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Agenda 9:45 Registration 10:00 Welcome and Introduction David Williams, Chief Officer, Glasgow City Health & Social Care Partnership 10:05 Health and Social Integration Update 10:25 Preparing and Delivering Change Aileen Brady, Head of Practice & Development, Inclusion 10:45 Preparing and Delivering Change Sam Smith, Director, C-Change 11:05 Table Discussion 12:00 Question and Answer Session 12:15 Conclusion

Health and Social Care Integration Update David Williams Chief Officer, Glasgow City Health & Social Care Partnership 30 November 2016

GCHSCP Partnership Vision The Partnership believes that the City’s people can flourish, with access to health and social care support when they need it. This will be done by transforming health and social care services for better lives.  We believe that stronger communities make healthier lives.

Integration and Transformation

A now familiar story in Glasgow .

Big decisions taken in Glasgow Review and reform of Occupational Therapy Major investment in strategic approach to technology enabled care Major investment in supported living and accommodation based strategy Proof of concept work with provider organisations An integrated out of hours health and social care provision Continued redesign of sheltered housing to more supported living complexes, a more personalised approach Safe Injecting Provision

Proof Of Concept Update: Review And Reform Of Social Care Contracts And Delivery Of The National Minimum Wage 2020 Workstreams: Contracts and Contract Management Care Management Finance and IT Communications To date outputs includes: Review and streamlining of PQR to focus on service user outcomes Review and streamlining of service concern process Ongoing development of service level outcomes measure Providers have begun to develop emerging proposals including: review and redesign of services; integrated models of care; staffing structure; service redesign and use of assistive technology PQR: Provider Quarterly Return is an electronic submission providers complete as part of Contract Management Framework focused on inputs and outputs e.g. Number of staff in post; Number of vacancies etc. It is now greatly abbreviated and less frequently (bi-annual)to place less of a burden on providers while ensuring no compromise of risk management and assessment. Contract Management Framework: Method by which Council ensures providers continue to deliver high level of service expected of them through: ongoing contract monitoring; provider meetings; analysis of service provision and performance; PQR data analysis. Service Concerns: How the Council responds to, processes an acts upon concerns which can be raised by a wide variety of individuals and agencies expressed about a Council purchased service. Service Level Outcomes: Work is ongoing on how we integrate services user outcomes and service performance into the wider Contract Management Framework- realignment from inputs/ outputs to outcomes.

A challenge to Improvement in Services – Joint Commissioning Culture Leadership Relationships Behaviour Power balance shift

Preparing And Delivering Change Aileen Brady Head of Practice & Development, Inclusion 30 November 2016

THE SCOTTISH LIVING WAGE NATIONAL MINIMUM WAGE SLEEPOVERS EVOLVING SERVICE DELIVERY

EVOLVING SERVICE DELIVERY 2015 we were approached by a Local Authority Young people living with their families at home Spending vast sums of money on crisis interventions – The dreaded Friday afternoon call Short interventions typically 6-9 weeks With Learning

LEARNING Identified if there was a need for ongoing support Strategies were put in place for the families: To minimise the incidences of crisis To deal with crisis situations To listen to the young person Listening is in because Alana truanted because classes were too big and she couldn’t cope but hadn’t told anyone

RESULTS This resulted in Families were able to stay together and have a real life Overall savings for Local Authority Able to transfer the learning and strategies to another Local Authority which is again successful

SLEEPOVERS One lady we work for has paranoia Agreed that sleepovers were to be removed Prior to removal assistive technology was put in place to monitor overnight activity This was sourced specifically to allow inconspicuous monitoring Disembodied voice coming through a machine would not have worked!

SLEEPOVERS Anxieties were addressed Lady was able to call for assistance if required System was tested!! Results : she now is safe in her own home overnight and the support she receives is meaningful helping her achieve her outcomes Pride in the fact that she doesn’t require overnight support and is flourishing

Preparing And Delivering Change Dr. Sam Smith Director, C-Change 30 November 2016

All that is valuable in human society depends upon the opportunity for development accorded the individual. Albert Einstein

Self directed support: Statement of intent Independent living means people of all ages having the same freedom, choice, dignity and control as other citizens at home, at work, and in the community. It does not mean living by yourself, or fending for yourself. It means having rights to practical assistance and support to participate in society and live an ordinary life… …Self-directed support, alongside other policies, is intended to support, promote and protect human rights and independent living of care and support users in Scotland. It aims to ensure that care and support is delivered in a way that supports choice and control over one’s own life and which respects the person’s right to participate in society. Statutory guidance to accompany the Social Care (Self- directed Support) (Scotland) Act 2013

2001 -2016 Bespoke support Adult, children and families Individual budgets Individually recruited teams Individual Service Funds Unique support arrangements

Unleashing Potential: What’s your gift Reducing financial resources Need to redraft the equation Snipping round the edges won’t do Changing expectations Collaboration and contribution

Self Directed Thinking @simonduffy Centre for Welfare Reform How else could this be done? What other resources are around? Who else should do this? How do we ensure we don’t get in the way? How do we ensure we recruit the right people?

Challenge and Change Clear vision – human rights/citizenship What matters most? Focus on outcomes How to do it – fundamental redesign Should it be us?

Change: Doing it Differently David and his family (anon) 9k budget Where we started. Where they took it. Where we stopped.

We cannot solve our problems with the same thinking we used when we created them. Albert Einstein

Change: Thinking Differently Exploring possibilities Tech developments Go beyond traditional sources Ramps and stair climbers Facetime and apps

Working Together Misery money Statement of intent Sandy Misery money Statement of intent Block contracts to individual budgets Culture change Vision Releasing potential

Working Together Focus on what matters most Listen hard and learn continually Cost less achieve more Sharing the learning Some things you cannot put a price on

Lessons The road may be bumpy Cultivate allies Hold the vision – human rights /citizenship Keep it simple where possible Focus on community Ensure technology works for you

Working it out together If you can't explain it simply, you don't understand it well enough. Albert Einstein

Table Discussion What does Joint Commissioning mean for you and your organisation? What opportunities exist for joint commissioning? What are the barriers? How could we make it work? Having seen the presentations from Inclusion and C-Change what lessons can be learned for implementing change? What are the parallels and differences between the two organisations? What are the parallels and differences in relation to your own organisation?  How are changes within your organisation being viewed by staff, service users and carers? SLW/ NMW Transformational Change Projects Technological Organisational

Question and Answer Session