1. A new way of delivering adult social care
Working with Health Colleagues
Tandra Forster

2. This Presentation
What is ‘a new way of delivering adult social care’? How is it different? What have we done so far?
What’s the evidence? What have we learnt?
Health and Social Care Integration – what opportunities are there?
The proposal for some joint work.
Benefits we would expect to see.
Next Steps.

3. A New Way of Delivering Adult Social Care. How is it different
A New Way of Delivering Adult Social Care. How is it different? Old System.
Social Care is a sorting office.
Contact centre keeps people out – divert, signpost away.
If people get in – they wait.
Eventually the offer is ‘an assessment for services’. Offer is ongoing time and task plan. Home care, day care, residential care.
Impersonal, ineffective, waiting = risk. Creates dependency culture.
Poor use of skilled workforce. Low value process-driven activity

4. A New Way of Delivering Adult Social Care. How is it different
A New Way of Delivering Adult Social Care. How is it different? New System.
No waiting lists, hand-offs, referrals. No passing people round the system.
Immediate conversations at point of contact:
Can I connect you to things that pre-exist in your community to help you get on with your life?
If you are in crisis, I will listen hard, understand what needs to change, and stick to you like glue for a short time to help effect that change.
Only after 1 and 2 will I consider a long term plan – based on a personal budget.

5. What have we done so far?
Started in January. 3 innovation ‘bubbles’ working differently. Different behaviour, culture, practice.
Rigorous collection of data so we can measure the impact, the change.
Focus on reflective practice and individual and team accountability for outcome and quality.
Just completed first phase of evaluation:
Impact on people and families
Impact on staff
Impact on activity
Impact on money.

6. What have we learnt? People and staff
People and carers:
More personal, talked to far fewer people
Higher satisfaction ratings compared to old system
Staff
12.5 % very satisfied with role ‘pre innovation’
87.5% very satisfied after innovation.
Staff much more able to use their skills and knowledge
Staff do not want to go back to their old way of working

7. What have we learnt? Activity
Early days but many fewer conversations about long term support. Old world: for every 10 new contacts, one long term plan. New system for every 20 new contacts one long term plan.
50% conversations are tier 1 (making connections for people)
45% conversations are at tier 2 – prevention plans to maintain independence.
5% conversations at tier 3 – ongoing support.

8. What have we learnt? Activity
Money
Having the 3 conversations takes a bit longer than ‘divert, signpost’ etc. Staff costs go up a little.
However massively outweighed by significant impact of fewer long term plans – factor of 6:1.
So for example an investment of circa £100k could reveal a financial benefit of £600k in reduced package costs.
However very early days. Need to scale up and prove this impact can be sustained.

9. Health and Social Care Integration – what opportunities are there?
We would like to learn more about how to work like this in an integrated environment with health partners.
We would particularly like to identify a GP practice where we could design an innovation site based on this way of working.
Can we improve the way we work with the 2% of popn. from current risk stratification?
Can we improve the way we work with the next 5% and prevent/reduce/delay their need for health and social care services?
Can we reduce workload on GPs and on A and E?
Can we the health and wellbeing, and the quality of experience of people and families.

10. Our Draft Proposal – for discussion. Can we:
Partner with an interested GP practice?
Define a cohort of people we want to work with?.
Create and work with a local network of health and social care resources – GP, Social Work, OT, District Nurse, Pharmacist etc..
Use our three tier conversation model and measure impact?
Collect data to create compelling evidence of what happens when we do.
Explore the core idea of:
A single view of the person across health and social care
One plan
One co-ordinator of the plan

11. Benefits we would be looking for.
Reduced pressure on GP workloads and appointments.
Reduce admission to A and E.
Greater resilience in people and communities to support independence and well-being.
A joined up and more effective response to heavy users of health and social care resources.
Much improved experience for people and families:
Clear co-ordination
One plan
Tell their story once

12. Next Steps. What do you think? Does this proposal have merit?
Is there a particular GP practice/area best suited to trying to work in this way?
If so we would like to have further more detailed conversations about how we could jointly design this work.