Lessons learnedon improving health and social care between PCTs and Local Authorities

A short presentation by Keith Skerman

• Background to discussion– personal lessons– recent national policy

• Cultural change + workforce • Developing health + social care: joint

commissioning + integrated provision • Governance in the care sector• Some technical issues

Agenda

Personal Lessons

• Health + Social Care career – seamless service

• Joint approach LA/NHS as Director SS Swindon

• Interim in LAs + PCTs since 2005 – Lambeth, Aberdeen, Staffordshire, Milton Keynes, Luton

• NHS Workforce Review Team focus on integrated services

Recent Policy Background

• DH World Class Commissioning (WCC)– PCT separation– NHS market development

• DH Putting People First (PPF)– Personal budget + Personalisation agenda– Choice + control

• 9 NHS DH guidance documents Nov 08-Jan 09• NHS Operating Framework (incl. collaboration +

competition)• Transforming Community Services • Safeguarding reviews

– Adult + children

• Care Quality Commission (CQC) starts April 09

Cultural Change & Workforce

• Focus on customers (patients, users, carers)• Shift from “professional gift” to “in control”• Care sector as key player in local economies• Sustainable improvement + quality dependent upon

investment in workforce• Stepped approach to change associated with

consistent focus on outcomes not process• Choice + competition with joint commissioning

Developing Health + Social Care

1)Commissioning (WCC) – NHS focus upon market management + PCT separation for VFM

- Joint commissioning issues with LAs led by NHS? Care pathway reviews, Patient experience, Security of supply versus Competition/choice

2)Provision – personalisation/choice impact upon health + social care, versus integrated services?

- Impact of mixed NHS economy/ WCC procurement on patient outcomes, + workforce

Governance In The Care Sector

• Coherence in community + political governance of care sector i.e. is there a thread from LSP/LAA to frontline services for health and social care?

• Joint Commissioning accountability – officers with NEDs + Members, + with users/carers

• Ownership and involvement in models of provision + innovation– NHS FT, PBCs, Social Enterprises, Direct Services, ?customer focus

• Quality – user/carer experience + outcomes

Some Technical Issues

• Access to capital, + developing assets (such as property, ICT) in credit crunch

• Shared services for integrated care providers• ICT support to users + carers for self

assessment, brokerage, telecare/health• Access to commercial expertise ( providers +

commissioners procurement) in care market• “Due diligence” techniques + support in new

providers to support sustainable solutions