1 The occupational therapy role in delivering social care in the next five years College of Occupational Therapists– 5 th June 2014 Glen Mason Director of People, Communities and Local Government Department of Health DH – Leading the nation’s health and care

2 Care and Support affect a large number of people Many people need some extra care and support during their adult years to lead an active and independent life. Three-quarters of people aged 65 will need care and support in their later years… DH – Leading the nation’s health and care

3 Supported …and around 5 million people caring for a friend or family member. …around 310,000 people in residential care, 60% of whom are state-supported …around 680,000 people in domiciliary care, 60% of whom are state-supported …1.8 million people working as care professionals In England there are … Supported …and around 5 million people caring for a friend or family member. …around 310,000 people in residential care, 60% of whom are state-supported …around 680,000 people in domiciliary care, 60% of whom are state-supported …1.8 million people working as care professionals … Care and support affects a large number of people DH – Leading the nation’s health and care There are 800,000 people living with dementia and it is forecast that 1 in 3 people currently over 65 will develop dementia 178,000 people receiving direct payments More and more people are living with one or more long term conditions e.g. heart disease, hypertension, diabetes, etc.

4 Drivers for Change in the English Care System Demographic pressure Unprecedented financial challenges Raising expectations Technological Change Systems failure eg: Mid Staffs Hospital and Winterbourne View A drive to integrate services DH – Leading the nation’s health and care

5 We will change care and support in two fundamental ways: The Care and Support Act – our vision 1. The focus of care and support will be to promote people’s independence, connections and wellbeing by enabling them to prevent and postpone the need for care and support. 2. We will transform people’s experience of care and support, putting them in control and ensuring that services respond to what they want. DH – Leading the nation’s health and care

6 “For adult care and support in England to respond to challenges it must help people to stay well and independent” The Care Act and other reforms will: Promote people’s wellbeing Enable people to prevent and postpone the need for care and support Put people in control of their lives so they can pursue opportunities to realise their potential People have greater certainty and peace of mind over the costs of meeting care and support needs | Implementing the Care Bill DH – Leading the nation’s health and care

7 A shift in the care and support system FromTo Repair Focusing only on response after a crisis Prevention Acting earlier to prevent or delay needs Fragmentation Isolated services focused internally Integration Joined-up services working as partners Paternal State knows best Personal Person knows best Exclusive “Doing to” Inclusive “Doing with” DH – Leading the nation’s health and care

8 Shifting the focus – from crisis to wellbeing Need for intensive care and support Living well Low-level needs Crisis People will be given better information and advice to plan ahead to prevent care needs, and will be better connected to those around them. More support within communities, better housing options and improved support for carers will help people maintain their independence and avoid a crisis. Re-ablement services and crisis response will help people regain their independence at home after a crisis. The new system will promote wellbeing and independence at all stages to reduce risk of people reaching a crisis point, and so improve their lives

9 DH – Leading the nation’s health and care Choice, control and quality People can choose between a range of high quality options, or create their own People develop their own care and support plan People have clear information to make good choices about care People are in control of their own budget People’s views are heard and help improve services In the new, person-centred system... i

10 The Care Act is built around people People’s well-being will be at the heart of every decision Carers rights on the same footing as those they care for Freedom and flexibility to encourage innovation and integration Preventing and delaying needs for care and support Personal budgets giving people greater control over their care Information and advice about the care and support system New guarantees to ensure continuity of care DH – Leading the nation’s health and care

11 The Care Act is built around people Promoting the diversity and quality of the local care market, shaping care and support around what people want Ensure that no one goes without care if their providers fails Puts adult safeguarding on a statutory footing for the first time Young adults receive care and support during transition Reforms what and how people pay for their care and support DH – Leading the nation’s health and care

12 What does the Occupational Therapy Workforce in Social Care look like now? 1.5 million people working in adult social care in total Of these, 3,800 are occupational therapists 2,800 occupational therapists work in a statutory setting and 1,000 work in an independent setting Occupational therapists have been working in social care since 1970 The workforce is mainly female (93%) Occupational therapists deal with between 35-45% of local authority referrals and yet make up only 2% of the workforce ? turnover rates (21%) DH – Leading the nation’s health and care

