1. 1 Social Partnership Forum’s Staff Passport Meeting Monday 18 th August Glen Mason Director of People, Communities and Local Government Department of Health DH – Leading the nation’s health and care

2. 2 Care and Support affect a large number of people Many people need some extra care and support during their adult years to lead an active and independent life. Three-quarters of people aged 65 will need care and support in their later years… DH – Leading the nation’s health and care

3. 3 Drivers for Change in the English Care System Demographic pressure Unprecedented financial challenges Raising expectations Technological Change Systems failure eg: Mid Staffs Hospital and Winterbourne View A drive to integrate services DH – Leading the nation’s health and care

4. 4 We will change care and support in two fundamental ways: The Care and Support Act – our vision 1. The focus of care and support will be to promote people’s independence, connections and wellbeing by enabling them to prevent and postpone the need for care and support. 2. We will transform people’s experience of care and support, putting them in control and ensuring that services respond to what they want. DH – Leading the nation’s health and care

5. 5 A shift in the care and support system FromTo Repair Focusing only on response after a crisis Prevention Acting earlier to prevent or delay needs Fragmentation Isolated services focused internally Integration Joined-up services working as partners Paternal State knows best Personal Person knows best Exclusive “Doing to” Inclusive “Doing with” DH – Leading the nation’s health and care

6. 6 Choice, control and quality People can choose between a range of high quality options, or create their own People develop their own care and support plan People have clear information to make good choices about care People are in control of their own budget People’s views are heard and help improve services In the new, person-centred system... i

7. 7 The Care Act is built around people Promoting the diversity and quality of the local care market, shaping care and support around what people want Ensure that no one goes without care if their providers fails Puts adult safeguarding on a statutory footing for the first time Young adults receive care and support during transition Reforms what and how people pay for their care and support DH – Leading the nation’s health and care

8. 8 Better use of resources Coordinated approach Organised around users Reduction in need to go to hospital Bring skills together around the user Services 7 days a week Better outcomes for users Benefits of integrated care The Better Care Fund

9. 9 What is Government doing to support this? The Better Care Fund June 2013 announcement: £3.8bn to be deployed locally in 2015/2016 on health and social care through pooled budget arrangements June 2013 announcement: £3.8bn to be deployed locally in 2015/2016 on health and social care through pooled budget arrangements Local authorities and NHS Clinical Commissioning Groups must agree a joint plan to deliver better, person-centred care before receiving funding Part of the £3.8bn allocated to local authorities includes a payment for performance element to incentivise ambition and real change Autumn Statement December 2013: Pooled budgets will be an enduring part of framework in future years Autumn Statement December 2013: Pooled budgets will be an enduring part of framework in future years DH – Leading the nation’s health and care

10. 10 The Better Care Fund (BCF) narrative DH – Leading the nation’s health and care The Better Care Fund (BCF) will accelerate the local integration of health and care services to deliver better outcomes for people NHS and social care services are now caring for people with increasingly complex needs and multiple conditions. There is consensus that to respond to this care should be organised around the person who needs it, and that person’s care team should work together to keep them better for longer. The Better Care Fund is one of the most concrete steps ever towards making this change happen everywhere. This is the start and pooled budgets are here to stay. Areas put in draft plans in April, and local areas are now revisiting these to make sure they are as clear and strong as possible to kick start the change we need from next April. As ever with system transformation – success depends on the people who are leading it to make it happen locally – people taking bold steps to move away from their old ways The BCF has accelerated and made happen conversations that have never happened before about joint working across agencies. Now we want this to happen everywhere and we are committed to support local areas to achieve this. Local areas teams and local government regions will have a crucial part to play. It is challenging, and will undoubtedly get harder before it gets easier – but we have seen in small pockets the immense value of the prize for patients, users, families, carers and staff.

11. 11 Examples of where it’s happening Greenwich – avoided 2000 patient admissions with a joint emergency team South Devon & Torbay – reduced physio waiting times from 8 weeks to 48 hours by bringing professionals together Tri-borough in London have produced new joint model to help people manage chronic conditions In Greater Manchester 10 local authorities and 12 CCGs have joined forces to support a large scale reconfirguation of hospital services The Better Care Fund Northamptonshire - targets have been exceeded by 14% on preventing emergency inpatient admissions- targets on preventing excess bed days exceeded by 4%

12. 12 Details of the Better Care Fund The June 2013 SR set out the following: 2014/152015/16 An additional £200m transfer from the NHS to social care, in addition to the £900m transfer already planned £3.8bn pooled budget to be deployed locally on health and social care through pooled budget arrangements Better Care Fund In 2015/16 the Better Care Fund will be created from the following: £1.9bn additional NHS funding £1.9bn based on existing funding in 2014/15 that is allocated across the health and wider care system. Composed of: £130m Carers’ Breaks funding £300m CCG reablement funding £354m capital funding (including c.£220m of Disabled Facilities Grant) £1.1bn existing transfer from health to social care Local areas free to add additional funds to the pooled budget Better Care Fund

13. 13 Next Steps Assurance process Support available for all areas up until 19 th September Local areas to develop/agree plans and submit by 19 th September 2014 £3.8bn pool to be deployed locally 2015/16 Additional £200m NHS transfer to LAs 2014/15 Ministerial final assurance of plans By end of October Better Care Fund

14. 14 Right Capacity GPs 40,265 Consultants 40,394 Registrars 39,404 GP practice nurses 23,458 Support to doctors & nursing staff 269,714 Support to ambulance staff 13,451 Central functions 106,696 Hotel, property and estates 71, 242 Manager and senior manager 37,314 Qualified ambulance staff 18,645 Allied health professionals 74,902 Healthcare scientists 31,173 Other scientific, therapeutic & technical staff 47,490 GP providers 26,886 Estimated number of NHS hospital & community health service and general practice workforce as at 30 September 2012: 1.36 million Professionally qualified clinical staff 687,810 Other doctors in training and equivalents 13,952 Other medical and dental staff 12,302 Other GPs 8,898 GP registrars 4,426 Qualified nursing, midwifery & health visiting staff 346,410 Support to clinical staff 343,927 Infrastructure support 215,071 Nursing 369,868 Doctors 146,075 Scientific, therapeutic & technical 153,472 Support to scientific, therapeutic & technical staff 61,345 Residential 675,000 Domiciliary 831,000 Estimated number of adult social care jobs by employer type in England, 2011: 1.85 million Day 96,000 Community 251,000 Other GP practice staff 113,832 Direct care 776,200 Managerial/supervisor y 31,700 Other 18,400 Professional 4,300 Adult Social Care Workforce NHS Workforce DH – Leading the nation’s health and care

15. 15 DH – Leading the nation’s health and care

16. 16 Challenges to the Workforce of Integration Staff need to develop new skills and to work across traditional boundaries Growth in personal assistants with individual care and health budgets Development of new roles Systems leadership Practical issues – TUPE etc Developing one culture DH – Leading the nation’s health and care

17. 17 Thank you and any questions? Glen Mason Director of People Communities and local Government Department of Health DH – Leading the nation’s health and care