual house increases;
Rent controls in the private rented sector;
A ban on new-build homes being sold to private landlords.
Politicians also appear more willing to consider unconventional positions: both the London Mayor and Leader of the Opposition have floated “use it or lose it” rules for undeveloped land.
Amid signs the public are also less inclined to view rising property prices as a good thing, the conditions now appear to be in place for manifestos in the 2015 general election to adopt the most radical policies on housing seen in decades.
This public debate will take stock of the new radicalism in debate on how public policy should respond to the effects of the housing shortage, and ask:
What are the key effects of housing under-supply for households and the economy? What policy responses are possible?
Why are we seeing new interest in unorthodox housing policy interventions now?
What are the lessons from overseas when governments have tried unorthodox measures?
How can we ensure that the new ideas and ‘special measures’ proposed are given a strategic direction and focus?
This document summarizes a discussion on raising pension contribution rates in the UK. It discusses how longevity has increased the ratio of time spent in retirement to time spent working. To achieve adequate retirement incomes, both high participation rates in pensions as well as adequate contribution rates are needed. Currently, reforms have focused on participation rates, but contribution rates of 8% of earnings may not be enough. Raising contribution rates could involve increasing regulations on minimum contributions, improving education, using incentives, or nudges like automatically increasing contribution rates over time. Both employee and employer contribution rates may need to increase, but this requires balancing adequacy with preventing increased opt-outs.
Help to Buy schemes aim to increase access to mortgage financing and boost the housing market. However, economic theory and evidence suggest they may primarily benefit existing homeowners and drive up house prices, while doing little for first-time buyers. Supply constraints from strict planning are a major underlying cause of high UK house prices. International experience shows subsidies are ineffective and risky; governments should instead focus on reforming planning to increase housing supply.
** 'Cold Society? Improving the UK's strategy for coping with the cold' **
Date(s) - 04/03/2013
5:30 pm - 7:00 pm
Location:
British Library Conference Centre
A British Library and Strategic Society Centre public debate about excess winter deaths and the cost of cold-related illness.
As winter draws to a close, the countdown begins until the Office for National Statistics publishes its annual estimate of ‘excess winter deaths’ – usually around 25,000 pensioners each year.
These deaths, and the cost of cold-related illness to the NHS – estimated to be £1.36 billion a year in England – are widely acknowledged to be unnecessary and preventable, particularly given the outcomes achieved in countries much colder than the UK.
Four government departments deploy policies directed at the effect of cold weather on the population: DH, DECC, DCLG and – spending by far the most – DWP.
However, it is still far from clear that the UK has an effective, adequate and joined up strategy for dealing with the effects of cold.
This event will therefore explore:
Are excess winter deaths and cold-related illness a problem of public health, low incomes, fuel poverty, poor home insulation or human behaviour?
Is government policy in this area effective or targeted?
As the biggest item of public spending in this area, what proportion of Winter Fuel Payments is spent on keeping warm? What would be the effect of scrapping Winter Fuel Payments on household fuel spending?
What is the scope for more joined-up policy interventions and choices?
Speakers at this event include:
Reg Platt, Research Fellow, Institute for Public Policy Research
Cormac O’Dea, Senior Research Economist, Institute for Fiscal Studies
James Lloyd, Director, Strategic Society Centre
Keep calm and carry on? Policy, psychology and the effects of 'economic war'Strategic Society Centre
1. The document discusses the psychological and health impacts of economic hardship and unemployment during periods of recession.
2. Past research has found that unemployment can significantly damage mental health and increase mortality risk, though the impacts may depend on context such as availability of social services.
3. Governments must prepare policies to help citizens cope with stress, support retraining, and curb rising inequality in order to minimize harm during economic downturns.
Slides from an APPG on Social Care public debate, in association with the Strategic Society Centre.
Date and time: 16.30-18.30, June 26th 2012
Location: Committee Room 18, House of Commons
Speakers at this event comprised:
James Lloyd, Director, The Strategic Society Centre
Paul Johnson, Director, IFS
Anita Charlesworth, Chief Economist, Nuffield Trust and former Director of Public Spending, HM Treasury
Caroline Abrahams, Director of External Affairs, Age UK
Slides from British Library and Strategic Society Centre joint debate, which took place on Monday November 26th, 2012 at the British Library Conference Centre.
