Torbay Multi-provider Conference April 2010 The Impact of Our Assumptions for an Evolving Market John Bryant Head of Commissioning: Community Services Torbay NHS Care Trust

Social Worker Domiciliary Care O.T. Family & Friends G.P. Practice Nurse District Nurse O.T. Diabetologist Cardiologist

Carers Memory Cafes Tele Care Transport Specialist Care Information & advice Choice & control Self Care Leisure Employment Individual budgets Housing Education Neighbourhoods Volunteers Home Treatment Tests & Investigations SAP Specialist Services Integrated Care Family & Friends

Under Pressure - Tackling the financial challenge for councils of an ageing population- Audit Commission Taking a strategic viewTaking a strategic view Managing costsManaging costs Prevention and interventionPrevention and intervention Using informationUsing information

Under Pressure - Tackling the financial challenge for councils of an ageing population- Audit Commission Taking a strategic viewTaking a strategic view Managing costsManaging costs Prevention and interventionPrevention and intervention Using informationUsing information High Quality Care and Services SafeSafe EffectiveEffective Client, Customer and Patient ExperienceClient, Customer and Patient Experience

Whole System Modelling Understanding ‘our’ needs – High level Care Home Beds needed in the short term. Identify the requirement for the next 2-3 years. Identify opportunities for change and rationalisation “Shape” a viable market able to withstand and support further system change, development and diversification Beds in the care ‘system’ overall, over the medium to long term. Forecast the number and type of beds required at (say) 5, 10, 15 and 20 years given demographic and system changes, analogous to the drivers of health and social care change in the Integrated Care Programme (ICP). Total Place modelling Look at the total bed stock (one indicator) – general needs housing plus community developments – and include the impact of business and economic developments.

Housing Care and Support Community Hospitals Acute Hospital(s) Whole System Modelling Our approach to key capacities and flows Home/ General population Demand characteristics and pressures Supply characs Supply characs Supply characs Care Homes Demand characteristics Supply characs Demand characteristics Sub-models linking to each other via demand, i.e. its scale, its characteristics, its rates of flow and its associated costs Who? Why? Where? How long? Access BY community services Access TO community services How does it all fit together at the moment? How do we want it all to work in the future?

Whole System Modelling Understanding ‘our’ needs A model of service & bed requirements which provides… A tool for testing different scenarios. Entry of assumptions at a local level. The testing of outputs from the Integrated Care Programme & collaborative initiatives A facility for use over several years – A tool for sharing not a single answer

Whole System Modelling Understanding ‘our’ needs – A model of bed requirements which allows for… Different “Whole System” contexts, e.g. more step up/ down Care Home beds reduces the number of acute hospital beds or community step up/ down beds.Different “Whole System” contexts, e.g. more step up/ down Care Home beds reduces the number of acute hospital beds or community step up/ down beds. Increased Personalisation many of whom elect for communal quality residential care, many others shaping the market by alternative demandIncreased Personalisation many of whom elect for communal quality residential care, many others shaping the market by alternative demand Forecasts based on effective intermediate care and the development of Support services, Workforce skill sets in domiciliary careForecasts based on effective intermediate care and the development of Support services, Workforce skill sets in domiciliary care The impact of Assistive Technology and adaptive aids to support providers & intermediate care.The impact of Assistive Technology and adaptive aids to support providers & intermediate care. Extra Care requirements.Extra Care requirements.

Whole System Modelling The model behind the tool Breakdown by: Age and gender Sector Reasons for admission Care requirements Locality Other TBC +/- Choice/ Personalisation +/- Social change? To include full set of assumptions Breakdown by: Year of forecast Sector Age and gender Reasons for admission Care requirements Locality Other TBC Breakdown by: Year of forecast Sector Client group Locality/ Site Other TBC For example including assistive technology To include full set of assumptions

Whole System Modelling Understanding ‘our’ needs Collaborative working Harmonised approaches Shared information Commissioning for Quality and Innovation Role of the commissioner information provider, co-ordinator, facilitator