1. Working Together Tim Crayford Maggie Atkinson John Dixon

2. Dr. Tim Crayford President, ADPH Director of Public Health & Medical Director, Croydon NHS Primary Care Trust

3. Central Government ‘Our Health, Our Care, Our Say’ DH 2006 To ensure there is more visible local leadership on health and wellbeing, particularly on public health issues such as childhood obesity, smoking rates and health inequalities. It is important that the local authority lead member for adult social services is able to influence the commissioning decisions of health and social care bodies, and drive action to reduce health inequalities by engendering systematic partnership working between NHS bodies, local authorities and other partners, for example through greater use of joint appointments, pooled budgets and joint commissioning. We want to see health and social care services delivered seamlessly around the needs of patients, families and carers, and local partners able to work together in tackling the wider causes of social exclusion, worklessness, and vulnerability

4. Our Health, Our Care, Our Say New powers for Scrutiny (APHR) Jointly appointed DsPH LDPs to become more aligned with LAAs

5. NHS view on commissioning

6. Strong and prosperous communities …by engendering systematic partnership working between NHS bodies, local authorities and other partners, for example through greater use of joint appointments, pooled budgets and joint commissioning. We want to see health and social care services delivered seamlessly around the needs of patients, families and carers, and local partners able to work together in tackling the wider causes of social exclusion, worklessness, and vulnerability …local authorities will now be under a statutory duty to (establish) Local Involvement Networks (LINks) formal arrangements for Directors of Public Health to be jointly appointed and held jointly accountable by the chief executives of local authorities and PCTs

7. Strong and prosperous communities statutory partnership for health and well-being under the LSP Strengthened role for LA Scrutiny esp. in relation to the DPH and the APHR A new Lead Member at local authority executive level, whom we will expect to play a leading role on local health and well-being partnerships LAAs strengthened

8. Pulling it all together Annual Public Health Report (HEAs) 6 Domains of Choosing Health JSNA LSP LAA

9. JSNA DPH DCSS DASS JSNA

10. Care Services Ideal Need Demand Want

11. Efficient delivery Need Demand Want

12. Current Care Services Need Demand Want

13. Wellness needs? Need Demand Want

14. Challenges: Joint DPH Appointments Variable interpretation Clearly the right direction Need to remain NHS-based ?account via the LSP

15. Challenges: JSNA Information Accessing it Pooling it Analysing it – mapping it Presenting it in a JSNA Sharing our experiences with it

16. Dr. Maggie Atkinson President, ADCS Director of children’s services, Gateshead Metropolitan Borough Council

17. Children’s Services: integrated! We are charged with being outcome focused...... not process obsessed or stuck in old models...... Which means a focus on addressing and narrowing gaps and taking out inequalities We are REQUIRED to work together: Health's NSFs, Every Child Matters, Our Health Our Care Our Say...And my friend, Mrs Cannybody.

18. Who’s she? She lives on Ubiquity Street, Anytown, Everyshire, in social housing, on the minimum wage She's a single parent and a busy woman She wants to ask one person for help, guidance, advice on public services and get a straight answer: –where to go –what to do –how to get support She wants her family to be healthier and better placed than she is She is not interested in who pays your wage, or mine She's interested in......

19. Good ante-natal, maternity and post- natal care for herself Advice on her baby, her older child, her teenage stepchild's smoking, drinking and risk taking life choices Advice on lifestyles, when finances are tight and diet, fitness, exercise Advice on stress: hers and others'... and on stopping smoking She wants us to.....

20. see the person, not the episode or the casework ask her to tell her story once, safely share and use what she tells us keep our promises that we can help think wellbeing and wellness, and plan services around helping her attain them join up to support her and her family, and MEAN IT! not make her second guess or be clever or articulate to get what's needed

21. Circle of intimacy Mum, Dad, carer, brothers & sisters others at home Circle of exchange Circle of participation Circle of friendship Aunt or uncle God parent grand father best friend cousin grand mother Places of worship People in the park Parents’ friends Other children in school Community of neighbours Class mates Football or other sports clubs scouts brownies guides Cadets etc Nurses Police And support officers Fire fighters Nanny or childminder Shopkeepers Community wardens Therapy services Baby sitter, Child minder Librarian Educational Psychologist Learning support assistant Dinner supervisor Lollipop person Doctors, health workers Teachers, tutors Lead Practitioner(s) Outreach workers Advisers, mentors Education Welfare Service Social worker Step sibling People next door

22. John Dixon President, ADAS Director of Social & Caring Services, West Sussex County Council

23. Inequalities and Well-being – Working Together John Dixon Executive Director of Adults and Children, West Sussex County Council and President, ADASS

24. Adults’ Services – A Changing Role Life Chances of Disabled People – Opportunity Age Independence, well-being and Choice – Our Health, Our Care, Our Say Safe and Prosperous Communities Place Shaping and The rise of well-being Shift in relationship between state and citizens 100% of population and personalisation DASS’s huge assimilation of roles

25. DASS: Joined Responsibilities 50% - Housing 40% - Crime Prevention Regeneration Safer Communities Neighbourhood Services 25% - Culture, Leisure, adult learning Most - Health 10% - Children ’ s as DCS

26. Targeted help to individuals Support to Communities Infrastructure for Community development and self-help Professional gift relationship Specialised interventions Resource Intensive Sustainability Customer in control All our Tomorrows - Revisited

27. Infrastructure for citizens to support informed safe choices & to help providers Housing/Accommodation/Supporting People Public Health Community Health Transport Access to Employment/Workforce Social Inclusion Lifelong Learning Community Safety Regeneration Leisure & Recreation opportunity

28. Effective Joint Commissioning All about patient/care pathways Best mix for patients of health/social care/3 rd sector input From self-care to tertiary care Choice and control – from professionals to users/patients Transferring activity & finance within care pathways: the ‘5% plus’ test Joining the two commissioning frameworks Achieving - user satisfaction - clinical outcomes - reconfiguration - financial sustainability

29. Personalisation, Eligibility & The Green Paper on Care & Support It ’ s about Social Justice as much as funding Need to agree principles of new settlement first Rethink dependency and contribution: The two groups : those currently eligible for state funding : those outside of the state net Those currently funded: not much longer affordable : to be given control Those not now funded : more than half the population Transparency and eligibility Some help for everyone, and more for those who need it most Public knowledge and affection: NHS vs. social care The weakest link in the welfare state: assurance for old age and disability? Affordability and £ 1.1trillion – insurance risk capping?

30. World Class Commissioning and Putting People First Comprehensive understanding of the needs of everyone in the community Planning in partnership with users and carers for services to meet agreed outcomes through improved choice and control Work with providers and Third Sector to develop services for independence and well-being More intelligent and responsive procurement of services to improve outcomes. Ensure individual purchasing is as near to the person as possible Improving evaluation of service provision as a return on investment Need to join up governance, leadership, basic skills and knowledge Need for workforce development Practice based commissioning – focus on needs of communities – links with local government – social care and children ’ s services with acknowledgements to Mark Britnell

32. ADASS Business Unit Local Government House Smith Square London SW1P 3HZ Tel: 020 7072 7433 Fax: 020 7863 9133 EMAIL: team@adass.org.uk WEB: www.adass.org.ukteam@adass.org.ukwww.adass.org.uk