Transforming Community Services

Vanessa Griffiths

What TCS is about

• Transforming community services – The interests of patients and carers are

paramount– Quality is the organising principle – Driven by a commissioning strategy which

has quality and reducing inequalities at its core

– Delivering value for money– Enabling integrated care

Separation of the functions of the PCT

• Part of the plans for transformation• Commissioning part of the PCT now NHSLCR• The provider services now LCR CHS• Functioning as an Autonomous Provider

Organisation (APO) with separate managerial and governance arrangements

• Legally remain a single organisation• Options for the future of total separation but not

yet• Contractual arrangements between NHSLCR

and LCR CHS for the services that they provide• Allows each part of the organisation to

concentrate on their main purpose

Strategies for delivery of service transformation

• To achieve transformation NHS LCR together with LCR CHS will need to develop a transformation programme which addresses

• Strategy• Culture• Technical/process• Structure

So what happens next?

Review of types of service provided

Identification of enabling programme by service line to support transformation i.e. clear articulation of the strategic goals; cultural change required and how; technical support such as information systems; structural change required

At the heart of change

• Any proposed changes must meet the key WCC challenges – e.g. should deliver:– Better health– Better care– Better value

• Robust risk assessment of change and mitigation plan in place

• Structural change is only part of the solution and is delivered through a commissioning process

Service lines for review - 1

• Promoting health and wellbeing– Nutrition and dietetics– Podiatry– Dental services

• Services for children and families– Children’s services– Specialist community children’s services

Service lines for review - 2

• Acute services closer to home– MIU/WIC– Intermediate care– Clinical navigation– Community hospitals– Outpatient services, diagnostics &

day cases– Out-of-hours

Service lines for review - 3

• Rehabilitation and long-term conditions– Community nursing– Physiotherapy outpatients– Speech and language therapy– Other outpatient therapies– Specialist nursing– Community matrons

• End of life care– Palliative care

Example: Intermediate care - 1

• Strategy: integrate care across health and social care to reduce cost and improve patient experience

• Culture: understand the different cultures of health and social care teams and develop interventions to support alignment to goals

Example: Intermediate care - 2

• Technical: develop joint commissioning strategy between PCT and LA.

• Align financial and performance incentives to support operational delivery.

• Implement information systems that support information sharing and feedback

• Structural: Possible section 75 agreement