1. Carers and place-based commissioning
ADASS Carers Leads Network
09 November 2017

2. Coming up Place based commissioning NHS Right Care Programme
Delivering the Forward View –
(NHS England Planning Guidance)
Sustainability and Transformation partnership (STPs)
Commitment to Carers
NHS England and the “Carers Toolkit”

3. Place based-commissioning

4. What is place-based commissioning?
NHS organisations and services work together to address the challenges they collectively face
Steps to better health, wellbeing and care can be driven by a place-based approach through integrated commissioning systems with devolved pooled budgets, participatory budgeting and agreed shared outcomes.
Individual institutions are encouraged to supplement planning with planning by place for local populations

5. The NHS Right Care Programme
Local partners collaborate to:
Make the best use of their resources
Understand their performance
Talk together about the same things to encourage joint decision-making
Focus on areas of greatest opportunity
Use tried and tested evidence based processes to make sustainable improvement to reduce unwarranted variation.
Under the Right Care Programme, local partners collaborate to:
Make the best use of their resources – by tackling over use and underuse of resources
Understand their performance – by identifying variation between demographically similar populations so they can adopt and implement optimal care pathways more efficiently and effectively
Talk together about the same things – about population healthcare rather than organisations and encouraging joint decision-making
Focus on areas of greatest opportunity by identifying priority programmes which offer the best opportunities to improve healthcare for people and ensuring taxpayer money goes as far as possible
Use tried and tested evidence based processes to make sustainable improvement to reduce unwarranted variation.

6. Delivering the Forward View (2015)
Requires commissioners to produce a sustainable transformation plan (STP) that involves 5 things:
local leaders coming together as a team
developing a shared vision with the local community, which also involves local government as appropriate
programming a coherent set of activities to make it happen
execution against plan
learning and adapting

7. STPs will bring together:
Carers
Citizens
Community
Partners
Local
Government/
HWB
Clinicians
Patients
Success for the Sustainability and Trasnformation Partnerships depends on having an open, engaging, and iterative process.
It will bring together the work of:
clinicians
patients
carers
citizens
local community partners (including the independent and voluntary sectors)
local government (through health and wellbeing boards)

8. What are the aims of STPs?
engage patients, staff and communities from the start, developing priorities through the eyes of those who use and pay for the NHS
develop services that reflect the needs of patients and improve outcomes by 2020/21 and, in doing so, help close three identfied gaps (in care quality, in public health and wellbeing, and in NHS finances)  .across the local health and care system
mobilise local energy and enthusiasm around place-based systems of health and care, and develop the partnerships, governance and capacity to deliver
provide a better way of spreading and connecting successful local initiatives, providing a platform for investment from the Sustainability and Transformation Fund
develop a coherent national picture that will help national bodies support what local areas are trying to achieve.
The scope of STPs is broad. The plans will need to show how local services will evolve and become sustainable over the next five years, with a focus on integrating social care — ultimately delivering the ‘Five year forward view’ by:
Improving quality;
Developing new models of care;
Improving health and wellbeing;
Improving efficiency of services

9. Our journey to building a carer-friendly care system
Commitment to Carers
2014
Carers Toolkit 2016
Primary Care Quality Framework 2018
Commissioning Carer-friendly services
2018/19
The Commitment to Carers provides a suite of products to help NHS and social care commissioners, NHS and social care providers, and third sector partners, to:
Improve the recognition and support that unpaid carers and their families receive
Do more to help identify, support and recognise carers’ vital roles
Help carers to provide better care and to stay well themselves
Work together in identifying, assessing and supporting the wellbeing of carers and their families
Meet their statutory duties under the Care Act (2014).

10. “Carers Toolkit” A national model for a local solution,
contains three elements:
Model for an integrated approach to identifying
and assessing carer health and wellbeing need
Template Memorandum Of Understanding, to articulate locally agreed approach
Examples of positive practice aligned round supporting principles
The central aim of the carers toolkit is to develop an integrated approach to the identification, assessment and support of carers’ health and wellbeing needs across health and social care to:
a. maintain the independence, physical health and emotional wellbeing of carers and their families
b. empower and support carers to manage their caring roles and have a life outside of caring
c. ensure carers receive the right support, at the right time, in the right place
d. respect the carer’s decision about how much care they will provide and respect the carer’s decision about not providing care at all
The Memorandum of Understanding (MOU)
This model sits on a number of supporting or delivery principles which describe how local partners will work together to implement the integrated approach; to help articulate this partnership, the toolkit contains a template Memorandum of Understanding. This should be adapted to meet the locally agreed approach.
Supporting delivery principles and positive practice
These principles are taken from what carers and their representatives have consistently told us would make the greatest improvement to the experiences of carers and their families.
Further information on NHS England and the Commitment to carers can be accessed at:

11. STPs and the Carers Toolkit
In Greater Manchester, 10 local authorities and 13 CCGs have developed a universal offer using the MOU for their 280,000 identified carers
Across Surrey, the county council, local authorities, six CCGs and a carers charity have committed to using the local MOUs to improve support for over 115,000 Carers
The West Yorkshire and Harrogate STP is using the MOU to identify support for over 223,000 unpaid carers
Across Hertfordshire County Council, the MOU has been used to plan support for over 109,000 unpaid carers
In Wiltshire, the MOU will help strengthen the support available to 48,000 registered carers.

12. Any questions?

13. Further information
Patient Experience Team NHS England Tel: Dave Ross Leadership Support