13 Benefits of integration Better use of existing resources for health and care services Better use of existing resources for health and care services Co-ordinated approach to health and social care Putting users at the heart of the service Better outcomes for users Bring together a greater range of skills and expertise Bring together a greater range of skills and expertise Access to care and support 7 days a week Reduction in demand on acute services DH – Leading the nation’s health and care Pioneers Programme and Better Care fund

14 Examples of where it’s happening In Greater Manchester the 10 authorities and 12 Clinical Commissioning Groups have joined forces to support the largest reconfiguration of hospital services in the National Health Service. Projected to save £270 million over 5 years. In Greater Manchester the 10 authorities and 12 Clinical Commissioning Groups have joined forces to support the largest reconfiguration of hospital services in the National Health Service. Projected to save £270 million over 5 years. Pioneers In November 2013 the Department of Health announced the 14 pioneers which will lead the way in co-ordinated care. These pioneers are driving the integrated care agenda forward by taking innovative new approaches in transforming the way health and care services are Delivered. Pioneers In November 2013 the Department of Health announced the 14 pioneers which will lead the way in co-ordinated care. These pioneers are driving the integrated care agenda forward by taking innovative new approaches in transforming the way health and care services are Delivered. In Greenwich 2,000 patient admissions have already been avoided thanks to interventions by the Joint Emergency Team. The team responds to alerts within care homes, A & E departments and GP surgeries. In Greenwich 2,000 patient admissions have already been avoided thanks to interventions by the Joint Emergency Team. The team responds to alerts within care homes, A & E departments and GP surgeries. At South Devon and Torbay they have found that by bringing professionals closer together it has cut waiting times. Patients used to have to wait 8 weeks for physiotherapy service, now they wait only 48 hours. At South Devon and Torbay they have found that by bringing professionals closer together it has cut waiting times. Patients used to have to wait 8 weeks for physiotherapy service, now they wait only 48 hours. The Tri-borough calculated that 20% of the local population account for 77% of health and social care costs. It’s new model designed to help people manage chronic conditions more effectively and reduce hospital admissions, is estimated to deliver £38m net savings per year. The Tri-borough calculated that 20% of the local population account for 77% of health and social care costs. It’s new model designed to help people manage chronic conditions more effectively and reduce hospital admissions, is estimated to deliver £38m net savings per year. DH – Leading the nation’s health and care

15 What is Government doing to support this? The Better Care Fund June 2013 announcement: £3.8bn to be deployed locally in 2015/2016 on health and social care through pooled budget arrangements June 2013 announcement: £3.8bn to be deployed locally in 2015/2016 on health and social care through pooled budget arrangements Local authorities and NHS Clinical Commissioning Groups must agree a joint plan to deliver better, person-centred care before receiving funding Part of the £3.8bn allocated to local authorities includes a payment for performance element to incentivise ambition and real change Autumn Statement December 2013: Pooled budgets will be an enduring part of framework in future years Autumn Statement December 2013: Pooled budgets will be an enduring part of framework in future years DH – Leading the nation’s health and care

16 DH – Leading the nation’s health and care

17 Role of Occupational Therapists in adult social care Helping people to remain in their own homes and carry out activities safely Promote and support personalisation A key to the delivery of re-ablement services Assess need for technology to support people to live independently in their own home Home safety checks Review care packages Assess and problem solve manual handling issues DH – Leading the nation’s health and care

18 The contribution of Occupational Therapists to social care A significant contribution is made by a small workforce: Provision of equipment reduces care package costs Housing adaptations can reduce or remove the need for daily care visits Prevention of falls at home leads to significant savings to health sector Postponing entry into residential care through adapting people’s homes results in significant cost savings Telecare can save costs where it replaces traditional care DH – Leading the nation’s health and care

19 Care Act 2014 – implications for Occupational Therapy Many Acts you have been familiar with have been repealed Introduction of the well being principle – this is fundamental to OT philosophy Duty of candour now enshrined in law Introduction of prevention where OTs have a key role to play Integration is in the act Please get involved in the consultation response on the guidance note. Julia Skelton is leading response from COT DH – Leading the nation’s health and care

20 Thank you and any questions? Glen Mason Director of People Communities and local Government Department of Health DH – Leading the nation’s health and care