1. Supporting NHS Wales to Deliver World Class Healthcare Intermediate Care in Context: Why we are here today Chris Hill and Lynda Chandler

2. Harry’s Story

3. Harry’s story: the alternative version Assessment A comprehensive unified assessment could have identified Harry’s holistic needs. Diagnostics Local arrangements/hot clinics could have provided rapid assess to pathology, radiology and endoscopy

4. Harry’s story: the alternative version Treatment options Admission for blood transfusion but early discharge to community support (rehab/reablement/social care package/step down). Follow up options Could include any combination of primary care, social care, telecare, supported housing, secondary care review.

5. Missed opportunities for admission avoidance/early discharge Ambulance decision to admit because no safe alternative MAU assessment – a turning point? Admission – early identification of health and social care needs. Clear risk assessment & management Community In reach teams Secondary/Primary care communications Early liaison, communication and discharge planning

6. Context for Today “ I have confidence to go outdoors again, I can get back onto public transport and meet my friends.” “I am much better now, I can lead a normal life again.”

7. Policy Backing? NSF Older People in Wales Strategy for Older people in Wales Designed for Life Fundamentals of Care Creating a Unified and Fair System for Assessing and Managing Care WHC (2002)128 IC Guidance Fulfilled Lives; Supportive Communities Designed to Improve Health and the Management of Chronic Conditions in Wales Fundamentals of Care To name but a few!

8. Threat or Opportunity? Potential from today and the SPICE programme to demonstrate: Effective Intermediate Care makes a real difference to individuals Properly planned community based services can effectively meet the continuum of care needs Return on Investment can be achieved

9. How can we do it? Participating in the SPICE programme Working together as a network to: - raise the profile of IC - develop an evidence base of what works in Wales and why - use an integrated approach to problem solving

10. “ You can’t wait for inspiration, you have to go after it with a club” Jack London