1. Community assets and mobilising: care in the community Paul Sinden Director of Commissioning 1 October 2013

2. Service priorities: Service model Integrated reablement & rehabilitation pilot Single point of contact, reablement & rehabilitation Community ward model Self-care Motivational interview training PAM scores facilitating targeted commissioning Systematic, supported self- management based on need Prevention Closing the prevalence gap Utilisation of systematic care pathways Goal orientated personalised care plans Enablers Risk stratification tool System wide information governance resolution Linked & shared information / data 2013/142014/152015/16

3. Urgent Care Outpatients Admissions SettingGPUrgent Care CentreA&E Tariff£25£54£72-£104 ClinicNewFollow-UpCase Tariff£200£100£400 AdmissionEmergency Short- stay EmergencyElective Tariff£800£2,000£1,200 Hospital costs and moving care into the community:

4. How will you know if you have succeeded? What process or outcome measures will be used? When, and who, will assess impact?  The whole pathway  Total costs  Quality & Experience  Health outcomes  Process What  Collaboration  Patients and carers: co- production  Academic insight  Frontline staff experience Who  Linked datasets  Matched case-control  Clearly defined intentions  Qualitative & quantitative  PMO Approach How 1. Pilot 2. Project evaluation 3. Whole- system What commissioners look for in a proposal:

5. How can you support people to stay out of hospital and be looked after in the community? How can you help support lifestyle change in the local community? What skills do you have to support this type of work? Where do you think you need to develop your skills within your organisations and what support do you need to do this? Questions: