Delivering Personal Health Budgets Lambeth

Transcription

1 Delivering Personal Health Budgets Lambeth Denis O Rourke NHS Lambeth CCG Rachel King Personal Health Budget Coordinator (Lambeth) Mark Young Support Planner/Broker (COT)

2 Background to Personal Health Budgets Lambeth PHB Pilot established in 2009 Co-produced by service users, carers, PCT, SLaM, VCS and LA Key driver lack of progress on recovery/personalisation Focus on working with people using primary and secondary mental health services Offering one-off and integrated PHBs Now part of the (DoH) Going Further Faster programme

3 The wider context in which PHB has developed in Lambeth 3

4 Create a platform for people to come together Voluntary Sector Providers Primary Care Clinicians Public Health Carers Social Care THE COLLABORATIVE Mental Health Trust People who use services Commissioners The Lambeth Living Well Collaborative

5 We trying to applying the principles of Co-production in our commissioning and service delivery 1. Recognising people as assets 2. Building on people s existing capabilities 3. Peers support networks 4. Blurring distinctions 5. Facilitating rather than delivering 6. Mutuality and reciprocity 10/04/12 Nef&Nesta

6 People Powered Health Programme - applying the principles of Coproduction at a system level (see PPH.Commissioning People Powered health 2013)

7 Running an ongoing process involving over 1,600 people actively contributing to the design and delivery of improved services

8 Key elements of our service model People as citizens and partners in delivery of their care Integrated care and support one caseload? Improved access Better guidance and support in the community Building primary care capacity Peer support in all settings Increased user control and choice Getting connected and supporting reciprocity

9 Our big 3 outcomes 1. To recover & stay well 2. To make their own choices 3. And to participate on an equal footing in daily life

10 Our road map trying to take whole system approach Programme Management LLWC Thursday monthly meetings MHIP Commissioning / QIPP Board meetings Lambeth CCG meetings Borough Wide Co-production Events Locality meetings (e.g. PC) Quarterly SLaM quality contract review meetings PAG/Commissioner monthly meeting Outcomes Impact Targets Support min 20 people move on from residential care (baseline 140) 250 people access service offer by March 2014 Big 3 outcomes progress Service offer evaluation (12 ppl) Service offer large evaluation (c250 ppl) Follow up of COT clients that have been discharged PHB/GFF 125 people to access PHB - by March 14 R&S uptake (monitor quarterly) Working with People Differently Timebanking Peer Support My Health Locker Mobilising people and changing our culture Workforce and Culture Change Strategy Communications Strategy Co-Production Platform/Academy Personal Budgets Integrated services to make a better offer Revise Collaborative vision and principles Reduction in Residential Care via SWOT Living Well Network implementation Rehabiltation Service Review Prototype Crisis Retreat Vocational and Employment services Redesign acute bed based services CMHT redesign Integrated Talking Therapies Improving info and choice options Connecting Communities / asset based framework Community Medication service - prototype Changing the way services are commissioned Modelling to support LWN and CMHT redesign Voluntary and Community Services GSTT Charity Bid development Collaborative Alliance Contracting/Commissioning Framework Development of Big 3/Health of the system Metrics Refresh system investment map Collaborative Leadership Build the case for change Engage and support the development of the cooperative council Engage with regional and national organisations and networks to promote and share co-production Continued development of the Collaborative platform and development of metrics to assess the 'health' of the collaborative

11 Impact to date Over 400 people supported by the Community Options Team/ Primary Care Support Service with c300 moved on from CMHT during 2012 Information and Resource Hub (managed joint with peers) opened June locality Timebanking partnerships growing Peer Support initiatives expanding (e.g. Missing Link, Solidarity in Crisis, Mind) Agreement on system change new front end Living Well Network and redesign of secondary care services Provider Alliance Group established full time project manager moving toward a single alliance contract So far over 80 people have a Personal Health Budget to support recovery

12 Types of Budgets offered One-off Personal Health Budgets Up to 500 Click to edit Master title style A way to support and enable isolated recovery needs Integrated Personal Budgets Click to edit Master text styles Merging and streamlining the Adult Health and Social Care processes Second level FACS eligible needs Third level Fourth level» Fifth level 12

