1. SUPPORTING PEOPLE TO LIVE AND DIE WELL EAST MIDLANDS REGIONAL OVERVIEW
11 JANUARY 2011
MICK CONNELL
DIRECTOR OF ADULTS AND COMMUNITIES

2. Key issues and concerns and end of life care
Context
Personalisation
Partnership
Efficiency
The Challenge Ahead

3. Context
Coalition Government
Massive Changes:
Localism
NHS White Paper
Big Society
Financial Climate
What does it all mean for us?

4. Personalisation in Leicestershire
Putting People
First (PPF)
Self-Directed
Support

5. Adult Social Care Service
New Customer Pathway
Community
Adult Social Care Service
Advice &
Information
Prevention
& Early
Intervention
Customer
Service
Centre
Re-
ablement
RAS 
Support
Plan
Personal
Budget
Review
Support in place.
Live your life.
Outcomes met

6. PPF is everyone’s business
Transport
Volunteering
Social Inclusion
Community development
Creative provider services
Information and advice access points
Regeneration and social enterprises
Transitions

7. Think Local, Act Personal
Next steps for Transforming Adult Social Care (PPF2):
A proposed sector-wide commitment to moving forward with personalisation and community based support
Building on progress, recognising the new political and financial climate
A vision for Adult Social Care: Capable communities and
active citizens
The 7 P’s – key principles for a modern system of social care

8. Encouraging continued reform
Personalised care and support (direct payments is the
preferred delivery model for most)
Preventative, community-based approaches
Integrated service delivery
Supporting the continuation of individuals, families and
communities
Reducing the need for acute health care and support
Reducing duplication and improving outcomes

9. Partnership
“shifting the power from the state to the people, where people, in their every day lives, in their homes, in their neighbourhood, in their work place ….. don’t always turn to official, local authorities or central government for answers to the problems they face” (David Cameron July 2010)
Continuation of Putting People First - Capable communities and
active citizens
Principles extended to the NHS – “No decision about me without
me”
Collaboration and strong partnership horizontally and vertically
At the same time government wants to curb local government
spending and the expectation is for councils to comply with the
policy and the requirements to reduce overall public expenditure.

10. Key elements of the Adult Social Care Vision and NHS Equity and Excellence: Liberating the NHS
Key Principles
Adult Social Care Vision
Partnership
Prevention
Personalisation
Plurality
Protection
Productivity
People
Key Values
Principles for the NHS
Putting Patients and public first
Improving healthcare outcomes
Autonomy, accountability and democratic legitimacy
Cutting bureaucracy and improving efficiency

11. Direction of travel for Adult Social Care and the NHS
Adult Social Care Vision
Breaking down barriers
Extending roll out of personal budgets
Increasing use of direct payments
Making services more personalised
and more preventative
Focused on outcome
Devolving power to frontline workers
and carers
Stable financial base for next 4 years
Equity and excellence: Liberating the NHS
Is centred on patients and carers
Achieves quality and outcomes
Refuses to tolerate unsafe and substandard
care
Reduces inequalities in care
Puts clinicians in the driving seat and sets
hospital and providers free to innovate
and adopt best practice
Is transparent and accountable for quality
Citizens have a greater say in how the NHS
is run
Is efficient and dynamic with reduced
bureaucracy nationally, regionally and locally

12. Implications for Adult Social Care
Challenges
Continuous and rapid change for next 3 years
NHS and Adult Social Care required to achieve unprecedented efficiency gains despite increase and growth in funding
Invest in Prevention – identify models to suit all groups
Meeting needs and addressing inequalities
GPs responsible for commissioning majority of services
New governance arrangements for Health and Wellbeing Boards
Capacity building, culture shift and embedding the new structure
Opportunities
Leadership role for Adult Social Care at all levels
Ambition to increase quality through implementing best practice and increase options for prevention
Integrated re-ablement with investment for NHS long term conditions and improved responses to hospital discharge
Increase profile for public health
ASC will have major role for integration both in commissioning and service
Better intelligence on needs (JSNA/mortality profiles)

13. Efficiency
It’s grim!
Some councils are affected more than others
Maximise efficiency in any way possible
Service reductions are inevitable
A new, more sustainable model is needed:
state and individual
new funding arrangements for social care

14. Population
Still growing
Growing ever older and more diverse
65+ Generation have £1trn of assets - in 2020 their assets will
exceed GDP and exceed national debt
Adults with complex needs are fastest growing and highest
demand client group for care and support - they have few assets
Inequality of health, wealth and opportunity widening

15. Health and Social Care
Putting People First - delivering but is it enough?
National Care Service - is there political will for a step change?
Integration - why this time?
Quality and innovation - can commissioning deliver?

16. Transformation How far / How fast? National / Local
Putting People First
Personal budgets
Self Assessment
Independence at home
Shift from day and residential services
Prevention and re-ablement
National Care Service
Prevention and reablement
One assessment
One service
One budget
All pay/some pay?
Pay now/pay later?
How far / How fast?
National / Local

17. 3 stages 2009 2014 … Efficiency System Reform Manage Impact
Maximise efficiency
Speed up reform
Squeeze costs
Make case for
Radical change
Deliver system
Change
Health
Local Government
Total Place
New Offer
Commercial options
Political repositioning
Either …
-Implement new
Offer and funding
Model or ..
Reduce core
Services and manage
Community impact

18. Common efficiency priorities
Review eligibility, high cost placements and Resource
Allocation System [how much does each individual get?]
Review, rationalise or reduce residential homes and day
services (including supported employment) [closing high cost,
inflexible, in-house services]
Reduce overheads through management restructures,
customer centres, higher productivity assessment and care
management [organising a lower cost system]
Stopping or reducing uplifts to providers and voluntary
organisations [passing efficiency targets on to the market and
partners]

19. The Future: Adult Social Care rising to the challenge

20. Key issues Build a sustainable model Empower individuals
Supporting carers and families
Cradle to grave
Getting the culture right
Reflecting diversity
Skilling up our workforce
Integrated approaches
Working together
Having confidence in ourselves

21. and don’t forget
TRUST and OPTIMISM