Integrated Care in Erewash The story so far ……… Date: 13th February 2014

Meet the team GPs, senior staff from CCG, Community & mental health trusts, secondary care trusts, healthwatch, CVS, Optum (United health UK) DHU and Adult Care Recently reviewed membership, looking to include community pharmacy rep.

The New Erewash Model Feedback from previous Stakeholder Forum: “It’s great, but people don’t just fall in office hours, Mon – Fri” “SPA – seamless and timely” “Data collection and info sharing in NHS/adult care systems may need further development” This is the Erewash model. Simplified versions on tables. Brief overview: 2 main flows – rapid response & pro active care

Progress of Integrated Care in Primary Care and the Community Shared Access to IT systems 7 day service – SPA & Community teams Sitting Service Welcome Home Service SPA – 5 day service Community Delivery Teams Care Coordinators Risk Stratification Rapid response In response to previous comments: New services being piloted now, will need to be fully evaluated Brief description of each service Catalyst = Patient and stakeholder feedback

Rapid response, including SPA Proactive Care – CDTs   Care Coordinators Rapid response, including SPA Proactive Care – CDTs Longer term rehab/specialist services As the model encompasses so many different aspects, we wondered whether it would be better to break it down into elements and present different parts in more detail over the next few events? Care Coordination Rapid response & SPA CDT/case management Support services and Specialist services Any other requests/suggestions? Today = Care coordinators

Examples of their work (case studies) Care Coordinators How many are there? Where are they based? What do they do? Examples of their work (case studies) 6 coordinators in Erewash – now going to be rolled out across Derbyshire Each coordinator is attached to 2 practices – same as community teams so services are wrapped round patients

Thank you for listening Questions? Comments? Note any for the feedback.