Improving the health and independence of older people in Croydon Feedback Meeting 6-8pm, Thursday 3 July Bernard Weatherill House, Croydon

Welcome Hannah Miller Executive Director for Adult Services Croydon Borough Council

The challenges Croydon has both a growing and ageing population Increasing numbers of patients are living with long-term conditions There is potential for Croydon to improve its performance in terms of care for patients over 65

What do want to achieve at this meeting? Set out the reasons why we are looking at services for older people Communicate how the views of the public, patients and carers have impacted the design of outcomes Provide an opportunity for attendees to look at the outcomes and discuss How the views of the public, patients and carers have impacted the design of outcomes The outcomes and find out from you if they reflect the needs of people over 65 in Croydon? what difference these outcomes might make to future services for over 65’s

Agenda Time Topic Lead 18:00 – 18:10 Welcome What do we want to achieve tonight? Hannah Miller 18:10 – 18:35 Overview of engagement work What have we been doing with the information we have collected? Liz Bailey 18:35 – 19:05 Break-out session 1 – Sharing the Outcomes 19:05 – 19:35 Break-out session 2 – Measuring the impact 19:35 – Close Close What is the vision for older people’s services and how will outcomes help us achieve this? Dr Agnelo Fernandes

Developing outcomes with Croydon residents Liz Bailey Outcome Development Lead

Outcomes Based Commissioning Engagement Programme What have we been doing? Engaging with a wide range of people who live in Croydon. Engaging with clinicians and practitioners who work in health and social care in Croydon. Collecting views, opinions and information about health and social care for the over 65’s. Running working groups with volunteers to develop an Outcomes Framework.

Summary of Engagement Activities 3 public Events One to One Interviews Lunch Clubs Surrey Street Market Access Croydon BME Forum Event Carers Day Event Sheltered Housing Primary Care Engagement Clinician and Practitioner Engagement Working Groups

Quotes from engagement events “Small groups meant we were able to input into the variety of topics under discussion” “Diversity of the group – age, ethnicity & gender. It was very informative” “It enabled us to express our thoughts and learn about other people’s views about the needs in Croydon” “Good discussions – we were able to put points forwards” “There were well run, well organised group discussions”

What is an Outcomes Framework? High Level Outcomes Produced with local people, clinicians and voluntary sector Outcome Goals Give more definition to the high level outcomes. Outcome Indicators Allow us to clearly demonstrate achievement or otherwise of the outcomes. Incentivised Indicators Chosen to incentivise outcome improvement

How the Outcomes Framework was developed. Looking at best practice care internationally Four themes were identified Themes were then used in our engagement events Literature Review Feedback, data and ‘I’ Statements collated from the events. 4 high level outcomes (‘I’ Statements) were then generated Data used to develop first draft of outcome goals Events & 1:1 interviews Volunteers from the public events, Clinicians and practitioners Tested and further develop the outcome goals Develop potential indicators Working Groups

How ‘I statements’ become “high level outcomes” Long Term Conditions I would like joined up treatment via a case manager who has access to all areas of health and social care. I would like to keep a dedicated GP who knows about my medical/personal history. I want to be supported by a member of the health and social care team who has had the training and has the specialist knowledge to understand how my health and social care needs affect me Unplanned Care I feel known as a person and a service specific to me I have care with the right input at the right time to return to “normal” as soon as possible I need treatment quickly and tailored to my needs. I want to be supported as an individual, with services specific to me Keeping Healthy and Well I would like to know that support is available if my health deteriorates. I want service to keep me as healthy as possible for as long as possible. I would like to be advised of opportunities and facilities to improve my healthy lifestyle. I want to stay healthy and active for as long as possible Independence I feel safe inside my “home” I feel people should be helped to stay in their own home or appropriate setting I want to receive the best quality care available in order to live as I choose and as independent a life as possible

The High Level Outcomes I want to stay healthy and active for as long as possible. I want to receive the best quality care available in order to live as I choose and as independent a life as possible. I want to be supported by a member of the health and social care team who has had the training and has the specialist knowledge to understand how my health and social care needs affect me. I want to be supported as an individual, with services specific to me. 4 High Level Outcomes

How were ‘outcomes’ and ‘outcome goals’ developed High Level Outcome 1 I want to stay healthy and active for as long as possible Outcome Goal 1.2 Prevent Obesity and malnourishment Eat well and keep active from a younger age - not just waiting until retirement eat well and keep active from a younger age Outcome Goal 1.10 Avoiding Loneliness Being socially included Sense of purpose Live as sociable a life as desired

Working Groups Three Working Groups were held in May and June. Participants were: Members of the public who attended Town Hall Events, clinicians and practitioners from health and social care organisations. Working groups used the raw information we received from the public and patients Outcomes and Outcome goals were refined to produce an ‘outcomes framework’

Working Groups Involvement from the public Why I volunteered. How I contributed as a member of the group. What I understand about the process. Why it was important to have public involvement in the development of the outcomes.

