The
Director of Adults’ Health and Care alongside representatives
from the NHS and Southern Health Foundation Trust provided a
progress update on Integrated Intermediate Care, last presented in
May 2019.
Cllr
Thornton joined the meeting at 10:09.
The
Chairman reviewed the concept of Integrated Intermediate Care (IIC)
and Members then heard:
-
Joint provision of services is intended to avoid
unnecessary admission to acute hospitals and to allow independent
living at home as soon as possible.
-
Support is offered free of charge for a time limited
period (6 weeks), though generally shorter with step down into a
community or care home setting.
-
Rehabilitation, reablement, and recovery are the key
elements.
-
Hampshire County Council (HCC) and Southern Health
Foundation Trust (SHFT) are progressing towards proposals for a
single integrated service.
-
Commissioning along NHS lines is critical but
complex due to lack of consistency in shared information and
technology across providers.
-
This is a positive direction and consultations will
follow in due course.
-
Arrangements covering all aspects and system
functions will be choreographed between HCC and NHS with a possible
Section 75 and Local Care Partnerships.
Cllr
Hayre joined the meeting at
10:14.
-
Modelling in terms of whole population and creating
an appropriate footprint with acute hospitals requires detailed
work and a business plan for ideal outcomes.
-
Commissioning and provider perspectives are both
critical to success.
-
With the challenges of Tt2021, ensuring services are
joined transparently in terms of finances, expectations, and
service delivery details is key.
-
Winter planning is now the focus to match additional
service demand across the county and ensuring appropriate services
and capacity are available for upcoming needs with greater
efficiency and productivity.
-
Service structure planning will reduce areas of
duplication with a thoughtful and sensitive approach that dovetails
together.
-
HCC and SHFT operational and clinical regimes are
different but the integrated service needs to be complimentary,
robust, and capable.
-
Consultation with staff will commence at the turn of
the calendar year.
-
New ways of working together are tested in
forerunner projects countywide with local access points and an aim
for patients to leave acute settings an at earlier stage as the
longer they are there, the more they decompensate.
-
To better their chances for recovery and independent
living, acute hospital avoidance is key for those who would receive
better care at home.
-
Recent collaboration with South Central Ambulance
Service (SCAS) has resulted in over 580 people avoiding acute
hospitals and easing the pressures on acute, community, and social
care providers, with ideal outcomes and benefits.
-
Communication and engagement with all stakeholders
are critical to find new ways of working ground up to meet
population needs.
-
The detailed business case is the current
focus. There will be consultations in
January with legal services, staff, providers, etc., to be brought
back to the HASC in March, and the Executive Member for Social Care
and Health, before the service going live in April
2020.
Cllr
Fairhurst joined the meeting at
10:21am.
In
response to questions, Members heard:
-
Collaboration, agreements, and aligned plans with
CCGs, STPs, and all partners are critical to develop service and
function proposals based on CQC Local System Review (next item on
the agenda) and insights from Newton Europe.
-
Conditions need to be created to work seamlessly to
overcome issues and effects of external forces, and make
compromises (hosting, configuration, etc.)
-
This is an opportunity to bring together Hampshire
care system and Southern Health with a singular goal across both
provider organizations.
-
700 staff members will be engaged, for a sense of
the scale, size, and reach.
-
Lack of and access to GPs are a community issue that
lead to more hospital visits, but there are layers of complexity
for both service users and providers.
-
Primary Care Networks (PCNs), IIC, and GPs will be
strongly linked and supported alongside a range of health care
workers to provide the right care in the right setting and monitor
complex patients to provide the best care.
-
The system is increasingly more difficult and
complex for people to navigate and this is an opportunity to
address challenges and make collective improvements to simplify and
delayer services for easy, effective, and timely
access.
-
With this shift, more NHS funding and resources will
need to flow from acute to community organizations.
-
People will need to better understand options
available to them and vulnerable service users with technology
challenges or language barriers must be helped.
-
The goal is to provide (previously separate and
difficult to access) joined up services with a single access point
with savings from scale and less duplication.
-
Collaboration with 111, PCNs, voluntary sector, and
SCAS will allow all enquiries to use Connect to Support
Hampshire’s directory of available services.
-
Face to face opportunities for advice will remain
for those who may need them.
-
The business case will be a joint one with a pooled
budget and clear service specifications in fine details from a
commissioners’ perspective and detailed operational service
and delivery structure proposals from a providers’
view.
-
This is an invest to save opportunity looking at
5-year demand capacity.
-
There is a cost to delivery and existing contracts,
but also a saving opportunity from acute bed avoidance and the
impact on long term care packages with more individuals better
managed in the right care setting.
-
Staffing and workforce issues remain at the
forefront of all disciplines, but this collaboration will avoid
duplication and release staff for other purposes.
-
The proposed development will be clear on the
financial envelope, quality from complementary skill sets of
organizations (clinical, service delivery, social care, etc.) but
the area of greatest concern consistently remains around work force
and competing against acute hospital staff recruitment.
-
Training and staff development in a holistic and
individual approach with new projects and innovation will attract
staff and allow them to upskill and access new career pathways with
additional qualifications and retain them to avoid
turnover.
-
Assumptions with regards to growth in people living
longer have been considered and will be monitored and
managed.
-
The immediate challenge is moving a large body of
currently acute setting patients to manage them in better care
settings and thus stabilize the numbers.
Members noted that they were impressed with the hard work,
direction, clear plan for future, joint up working, safeguarding,
and avoiding duplication. The Chairman
congratulated the collaboration and looked forward to receiving the
finance details in March 2020.
RESOLVED
That the Committee:
-
Noted and supported the project approach and
developments as set out in this report.
-
Will receive a further update in March 2020 prior to
an anticipated Executive Member decision to approve creation of the
service (subject to consultation).
The
Vice-Chairman left the meeting at 10:57.