Community Health Partnerships

Gill McVicar

“The most important policy issue facing European Governments over the next 50 years is how to cope with ageing populations……For Scotland the future is now……Its population is ageing faster and dying quicker than any other industrialised nation.”

The Scottish Report – Scotland the Grave (2003)

Demography

18 weekRTT

Long Term ConditionsCollaborative

Mental Health Collaborative

Other initiativesProjects/targets

Financialposition

Contracts, MMC, EWTD

Our Iceberg

Ageingpopulation

Healthinequalities

CapacityCapability

Shifting the balance of care

WANT TO CHANGE V

HAVE TO CHANGE

Partnership for Care

• “New Community Health Partnerships, more accountable to local communities, better matched with Social Work services and better able to represent local interests within NHS Boards”

Partnerships will….• Ensure patients and a broad range of

healthcare professionals are fully involved

• Establish a substantive partnership with Local Authority services

• Have greater responsibility and influence in the deployment of resources by NHS Boards

• Play a central role in service redesign locally

• Act as a focus for integrating health services, both primary and specialist at local level

• Play a pivotal role in delivering health improvement for their local communities

Better Health Better Care-CHPs• Key to delivery• Partnership re emphasised• Broader range of delegated resources• Greater flexibility in decision making• Integrated resource framework – joint

commissioning, collaborative contracts, budgets devolved to local level

• Extend responsibility and accountability

Expectation of CHPs• Shift the balance of care• More local services• Improve access• Waiting times – new targets• Manage demand• Reduce unnecessary referrals to specialist

services• Provide better community care services

CommunityPlanning

HealthImprovement

Culture Leisure

FoodNutrition

CommunityDevelopment

CommunityLearning

CommunityResilience

Seek out thoseMost at risk

Promote/supportSelf care

Better Information

EarlyIntervention

Textmessages

Case/CareManagement

Practice Accessprogrammes

Team approachExtended roles

LTCManagement

HomeCare access

MentalWell being

IT

SpecialistRoles in PC

Hospitalat home

Intermediate care

CommunityRehab

Demandmanagement

CommunityHospitals

Consultants in Community

Nurse/AHPConsultants

ReferralManagement Centres

SpecialistServices

AmbulatoryCare

Patients

PublicStaff

Local Authority

SecondaryCarePrimary

Care

TertiaryCare

Voluntary Sector

IndependentSector

Communities

Carers

PatientCommunity

Primary Care

SpecialistCare

Local Authority

Voluntary Independent

Carers

Whole system engagement

Web of connections and communications

Integrated Teams

Integrated Resource

Framework

Right personRight place,Right time

Right information

New flexibleTraining and learning

opportunities

BetterAnticipatory care

Earlyintervention

HealthImprovement

Self caresupport

TechnologyInformation sharing

Leadership

New roles

?Joint StandardsJoint Inspection

Considerations

• Staff• New roles, development

opportunities• ££• Partnership• Community• Time

Support to shift the focus?• Sensible governance and performance

management v time consuming bureaucracy

• Freedom to manage• Flexible training and education,

quickly• Bust the barriers • Public awareness• Mutuality• Manage expectations

Anticipatory Principle• Collective imagination and discourse about

the future• Image of the future guides current behaviour• Project ahead – horizon of expectation• Bring future powerfully to present (mobilise)• Inquire in ways that serve to refashion

anticipatory reality

(Cooperider et al, Appreciative Inquiry, 2000)

…a time for bold imaginings, thinking the unlikely, doing the unreasonable.

Charles Handy