The Gathering 23 February 2011 Mike Martin Partnership Improvement and Outcomes Division

Doing it right – getting it wrong!!!

WHY we need to ‘Reshape’ Care:  Sustainability – Rapidly ageing population – Declining public finances  Desirability – Promoting independence not dependence

PAUSE FOR THOUGHT:  More of the same will cost an extra £1.1 billion by 2016 – where will this come from?  Over 1/3 of all money spent on health/social care for over 65’s is on emergency hospital admission [£1.4 billion out of £4.5 billion each year]  89.5% of people over 65 yrs are not in the ‘care system’ [97% of people between yrs]  3,000 people 65 yrs+ receive more than 20hrs paid care per week  40,000 people 65 years+ provide more than 20hrs unpaid care per week

How do we spend the £4.5 billion …

Current service provision by service type

Current service provision by age group % 88% 60%

The challenge of change – more HOW than WHAT? WHAT:  A new philosophy of care – partnership and co- production  A shift of focus – enablement, empowerment, responsibility  A shift of resources – from institution to community  A conducive infrastructure to promote rather than prevent integration

HOW  Build an enduring consensus for the long haul  Clarity of ambition – what will success look like?  A decommissioning strategy – will impact on the acute sector  A commissioning strategy – coherent service redesign and development  Mutually reinforcing national and local strategies  Building Community Capacity – the ‘spine’ for re- shaping care

HOW – THE CHANGE FUND  £70 million for 2011/12 [circa £300 million over 4 yrs]  Subject to Change Plans – developed/agreed by Council/Health Board/3 rd sector/Independent Sector  To invest in community based provision – preventative and anticipatory  To impact on Core Budgets to promote de- commissioning  To promote effective partnership working

Reshaping Care for Older People – A Programme for Change  Publish on 4 March 2011  Our commitments:  Double proportion of spend on care at home – from 6.7% to 13.5%  Build capacity of community/3 rd sector to support/grow “supported self care”  Change Fund introduced - £300m over 4 yrs  Reduce unnecessary variation – potential to take out 11% of hospital beds  Reduce bed days for 75+ due to emergency admissions by 10% by 2015  No discharge direct from hospital to care home  All over 75+ to be offered a telecare package based on assessed need

OVERVIEW: COMMUNITY CAPACITY AND CO-PRODUCTION WORKSTREAM

CONTEXT >DEMOGRAPHY/ECONOMY >RESHAPING CARE FOR OLDER PEOPLE >WORKSTREAMS >CHANGE FUND >OPPORTUNITIES/CHALLENGES

COMMUNITY CAPACITY AND CO-PRODUCTION WORKSTREAM (1) >Values the capacity, skills, knowledge connections and potential in a community…sees citizens and communities as co-producers of health and well being (and) instead of doing things for people shares power and helps a community to do things for itself’ (Improvement and Development Agency, 2010)

COMMUNITY CAPACITY AND CO-PRODUCTION WORKSTREAM (2) >Older People are an asset not a burden >Community capacity building is working with the voluntary and community sectors to build a philosophy of care based on co-production principles and to develop new community driven models of care provision. >A partnership between those providing care and support and those providing it.

COMMUNITY CAPACITY AND CO-PRODUCTION WORKSTREAM (3) >Success has as much to do with shifting attitudes and expectations as it has about shifting resources, care institutions, providers and workforces. >Change Fund/ Change Plan – Opportunity and Challenge!

OUR ROLE >General Support for Partnerships >Developing the Knowledge and Evidence base >Building Networks and Communities of Practice >Sharing Good Practice >Signposting/Developing Guidance >Link to Scottish Government

Contact Details Scottish Government leads for Community Capacity Building & Co-production >Gerry Power >Andrew Jackson

Co-production >Delivering public services in an equal and reciprocal relationship between professionals, people using services, their families and their neighbours. Where activities are co-produced in this way, both services and neighbourhoods become far more effective agents of change. National Endowment for Science, Technology & the Arts (NESTA) & New Economics Foundation (NEF)