How engagement has shaped the outcomes The engagement activities were co-designed with local voluntary sector organisations. As a result, we have engaged over 400 Croydon residents through a range of engagement activities. All suggestions are properly considered and priority given to those where there has been agreement about their relevance and importance. The views of the public, patients and carers have fundamentally shaped the outcome framework

Breakout session 1 – Sharing the Outcomes What difference will these outcomes make to future services for over 65’s? How might things change?

Breakout session 2 – Measuring the impact Using one of the outcome domains as an example answer the following questions: What will this mean for services, patients, carers, clinicians in the future? How will we know this is happening? How will we know the outcomes are being delivered?

Outcome 1. I want to stay healthy and active for as long as possible. Outcome Goals Be able to manage my memory loss and dementia Eat well and keep active from a younger age Have access to information, that is consistent, in a format that is accessible and understandable to me. Expect and have access to proactive and preventative care feel that their wider social networks (including faith groups) are involved and supported to help me stay well Feel that I and my family are supported to help me stay well Have access to appropriate choices about services Have equality of access to services regardless of where I live and my financial status. Live an active a life as possible Live as sociable a life as desired Maintain positive mental wellbeing when my circumstances change. Plan for old age – emotionally, e.g. coping with physical, mental and social decline Plan for old age – Practically, e.g. finances, washing (life skills)

Outcome 2. I want to receive the best quality care available in order to live as I choose and as independent a life as possible. Outcome Goals Meet my full physical, mental and social potential Plan for a more dependent future... whilst I can Plan for old age - Practically e.g. finances, personal care ...life skills Meet their full physical, mental and social potential Live "at home, not in a home" for as long as safely possible and for as long as I choose, including by self-care Know how to access services Feel that my wider social networks (including faith groups) are involved and supported to help them stay well Feel safe in my own home Feel safe in my community Expect and have access to proactive and preventative care Can access opportunities to meet my desire for social activities and choose when and where I meet others and socialise Carers and families feel supported to help people to maintain my well being. Access transport and travel options Access respite care when needed Access appropriate housing Access appropriate assistive technologies to support my access to services and my independence. Manage the process of gradual deterioration in: eyesight, hearing & mobility and mental capacity including self care

Outcome 3. I want to be supported by a member of the health and social care team who has had the training and has the specialist knowledge to understand how my health and social care needs affect me. Outcome Goals Be assured that when something unexpected happens their next of kin and GPs are contacted early to find out about me. Can experience appropriate translation services Manage the level of pain experienced Expect care from the right person at the right time in the right place Expect care that is on time and punctual. Have help to navigate my way though the system Expect information that is in line/coordinated with the care I receive Expect integrated and co-ordinated healthcare, social care and voluntary sector involvement Expect to be respected and treated as an individual even in a group with similar needs Expect and receive support to ensure appropriate treatment / feel I am a partner in their decisions about my care Expect that the care I receive will be safe Expect to be treated as a whole person (holistically) and not a single condition including social, cultural and psychological aspects Expect to have a plan in place that anticipates crises Expect a timely recovery to maximum possible level of health. Receive information that is in line/coordinated with the care I receive Expect to receive a good care when in a crisis

Outcome 4. I want to be supported as an individual, with services specific to me. Outcome Goals Expect care from the right person at the right time in the right place Expect consistency of care between providers Have access to information, that is consistent, in a format that is accessible and understandable to me. Expect integrated and co-ordinated healthcare, social care and voluntary sector involvement Expect that the care I receive will be safe Expect my feedback will be listened to and effect change where appropriate Expect to be treated as a whole person (holistically) and not a single condition including social, cultural and psychological aspects Experience care that is tailored to me, physically psychologically and socially including with regard to issues around privacy. Experience care that is timely including to prevent deterioration and promote recovery. Feel supported to care for myself where appropriate Feel I am a partner in their decisions about their care including identifying risks Receive information that is in line/coordinated with the care I receive

Dr Agnelo Fernandes Assistant Clinical Chair Croydon CCG Thank you Dr Agnelo Fernandes Assistant Clinical Chair Croydon CCG