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Social Partnership Forum’s Staff Passport Meeting
Monday 18th August
Glen Mason Director of People, Communities and Local GovernmentDepartment of Health
DH – Leading the nation’s health and care
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Care and Support affect a large number of peopleMany people need some extra care and support during their adult years to lead an active and independent life. Three-quarters of people aged 65 will need care and support in their later years…
48 per cent of men and 51 per cent of women will
need domiciliary care only
33 per cent of men and 15 per cent of women will never need formal care
19 per cent of men and 34 per cent of women will need residential care
Who needs care? At age 65, what are your chances of needing different types of care within your lifetime?
DH – Leading the nation’s health and care
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Drivers for Change in the English Care System
• Demographic pressure
• Unprecedented financial challenges
• Raising expectations
• Technological Change
• Systems failure eg: Mid Staffs Hospital and Winterbourne View
• A drive to integrate services
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We will change care and support in two fundamental ways:
The Care and Support Act – our vision
1. The focus of care and support will be to promote people’s independence, connections and wellbeing by enabling them to
prevent and postpone the need for care and support.
2. We will transform people’s experience of care and support, putting them in control and ensuring that services respond to what they
want.
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A shift in the care and support system
From To
RepairFocusing only on response after a crisis
PreventionActing earlier to prevent or delay needs
FragmentationIsolated services focused internally
IntegrationJoined-up services working as partners
PaternalState knows best
PersonalPerson knows best
Exclusive“Doing to”
Inclusive“Doing with”
DH – Leading the nation’s health and care
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Choice, control and quality
People can choose between a range of high quality options, or create their own
People develop their own care and support plan
People have clear
information to make good
choices about care
People are in control of their own
budget
People’s views are heard and
help improve services
In the new, person-centred system...
i
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The Care Act is built around people
• Promoting the diversity and quality of the local care market, shaping care and support around what people want
• Ensure that no one goes without care if their providers fails
• Puts adult safeguarding on a statutory footing for the first time
• Young adults receive care and support during transition
• Reforms what and how people pay for their care and support
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Better use of resources
Coordinated approach
Organised around users
Reduction in need to go to hospital
Bring skills together around the user
Services 7 days a week
Better outcomes for users
Benefits of integrated care
The Better Care Fund
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What is Government doing to support this?
The Better Care FundThe Better Care Fund
June 2013 announcement:
£3.8bn to be deployed locally in
2015/2016 on health and social care through pooled
budget arrangements
June 2013 announcement:
£3.8bn to be deployed locally in
2015/2016 on health and social care through pooled
budget arrangements
Local authorities and NHS Clinical Commissioning Groups must
agree a joint plan to deliver better, person-centred
care before receiving funding
Local authorities and NHS Clinical Commissioning Groups must
agree a joint plan to deliver better, person-centred
care before receiving funding
Part of the £3.8bn allocated to local
authorities includes a payment for performance element to
incentivise ambition and real change
Part of the £3.8bn allocated to local
authorities includes a payment for performance element to
incentivise ambition and real change
Autumn Statement
December 2013:Pooled budgets
will be an enduring part of
framework in future years
Autumn Statement
December 2013:Pooled budgets
will be an enduring part of
framework in future years
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The Better Care Fund (BCF) narrative
DH – Leading the nation’s health and care
The Better Care Fund (BCF) will accelerate the local integration of health and care services to deliver better outcomes for people
NHS and social care services are
now caring for people with increasingly
complex needs and multiple conditions.
There is consensus that to respond to
this care should be organised around
the person who needs it, and that
person’s care team should work
together to keep them better for
longer.
The Better Care Fund is one of the
most concrete steps ever towards
making this change happen
everywhere. This is the start and pooled budgets
are here to stay.
Areas put in draft plans in April, and
local areas are now revisiting
these to make sure they are as clear
and strong as possible to kick
start the change we need from next
April.
As ever with system
transformation – success depends
on the people who are leading it to make it happen locally – people
taking bold steps to move away from
their old ways
The BCF has accelerated and made happen
conversations that have never
happened before about joint working across agencies.
Now we want this to happen
everywhere and we are committed to support local areas to achieve this. Local areas teams and local
government regions will have a crucial part to play.
It is challenging, and will
undoubtedly get harder before it
gets easier – but we have seen in
small pockets the immense value of
the prize for patients, users, families, carers
and staff.
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Examples of where it’s happening
Greenwich – avoided 2000 patient admissions with a joint emergency team
South Devon & Torbay – reduced physio waiting times from 8 weeks to 48 hours by bringing professionals together
Tri-borough in London have produced new joint model to help people manage chronic conditions
In Greater Manchester 10 local authorities and 12 CCGs have joined forces to support a large scale reconfirguation
of hospital services
The Better Care Fund
Northamptonshire - targets have been exceeded by 14% on preventing emergency inpatient admissions- targets on
preventing excess bed days exceeded by 4%
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Details of the Better Care Fund
The June 2013 SR set out the following:
2014/15 2015/16
An additional £200m transfer from the NHS to social care, in addition to the £900m transfer already planned
£3.8bn pooled budget to be deployed locally on health and social care through pooled budget arrangements
Better Care Fund
In 2015/16 the Better Care Fund will be created from the following:
£1.9bn additional NHS funding
£1.9bn based on existing funding in 2014/15 that is allocated across the health and wider care system. Composed of:
• £130m Carers’ Breaks funding
• £300m CCG reablement funding
• £354m capital funding (including c.£220m of Disabled Facilities Grant)
• £1.1bn existing transfer from health to social care
Local areas free to add additional funds to the pooled budget
Better Care Fund
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Next Steps
Assurance processSupport available for all areas up until 19th September
Local areas to develop/agree plans and submit by19th September 2014
£3.8bn pool to be deployed locally2015/16
Additional £200m NHS transfer to LAs2014/15
Ministerial final assurance of plansBy end of October
Better Care Fund
Better Care Fund
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Right Capacity
GPs 40,265
Consultants 40,394
Registrars 39,404
GP practice nurses 23,458
Support to doctors & nursing staff 269,714
Support to ambulance staff 13,451
Central functions 106,696
Hotel, property and estates 71, 242
Manager and senior manager 37,314
Qualified ambulance staff
18,645
Allied health professionals 74,902
Healthcare scientists 31,173
Other scientific, therapeutic
& technical staff 47,490
GP providers 26,886
Estimated number of NHS hospital & community health service and general practice
workforce as at 30 September 2012:
1.36 million
Professionally qualified clinical staff
687,810
Other doctors in training and equivalents 13,952Other medical and
dental staff 12,302
Other GPs 8,898
GP registrars 4,426
Qualified nursing, midwifery & health
visiting staff 346,410
Support to clinical staff
343,927
Infrastructure support 215,071
Nursing369,868
Doctors146,075
Scientific, therapeutic & technical 153,472
Support to scientific, therapeutic & technical staff 61,345
Residential 675,000
Domiciliary 831,000
Estimated number of adult social care jobs by employer type in England, 2011:
1.85 millionDay 96,000
Community 251,000
Other GP practice staff 113,832
Direct care 776,200
Managerial/supervisory 31,700
Other 18,400
Professional 4,300
Adult Social Care Workforce NHS Workforce
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Challenges to the Workforce of Integration
• Staff need to develop new skills and to work across traditional boundaries
• Growth in personal assistants with individual care and health budgets
• Development of new roles
• Systems leadership
• Practical issues – TUPE etc
• Developing one culture
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Thank you and any questions?
Glen Mason
Director of People Communities and local Government
Department of Health
DH – Leading the nation’s health and care
