1. Improving the health and independence of older people in Croydon
Feedback Meeting
6-8pm, Thursday 3 July
Bernard Weatherill House, Croydon

2. Welcome Hannah Miller Executive Director for Adult Services
Croydon Borough Council

3. The challenges Croydon has both a growing and ageing population
Increasing numbers of patients are living with long-term conditions
There is potential for Croydon to improve its performance in terms of care for patients over 65

4. What do want to achieve at this meeting?
Set out the reasons why we are looking at services for older people
Communicate how the views of the public, patients and carers have impacted the design of outcomes
Provide an opportunity for attendees to look at the outcomes and discuss
How the views of the public, patients and carers have impacted the design of outcomes
The outcomes and find out from you if they reflect the needs of people over 65 in Croydon?
what difference these outcomes might make to future services for over 65’s

5. Agenda Time Topic Lead 18:00 – 18:10 Welcome
What do we want to achieve tonight?
Hannah Miller
18:10 – 18:35
Overview of engagement work
What have we been doing with the information we have collected?
Liz Bailey
18:35 – 19:05
Break-out session 1 – Sharing the Outcomes
19:05 – 19:35
Break-out session 2 – Measuring the impact
19:35 – Close
Close
What is the vision for older people’s services and how will outcomes help us achieve this?
Dr Agnelo Fernandes

6. Developing outcomes with Croydon residents
Liz Bailey
Outcome Development Lead

7. Outcomes Based Commissioning Engagement Programme
What have we been doing?
Engaging with a wide range of people who live in Croydon.
Engaging with clinicians and practitioners who work in health and social care in Croydon.
Collecting views, opinions and information about health and social care for the over 65’s.
Running working groups with volunteers to develop an Outcomes Framework.

8. Summary of Engagement Activities
3 public Events
One to One Interviews
Lunch Clubs
Surrey Street Market
Access Croydon
BME Forum Event
Carers Day Event
Sheltered Housing
Primary Care Engagement
Clinician and Practitioner Engagement
Working Groups

9. Quotes from engagement events
“Small groups meant we were able to input into the variety of topics under discussion”
“Diversity of the group – age, ethnicity & gender. It was very informative”
“It enabled us to express our thoughts and learn about other people’s views about the needs in Croydon”
“Good discussions – we were able to put points forwards”
“There were well run, well organised group discussions”

10. What is an Outcomes Framework?
High Level Outcomes
Produced with local people, clinicians and voluntary sector
Outcome Goals
Give more definition to the high level outcomes.
Outcome Indicators
Allow us to clearly demonstrate achievement or otherwise of the outcomes.
Incentivised Indicators
Chosen to incentivise outcome improvement

11. How the Outcomes Framework was developed.
Looking at best practice care internationally
Four themes were identified
Themes were then used in our engagement events
Literature Review
Feedback, data and ‘I’ Statements collated from the events.
4 high level outcomes (‘I’ Statements) were then generated
Data used to develop first draft of outcome goals
Events & 1:1 interviews
Volunteers from the public events, Clinicians and practitioners
Tested and further develop the outcome goals
Develop potential indicators
Working Groups

12. How ‘I statements’ become “high level outcomes”
Long Term Conditions
I would like joined up treatment via a case manager who has access to all areas of health and social care.
I would like to keep a dedicated GP who knows about my medical/personal history.
I want to be supported by a member of the health and social care team who has had the training and has the specialist knowledge to understand how my health and social care needs affect me
Unplanned Care
I feel known as a person and a service specific to me
I have care with the right input at the right time to return to “normal” as soon as possible
I need treatment quickly and tailored to my needs.
I want to be supported as an individual, with services specific to me
Keeping Healthy and Well
I would like to know that support is available if my health deteriorates.
I want service to keep me as healthy as possible for as long as possible.
I would like to be advised of opportunities and facilities to improve my healthy lifestyle.
I want to stay healthy and active for as long as possible
Independence
I feel safe inside my “home”
I feel people should be helped to stay in their own home or appropriate setting
I want to receive the best quality care available in order to live as I choose and as independent a life as possible

13. The High Level Outcomes
I want to stay healthy and active for as long as possible.
I want to receive the best quality care available in order to live as I choose and as independent a life as possible.
I want to be supported by a member of the health and social care team who has had the training and has the specialist knowledge to understand how my health and social care needs affect me.
I want to be supported as an individual, with services specific to me.
4 High Level Outcomes

14. How were ‘outcomes’ and ‘outcome goals’ developed
High Level Outcome 1
I want to stay healthy and active for as long as possible
Outcome Goal 1.2
Prevent Obesity and malnourishment
Eat well and keep active from a younger age - not just waiting until retirement
eat well and keep active from a younger age
Outcome Goal 1.10
Avoiding Loneliness
Being socially included
Sense of purpose
Live as sociable a life as desired

15. Working Groups Three Working Groups were held in May and June.
Participants were: Members of the public who attended Town Hall Events, clinicians and practitioners from health and social care organisations.
Working groups used the raw information we received from the public and patients
Outcomes and Outcome goals were refined to produce an ‘outcomes framework’

16. Working Groups Involvement from the public Why I volunteered.
How I contributed as a member of the group.
What I understand about the process.
Why it was important to have public involvement in the development of the outcomes.