Speakers at the event comprised:
Carl Emmerson, Deputy Director, IFS
José Iparraguirre, Chief Economist, Age UK
James Lloyd, Director, Strategic Society Centre
Nano-gold for Cancer Therapy chemistry investigatory projectSIVAVINAYAKPK
chemistry investigatory project
The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
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Osvaldo Bernardo Muchanga
Gastrointestinal Infections
GASTROINTESTINAL INFECTIONS result from the ingestion of pathogens that cause infections at the level of this tract, generally being transmitted by food, water and hands contaminated by microorganisms such as E. coli, Salmonella, Shigella, Vibrio cholerae, Campylobacter, Staphylococcus, Rotavirus among others that are generally contained in feces, thus configuring a FECAL-ORAL type of transmission.
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These are generally consequences (signs and symptoms) resulting from gastrointestinal infections: diarrhea, vomiting, fever and malaise, among others.
The treatment consists of replacing lost liquids and electrolytes (drinking drinking water and other recommended liquids, including consumption of juicy fruits such as papayas, apples, pears, among others that contain water in their composition).
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Summer is a time for fun in the sun, but the heat and humidity can also wreak havoc on your skin. From itchy rashes to unwanted pigmentation, several skin conditions become more prevalent during these warmer months.
One budget, one care should the uk adopt a single health and care system
1. One Budget, One Care: Should
the UK adopt a single health
and care system?
Twitter: #onebudget!
June 25th 2013!
2. Chair: Andrea Sutcliffe, Chief Executive, Social Care
Institute for Excellence!
Rt. Hon Stephen Dorrell MP, Chair, Health Select
Committee!
James Lloyd, Director, Strategic Society Centre!
Dan Gascoyne, Assistant Director for Corporate Policy,
Strategy and Partnerships, Essex County Council!
Matthew Flinton, Director of Legal and General Counsel,
Bupa UK!
6. Everyone…
Health Committee: Report on Social Care
(2012)!
Department of Health!
Labour Party – Independent Commission
on Whole-Person Care, under Sir John
Oldham!
8. Everything…
Multiple meanings have created confusion, but…!
Single assessment processes!
Integrated care pathways!
Joined up working among providers!
DH plan for ‘joined up’ care by 2018!
Joint commissioning of health and care services!
Single providers of health and social care!
9. All these models lie in different parts of the
‘integrated care matrix’…
Source: Lloyd J and Wait S (2006) Integrated
Care: A guide for policymakers
Provider(
integra-on(
User(
integra-on(
High%
High%
Low%
Low%
Models of integrated
care can be located in
different parts of this
matrix
10. …What is the most radical vision of
integrated care?
11. The ‘one budget’ approach…
The full merging of ‘health’ and ‘social
care’ budgets;!
+ Housing!
+ Mental health!
One integrated budget for achieving an
integrated outcomes framework, enabling
the commissioning of integrated services.!
12. …Why have this conversation now?
A simplified view of the health and
care system in England: ‘before and
after’
17. Various potential benefits…
End to cost-shifting between health vs. care
budgets!
End to arguments over defining types of need!
Enable development of integrated, holistic
services!
End to cost-shifting between service providers!
Enable fewer assessments, Less administration!
Better user experience!
18. Various potential benefits…
Incentives to invest in cost-effective social
care services!
Shift resources from ‘health’ to ‘social care’!
“Handrails, not falls treatment”!
More space for innovation in practice and
delivery !
E.g. development of new professional roles,
such as ‘Local Area Coordinators’!
19. But also some risks…
Resources may be pulled up to acute care!
Hospitals important to politicians, so will still
be a priority!
Complexity, transition risks, etc.!
Others?!
20. ...Why is there such interest in a
‘one budget’ approach now?
21. Two factors are changing the
agenda…
Health and Wellbeing Boards present an
opportunity!
Potential ‘structure’ for full single, sovereign,
integrated health and care budgets; !
Emergence of a ‘burning platform for
change’: the crisis in A&E/NHS pressures!
Blamed on division between health and care
system!
Also blamed on social care budget shortfalls,
which could be met from NHS resources!
22. …So, do Health and Wellbeing
Boards really provide the big
opportunity for one, integrated
budget?
23. Yes…
Does not require complete reorganisation of local
government financing;!
Local authorities can ‘devolve’ practical responsibility
for meeting their duties!
Shift lots of CCG and Local Authority social care staff
to enlarged ‘Health and Wellbeing Commissioning
Boards’!
Each local HWCB can proceed at own pace!
No top-down change forced through !
In line with development of integrated services by
providers!
24. But…
Still lots of questions/issues to address!
HWCB legal structure likely requires
enhancement through primary legislation at
Westminster!
HWB experience so far is mixed!
Resistance to giving up sovereignty and money!
So, ‘one budget’ approach would still need a push
from Westminster?!
28. So what are the issues we need to
be thinking about?...
29. Many, but three I want to flag…
Integrated service providers!
Personal Budgets!