13 Achievements Co-production as the start point for everything. Integration of social care and health processes. Click to edit Master title style Peer support. Borough wide Recovery and Support Plan. Click to edit Master text styles Currently developing an integrated assessment. Voluntary Second sector s level role: support planning and brokerage. Third level Personalisation and personal budgets as the Fourth level cornerstone to all» Fifth service level development/s. 13

14 Outcomes Recovery Star Outcome Comparisons 90% 100% 80% 70% 60% 50% 40% 30% 20% 10% 0% Click to edit Master title style Click to edit Master text styles Second level Third level Fourth level» Fifth level Reduction Same Improvement 14 Managing Mental Health Physical Health and Self Care Living Skills Social Networks Work Relationships Addictive Behaviours Responsibilities Identity & Self Esteem Trust & Hope Recovery Star Outcome Area

15 How budgets were spent Area Furniture/Household Example of spends Washing machines, curtains, carpet, removals, fridges, cookers, redecoration, doorbell, showerhead, cupboard conversion Electronics Fitness/Gym Travel Laptops, SAD lights, camera Click to edit Master title style Gym membership, trainers, treadmills, bicycles and associated Vocational/Leisure Assistive Technology Assistance/Reskilling Spiritual accessories, rowing machine, fitness DVD Train ticket to visit family, respite breaks, travel to access support services Click to edit Master text styles Driving lessons, gym instructor courses, writing courses, singing courses, Sky TV, ESOL 1:1 tutoring, art materials, tattoo convention ticket, media course, internet connection Second level Pivotal, door alarms, gas shut offs, personal alarms Third level Personal assistant/s Fourth level» Fifth level Religious retreats, headstone 15

16 Joe Click to edit Master title style Click to edit Master text styles Second level Third level Fourth level» Fifth level 16

17 Joe s Integrated Personal Budget 4 hours of Personal Assistant (PA) support per week - Budgeting/debt repayments Click to edit Master title style - Cleaning/laundry/shopping - Prompting for self care, medication monitoring Click to edit Master text styles Cooker/fridge/doorbell/showerhead Key safe Second level Third level Home and Dry redecoration Fourth level Deep clean/rubbish removal» Fifth level 17

18 Benefits of Integrated Personal Budgets A personalised approach to support Greater involvement in planning of support Click to edit Master title style Indications that this reduces frequency of contact with secondary services, and reduces length of hospital stay Click to edit Master text styles More flexibility around how funds can be spent Second level Health and social care needs met with the one package of Third support level Fourth level» Fifth level 18

19 Challenges going forward Mainstreaming personal health budgets; developing the PA market and RAS. Mainstreaming the integrated assessment and single recovery plan across 4 boroughs Click to edit Master title style A risk aware approach to supporting people Ongoing reduction in public sector expenditure 25% cuts in LGovt Click to edit Master text styles Integrated provision through Alliance Contracting c 70M Aligning PbyResults with outcomes? Second level Workforce culture change to support co-production at all levels Third level System commitment Fourth to transformation level through co-production Lambeth Big Health Debate» Fifth level 19

20 Integrated Provision - Alliance contract Current Multiple Click 2012/13 to edit Current Master title Single style Multiple Contract values 49 Primary care practices Future Click 20 Third sector edit Master profiles text Venture styles providers MH Trusts (SLaM, Second SWLSTG) level Third level Fourth level 2012/13 service, activity and productivity» Fifth level 2015/16 Alliance Contract / Joint framework Future Single 2015/16 Big 3 outcomeand productivity profiles 20

21 System transformation road map Apply innovation methods Develop diffusion strategy Develop technology strategy Articulate vision Build case for change Create system conditions Click Develop to edit Master title style health Diagnose system Engage workforce strategy progress stakeholders Click to Lead edit & Master Mobilizetext styles Identify metrics manage change Second level Third level Fourth level GENERIC INNOVATION HEALTH» Fifth level resources Develop new packages Identify innovation priorities Develop New outcomes Develop new relationships 21

22 Click to edit Master title style Click to edit Master text styles Second level Third level Fourth level» Fifth level 22

23 Denis O Rourke (NHS Lambeth CCG) denisorourke@nhs.net Rachel King (Personal Health Budget Co-rd) rachel.king@slam.nhs.uk Click to edit Master title style Mark Young (Support Planner/Broker - COT) Click to edit Master text styles mark.young@thamesreach.org.uk Second level Third level The Collaborative Fourth level Fifth level 23