POLYCLINICS AND THE OPPORTUNITIES FOR INTEGRATION WITH LOCAL AUTHORITIES

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• POLYCLINICS AND THE OPPORTUNITIES FOR INTEGRATION
  WITH LOCAL AUTHORITIES
• John Drew
• Director of Housing and Community Services
• London Borough of Redbridge
• Regional Secretary
• Association of Directors of Adult Social Services

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• Why integrate?
• better patient/service user experience
• improved use of resources
• improved outcomes and quality
• efficient planning arrangements and
• improved health and well-being.

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• Why local authorities?
• traditionally NHS partner was social services
• social services now split
• recognition of contribution of other departments
  to well-being
• increasing importance of joint intelligence and
• efficiency of shared services.

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• Or from the patients perspective
• ENQUIRIES TO A ONE STOP SHOP LOCATED IN A
• LARGE HEALTH CENTRE 2007/8 THE REDBRIDGE
  EXPERIENCE
• Welfare Benefits 316 43
• Others 119 16
• Transport 82 11
• Social Care 77 10
• Legal 37 5
• Health 31 4
• Trading Standards 27 4
• Housing 26 4
• Leisure 15 2
• Additional benefit claims for 54 patients
  produced an average benefit of 3,354 p.a. per
  claim.
• Source One Stop Shop for
  Older People, Hainault, Redbridge

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• What is already working in integration?
• Social Care
• CMHTs
• Childrens Trust
• Intermediate care
• Integrated services for adults with learning
  disabilities
• .
• Local authorities
• Funding streams for voluntary and community
  services
• Joint intelligence/public health
• JSNA
• Leisure and health
• Advice and information
• .

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• Overriding priorities for any integration
• Effective and appropriate commissioning/joint
  commissioning
• strong local leadership and
• investment in early intervention and community
  based services.

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• What might we mean by integration in
• the context of Polyclinics?
• Polyclinics as service model
• or buildings
• Importance of buildings a different
  perspective?
• Central importance of good advice and information
  services
• Co-location as an aid to full integration

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• Integration of service models
• Commissioning integration
• Joint Strategic Needs Assessments
• Support in the home
• Home care
• Housing models
• Extra care sheltered housing
• Early intervention services/Reablement/Recovery
• Identifying target populations
• One coordinator
• One person to access resources
• Unlocking the occupational therapy maze
• Poverty and health
• Patients at the centre of services
• Our staff

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• Barriers to integration
• Weak partnerships
• Lazy planning
• A history that values failure above success
• Buildings and costs
• Lack of a shared vision?
• Politics
• Methods of gate-keeping
• Charging
• Transforming adult social services

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• Transforming adult social services
• Huge change agenda planned for next 2½ years
• Radical re-position on issues of choice and
  control
• Personalisation centred around Direct Payments
  and Individual Budgets
• Reablement services
• Reducing admissions to acute care
• Appropriate and speedy discharge
• Rapid reablement post discharge

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• Reablement the Wandsworth experience
• 211 patient completed programme in first 17
  months
• After 6 weeks only 91 still in need of service
• 73 reduction from originally assessed hours for
  home care.

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• Taking integration forward a check list
• Joint vision fuelled by JSNA
• Strong local leadership and vision
• Commitment to invest in early intervention and
  community based services
• Re-positioning of Intermediate care or
• new service to respond to long term conditions
• Commitment to identify key populations
• Willingness to adapt model to local circumstances

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Thank you

• John Drew
• Director of Housing and Community Services
• London Borough of Redbridge
• Regional Secretary
• Association of Directors of Adult Social Services
• 21.05.2008