Partnership between individual and state
in paying for “social care”!
30. Integrated service providers…
To be truly worthwhile, ‘one budget’ approach
needs integrated providers!
Providers able to take a holistic ‘whole person’ view of
person and needs!
But this is a major challenge to providers:!
How quickly can providers respond?!
On what basis will they be happy to be
commissioned?!
Is the regulatory framework ready?!
31. What is the Personal Budgets issue
for the ‘one budget’ approach?...
35. Questions for Personal Budgets and
‘one budget’ approach…
How would Personal Budgets be determined
under a ‘one budget’ approach? And ‘choice and
control’ preserved?!
Local authority Resource Allocation Systems (RAS)
for social care already a contested area!
Unclear how RAS could be used to determine
Personal Budget when HWCB is commissioning for
single integrated outcomes framework from a single
budget!
More difficult to determine £RAS on basis of services
available in different market?!
39. Option 1: Scrap all means testing…
Very expensive, despite emerging efficiency
savings from ‘one budget’ approach;!
Social care will never be ‘free at the point of use’
like NHS;!
Why? If everyone in residential care receives the LA
‘usual cost’ rate as cash-based Personal Budget,
untenable to prevent private ‘top-ups’!
Current ‘self-funders’ would use additional LA money
to pay more and get more!
Implications for care market, prices and inflation!
40. Option 2: Retain means testing and
charging framework, but adapt it…
Individuals charged for services proportional to
means!
But which services? !
‘One budget’ approach seeks to blur boundaries
between health vs. care needs, services and costs!
Plus, in context of ‘one budget’, most cost-effective
way to distribute resources may not be to retain care
eligibility thresholds and means tests for what was
once known as ‘social care’;!
Why? May be cheaper to provide free ‘care’ services to “rich”
people if it keeps them out of hospital.!
42. ‘Capped cost’ reforms…
Dilnot Commission published recommendations in July
2011!
Proposed significant changes to current means tested
system in England!
Core principle: only the state can protect individuals from
‘catastrophic’ care costs!
Government has committed to implement ‘capped
cost’ reforms from April 2016!
‘Cap’ on notional accumulated ‘Personal Budgets’ that
wealthy individuals are excluded from by LA means test!
43. ‘One budget’ and the ‘capped cost’
reforms’…
‘One budget’ approach seeks to breakdown distinction of
health vs. care needs, costs and services!
So, current local authority FACS (Fair Access to Care Services)
eligibility framework and RAS systems will need to be completely
reworked to enable ‘one budget’ approach. !
However, these frameworks/systems are building blocks of
‘capped cost’ reforms for metering costs of care in the
community;!
So, the ‘capped cost’ reforms cannot be implemented in
current form under ‘one budget’ model. !
Need to rethink how to apply the ‘capped cost principle’ in
context of one budget approach?!
45. Conclusions…
A&E crisis + HWB framework + political
consensus may be tipping point for radical
integration of health and social care spending!
But huge questions for Personal Budgets,
integrated providers, definitions of need, and
potential for unintended consequences!
Opens up again question of ‘partnership’
between individual and state in paying for
what was previously known as ‘care and
support’.!
47. Strategic Society Centre Debate
25th June 2013
Dan Gascoyne
Assistant Director for Corporate Policy, Strategy and
Partnerships, Essex County Council
48. • Partners across Essex, Southend and Thurrock have long supported the
development of Community Budgets as a means of improving local
outcomes and have worked to shape the concept since its inception.
• In December 2011 partners submitted a successful expression of
interest to become one of four Whole Place Community Budget pilots.
• Following selection we’ve worked with secondees from central
government to co-design proposals for sustained system-change in
local public services through our Whole Essex Community Budget
(WECB) programme.
• Operational Plan submitted 31st October 2012
• Proposals developed during the pilot phase will deliver total cumulative
net benefits worth £388m to 2019-20 of which £118m will be direct
cashable savings.
• In March 2013 resources were committed to detailed implementation
plans and governance to deliver these proposals and develop further
opportunities.
2
Whole Essex Community Budget: background
50. Moving from business cases to phased implementation
4
WECB Programme Overview
Health and
Wellbeing
Integrated
Commissioning
Economic
Opportunity
Skills for Growth
Community
Safety
Reducing
Reoffending
Reducing
Domestic Abuse
Family Solutions
(FCN)
Strengthening Communities
Essex Deal For
Growth
Social Investment
Housing – new project
54. Where are we now?
8
• Domestic Abuse – Alan Ray
• Strengthening Communities – Jasmine Frost
• Housing -
Project Project overview Update
Integrated
Commissioning
Driving forward strategic
integration across the
Health and Social Care
system in Essex.
