All-Party Parliamentary Health Group – Case Study from Solihull Care Economy (ICASS) Tuesday 15th November 2016

ICASS aims & objectives Over the next five years, we’ll make the kind of changes that will really make a difference to people living in Solihull: We will support you and your family so that you are better able to look after yourselves We will work with you to make sure you’re getting the right care and support We will provide you with care where it’s best for you We will reduce the number of people who end up in hospital unnecessarily, or find themselves in a home for long-term care

A supplier perspective Andrew Young

Background Supported a Population Health Management company to identify opportunities for integrating care across the NHS and Social Care. Contract came to an end in January 2016. Met with ICASS Board to agree a pilot across Solihull Health and Social Care Economy Confirmed a project working with Integrated Community Team and Discharge to Assess Team Memorandum of Understanding signed with system leaders in June 2015 to deliver a pilot

Successes Good relationships built across the various stakeholders at a system leadership level Consistent involvement of front line staff in developing statement of works Focus on business and clinical issues not technical specifications Part of Solihull’s bid to win Vanguard status for Urgent and Emergency Care

Failures (up to January 2016) Difficulty in gaining access to data in a key system Information Governance issues were on-going Could have been more emphasis placed on outcomes Lines of accountability across stakeholders blurred at times Not easy to maintain senior level commitment to the pilot

Lessons Learnt Data – needs to be made available Budgets – helpful if they are jointly agreed Workforce – must be kept involved at all levels Governance – should have clear lines of accountability Return on Investment – be clear what outcomes are expected

An acute hospital perspective Prof Matthew Cooke

Background Increasing demand; people living longer with more illnesses “Congested” hospitals People deteriorating whilst waiting in hospital Isolated improvement projects not achieving change required in outcome or scale Moving the problem around the system not solving it Local history of collaboration

Successes Staff working together at patient level Understanding the local population rather than “patients” Population health not illness Earlier discharge Whole system solutions focussing on people Moving care closer to home

Failures Fit with other national initiatives, priorities & systems Financial systems limiting creativity Process change faster than cultural change Creating cross professional working of individuals Radical long term solutions Not sufficiently resilient to withstand organisational change

Lessons Learnt Focus on delivery, ensure governance Focus on individuals not organisations Delivering at pace but with sustainable solutions Trust and allegiances of senior leaders are essential Local people at the heart of decision making

A social care perspetive Ian James

Background Demography, Austerity, Local Government and Local Communities Staff across Health and Care working their socks off in a failing system Empowerment v. Paternalism Local Political Leadership key to achieving Health Transformation

Successes Alignment of Political, Professional and People Aspirations Health and Care as part of a wider People and Place and Public Sector Agenda Staff Empowerment (HSJ Secondary Care Redesign Award 2014) Low admission rates to RC and NC, reduced hospital readmissions for over 65’s

Failures Lack of engagement with wider NHS commissioning and regulatory system Governance and senior relationships not robust enough to withstand significant senior Leadership changes Cultural and workforce changes not embedded

Lessons Learnt Governance v Delivery – It’s not a trade-off, it’s both Need to deliver immediate impact but recognise sustainable change is a long-haul Senior Leader Relationship really are Key Politics, professionals and Local people

All-Party Parliamentary Health Group – Case Study from Solihull Care Economy (ICASS) Tuesday 15th November 2016