1. New models Anticipating the future and getting ahead of the game

2. West London Whole systems Model: Core elements #2 Increasing health and social care needs Shifting focus from proactive to reactive care Self-care and self-management enabled throughout 2 Personalised and tailored to changing health as well as social needs, covering planned as well as reactive needs and one that empowers self-care Tier 0: Mostly healthy over 65s Tier 2: At risk, under monitoring Tier 1: Over 65s with well managed LTCs Tier 3: Complex and / or with intense needs Segmentation based on holistic assessment of medical as well as social needs including risk scores, frailty, loneliness, social support etc. 2

3. Trends Funding follows the person, person has greater choice and control – Personal budgets – Spot purchase – Payment by results – Provider takes the financial risks – Big contracts more attractive than small grants

4. How can VCOs respond? Hope that it won’t happen in K&C/Westminster Convince Commissioners of the error the their ways Decide not to provide services Find new ways of working

5. KCSC response KCSC has responded by facilitating a new way of working Established a Special Purpose Vehicle (SPV), Kensington & Chelsea Community Enterprises, specifically to bid for contracts Sought to ensure funding through whole systems for ‘Self- Care’ and ‘Self-Management’ Sought to establish small VCOs as a key deliverer Examined contracts and models elsewhere e.g. Rotherham Social Prescribing and Hackney and City Together Run a Community Health in Paddington event and participated in a Westminster event looking at Developed a model for Kensington based on the above

6. The whole systems proposal Currently referrals are being made to VCOs without any funding Assumption that VCOs will absorb referrals within their current capacity KCSC are proposing that VCOs should be paid for all referrals, either through spot purchase or, for block purchase

7. Purpose of today Present our model Facilitate a discussion

8. The model One contract with an independent lead – KCSC KCSC believes that to meet the needs of a diverse community clients need to have services provided near to their home by local organisations that are familiar with the needs

9. Why KCSC in touch with local area and WLCCG will ensure integrated working between local providers and increase community based services is a conduit to multiple providers = greater choice will capacity build to grow the marketplace has tri-borough connections

10. Why local voluntary sector Add social value Know their communities Clients can access services near where they live Providers can signpost Offer additionality

11. What the patients said Accessible transport is a concern Hubs should be part of the local community Co-ordination needs to be at the centre of the model Quality assurance of the whole systems Patients to take responsibility for their own health and wellbeing, self-help, self-management, should be integral Enable informal carers to continue to care Older people should be recognised as assets

12. What we need from you Advantages from the perspective of: – WLCCG – Patients – Voluntary organisations Disadvantages from the perspective of: – WLCCG – Patients – Voluntary organisations What are the alternatives?

13. KCSC KCSC lead body SPV Contract held by CIC CIC board appointed by KCSC Asset locked to KCSC Providers Local provider list (primarily third sector) Agreement with CIC (block or spot-purchased) Monitored through CIC

14. PCN referral KCSC pass to PCN Referral other source PCN has copy of providers list PCN liaises with provider PCN refers client Provider confirms service to KCSC Provider sends client details to KCSC Provider completes datababase KCSC agrees spot contract terms Service provided Place agreed Block contract in place Assessment provided KCSC find placement Place commissioned Monitoring sent to CCG Yes No Yes No