Led by the Essex Health
and Wellbeing Board.
• All 5 Essex CCGs have produced Integrated
Plans which set out how they will deliver QIPP
(Quality, Innovation, Productivity and
Prevention) and how they will work with ECC on
integrated commissioning this year and in the
future.
• As part of ECC transformation 5 joint posts are
being recruited to, covering each of the five
Essex CCG areas
• Partners working to define the ‘end state’ and
how we will get there and commit the capacity to
progress the work programme at pace, agreed
programme management approach.
• Integrated Care Pioneer proposals being
developed to support direction of travel
55. Outline framework to progress integrated commissioning has been
agreed by partners across Health and Social Care. Shaped through
five key service areas:
• Older People
• Mental Health
• Learning Disabilities
• Children’s Services
• Public Health
9
2013/14 Commissioning Framework
57. 11
Principles*
Our work on integrated commissioning is guided by the
principles that:
• services are commissioned based upon customer needs
• where possible, they should be local and easily accessible
• addressing the needs of whole communities
• with an emphasis on prevention and early intervention
• organisations will share resources to maximise value for money
• sharing equally the responsibility for risk
• ensure service quality underpins decisions to allocate resources
58. Benefits
We expect our approach to deliver the following benefits:
• Realising economies of scale and providing services at lower cost
• Improving outcomes by tackling entrenched problems
• Greater focus through prioritisation
• A more stable planning cycle
• Less complexity through clearer governance and accountability
• Streamlined pathways with reduced duplication
• A shared language and common understanding of purpose
• Greater responsiveness to community and individual needs
• Increased service provision in preferred settings e.g. community
• Ability to focus on preventative approaches to service delivery
• Innovation through working across agency and professional silos.
"
12
60. Some key messages
1. Community budgets should be focused on sustainable system-change: they
have the potential to bring about wholesale system-change in public services:
joining-up and co-ordinating services, streamlining processes and improving
citizens’ experiences.
2. Community budgets should focus on shared outcomes rather than pooled
budgets: there are risks associated with the creation of a single funding pot. A
focus on shared outcomes and integrated commissioning, rather than on the
mechanics of pooled budgets, is what’s needed.
3. Community budgets are a tool to change culture: This offers great value and
requires local innovation and greater flexibility within Whitehall and local partners.
Policy frameworks established by central government departments must be
flexible if they are to support, rather than limit local system-change
4. Government should not seek to artificially limit the scope of community
budget activity: focusing proposals on social outcomes is not enough –
economic outcomes are equally important and complementary to prevention.
14
61. • Dedicated resources, robust programme management &
governance – invest to save, for the long run
• Clear understanding of place: priorities, leadership, behaviours
• Importance of focus
• Genuine co-design – locally and nationally
• Understanding sovereignty
• Deep, lasting engagement and ownership from key stakeholders
• Willingness to flex, adapt and connect with a dynamic system e.g.
12/13 - NHS reforms; PCC; Heseltine; Transforming Rehabilitation;
ECC TMII; Integrated Care; etc
15
Making a community budget successful
62. 16
!
“The only way the world is going to address social problems is
by enlisting the very people who are classified as ‘clients’ and
‘consumers’ and converting them into co-workers, partners and
rebuilders of the core economy.”
Professor Edgar Cahn,
US civil rights lawyer and inventor of time banks.""
www.wecb.org.uk
www.communitybudgets.org.uk
64. Questions for discussion…
Integration choices – can real efficiency savings be achieved from joint
commissioning, or will they only really be possible from full merging of
health and care budgets to enable a single budget with a single
commissioner?!
Budget pressures – is integration of health and care budgets made easier,
harder or inevitable by the unprecedented budget pressures confronting the
health and social care systems over the next decade? !
Implementation – how would a single health and care budget be created
from the new structures in the NHS and local government? Do Health and
Wellbeing Boards provide the key?!
Defining need – would a single budget for health and care retain distinctions
between health and care needs, or just focus on commissioning services for
outcomes?!
Paying for care – what, if any, services would individuals be charged for
under a single health and care budget? Would social care still be means
tested?!
Capped costs – what do radical models of integrated commissioning and
funding mean for the government’s plans to cap people’s care costs?!
65. !
!
!
!
!
!
Strategic Society Centre
32-36 Loman Street
London
SE1 0EH
Tel. 020 7922 7732
info@strategicsociety.org.uk!
www.strategicsociety.org.uk
Twitter: @sscthinktank !
The Strategic Society Centre is a registered charity (No. 1144565) incorporated
with limited liability in England and Wales (Company No. 7273418).!