17. How engagement has shaped the outcomes
The engagement activities were co-designed with local voluntary sector organisations.
As a result, we have engaged over 400 Croydon residents through a range of engagement activities.
All suggestions are properly considered and priority given to those where there has been agreement about their relevance and importance.
The views of the public, patients and carers have fundamentally shaped the outcome framework

18. Breakout session 1 – Sharing the Outcomes
What difference will these outcomes make to future services for over 65’s?
How might things change?

19. Breakout session 2 – Measuring the impact
Using one of the outcome domains as an example answer the following questions:
What will this mean for services, patients, carers, clinicians in the future?
How will we know this is happening?
How will we know the outcomes are being delivered?

20. Outcome 1. I want to stay healthy and active for as long as possible.
Outcome Goals
Be able to manage my memory loss and dementia
Eat well and keep active from a younger age
Have access to information, that is consistent, in a format that is accessible and understandable to me.
Expect and have access to proactive and preventative care
feel that their wider social networks (including faith groups) are involved and supported to help me stay well
Feel that I and my family are supported to help me stay well
Have access to appropriate choices about services
Have equality of access to services regardless of where I live and my financial status.
Live an active a life as possible
Live as sociable a life as desired
Maintain positive mental wellbeing when my circumstances change.
Plan for old age – emotionally, e.g. coping with physical, mental and social decline
Plan for old age – Practically, e.g. finances, washing (life skills)

21. Outcome 2. I want to receive the best quality care available in order to live as I choose and as independent a life as possible.
Outcome Goals
Meet my full physical, mental and social potential
Plan for a more dependent future... whilst I can
Plan for old age - Practically e.g. finances, personal care ...life skills
Meet their full physical, mental and social potential
Live "at home, not in a home" for as long as safely possible and for as long as I choose, including by self-care
Know how to access services
Feel that my wider social networks (including faith groups) are involved and supported to help them stay well
Feel safe in my own home
Feel safe in my community
Expect and have access to proactive and preventative care
Can access opportunities to meet my desire for social activities and choose when and where I meet others and socialise
Carers and families feel supported to help people to maintain my well being.
Access transport and travel options
Access respite care when needed
Access appropriate housing
Access appropriate assistive technologies to support my access to services and my independence.
Manage the process of gradual deterioration in: eyesight, hearing & mobility and mental capacity including self care

22. Outcome 3. I want to be supported by a member of the health and social care team who has had the training and has the specialist knowledge to understand how my health and social care needs affect me.
Outcome Goals
Be assured that when something unexpected happens their next of kin and GPs are contacted early to find out about me.
Can experience appropriate translation services
Manage the level of pain experienced
Expect care from the right person at the right time in the right place
Expect care that is on time and punctual.
Have help to navigate my way though the system
Expect information that is in line/coordinated with the care I receive
Expect integrated and co-ordinated healthcare, social care and voluntary sector involvement
Expect to be respected and treated as an individual even in a group with similar needs
Expect and receive support to ensure appropriate treatment / feel I am a partner in their decisions about my care
Expect that the care I receive will be safe
Expect to be treated as a whole person (holistically) and not a single condition including social, cultural and psychological aspects
Expect to have a plan in place that anticipates crises
Expect a timely recovery to maximum possible level of health.
Receive information that is in line/coordinated with the care I receive
Expect to receive a good care when in a crisis

23. Outcome 4. I want to be supported as an individual, with services specific to me.
Outcome Goals
Expect care from the right person at the right time in the right place
Expect consistency of care between providers
Have access to information, that is consistent, in a format that is accessible and understandable to me.
Expect integrated and co-ordinated healthcare, social care and voluntary sector involvement
Expect that the care I receive will be safe
Expect my feedback will be listened to and effect change where appropriate
Expect to be treated as a whole person (holistically) and not a single condition including social, cultural and psychological aspects
Experience care that is tailored to me, physically psychologically and socially including with regard to issues around privacy.
Experience care that is timely including to prevent deterioration and promote recovery.
Feel supported to care for myself where appropriate
Feel I am a partner in their decisions about their care including identifying risks
Receive information that is in line/coordinated with the care I receive

24. Dr Agnelo Fernandes Assistant Clinical Chair Croydon CCG
Thank you
Dr Agnelo Fernandes
Assistant Clinical Chair
Croydon CCG