Joint Commissioning Strategy

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Joint Commissioning Strategy For People with a
Learning Disability Presentation by Stephen
Rogers
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What is Commissioning

• Strategic analysis of need.
• Understanding current service provision and
  resources.
• Gap analysis.
• Service redesign.
• Close links with Contracting and Procurement .
• Monitoring of performance.
• Outcome measurement and review

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• That people get the best outcomes possible from
  public money

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Joint Commissioning Strategy

• Approved by Cabinet in April 2011
• Meeting future demand
• Redesign services
• Shows what will change and how far it will change
  by 2015

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Commissioning Objectives
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Key Objectives for 2013/15

• Follow the Joint Commissioning Strategy
• Meeting Increasing demand
• Keeping within budget
• More Choice and helping the market to respond to
  personal preference
• Improving Health Outcomes in Primary and Acute
  Care.Plus
• Winterbourne View recommendations

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Increases in demand

• General Population Growth
• Norfolk is a popular destination
• More young people with complex needs
• Increasing needs of older people already
  receiving service
• Increasing customer expectation
• Section 117 and Ordinary Residence issues

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Increased Demand for Learning Difficulties
Services
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Keeping within Budget

• The Department of Health now pays most of the
  Health contribution direct to local authorities
• In Norfolk this means that the County Council
  will spend 100.2 million on services in 2013/14
• The NHS continues to directly commission
  assessment and treatment services, very
  specialised hospital placements and continuing
  health care 15 million. CCGs hold these budgets
• Joint Commissioning in place to ensure effective
  commissioning across the whole market takes
  place.
• Financial savings are required to meet future
  demand and keep the books in balance.
• EU Social Investment Fund

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How the NCC cash is spent

• 81.5m Purchase of care
• 3m Transport
• 6.5m Joint Community Teams
• 9.5m In house services (supported living and
  day services)
• 0.85m Psychiatry
• 0.56 Specialist Health Respite

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More Choice

• Valuing People and Think Local Act Personal
• All who want a personal budget will have one
• All people assessed for service will have been
  offered support with a PCP.
• Market responding to provide services that meet
  individual needs
• Range of services are becoming available to meet
  changes in service demand

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Improving Health

• Get all Norfolk GPs signed up to DES.
• More people having annual health checks
• Numbers of Acute admissions going down
• Numbers of readmissions going down
• A good experience when in Hospital
• More people using mainstream health services
  rather than having specialist services

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Supported Living/Residential Care

• New Models eg sharing overheads leading to
  Value for Money
• Planning with Housing Providers and Social
  Landlords and families.
• Planning with Residential Providers
• Good Supply and Demand Management in local areas.

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Better Transition

• All young people who attend special schools,
  mainstream schools with 25 hours support, Out
  of County placements or are Looked after Children
  have Comprehensive Transition plans
• The information from these plans informs the
  development of services.
• Develop transition services to help young people
  develop independence
• Develop services that prevent young people being
  placed out of County and help them when they
  return

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Respite Care Services

• More innovative respite care options
• Pooling of Personal Budgets
• Guideposts scheme
• Good quality services for people with significant
  medical needs

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Dementia Services

• Improved community services for people with early
  on set dementia
• The needs of people with LD are well represented
  in the delivery of the Norfolk Dementia Strategy.

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Changing Day Services

• Valuing People Drive to change large
  traditional day services - Non segregated models
• Norfolk County Council will no longer be the
  provider
• Independence Matters new social enterprise
• Individuals should be able to access support
  according to their assessed needs and identified
  outcomes. Not become dependent upon services
• Help people to progress - so that there is always
  support to gain or regain maximum independence
• Moving on and on..Progression
• Local Services - Participation in the community
• Better routes into employment

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Employment

• More people will be in paid, real jobs- 300 by
  2015?
• Ist April 2013 -164 in paid employment
• 44 in Voluntary employment
• 36 in training
• Project Search expanded and 50 of students will
  secure employment- NHS, NORSE
• ASDA, Waitrose, MS, Co-op
• More social enterprises support into employment
  eg CSV cafes

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Tackling Hate Crime

• Effective reporting and joint working with
  Norfolk Police.
• Extend Norfolk Safer Places Scheme

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Improved Advocacy

• All Advocacy funding supported by contracts with
  clear outcomes
• The service will be more equitable across Norfolk
  leading to improved access
• New contract now in place

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Market Management

• Develop Quality Incentives
• Capture and encourage innovation
• Progression and outcomes evidence
• Use of Assistive Technology

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Winterbourne Expectations

• Review the care of all people in learning
  disability or autism inpatient beds assess who
  ought to move
• Agree a personal care plan for each individual
  based on their and their families needs and
  agreed outcomes
• By June 2014 community based care arrangements
  need to be in place for all people who do not
  need a hospital placement and
• Develop the market to ensure people can move into
  the community

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Winterbourne

• We want to make sure that we have the right
  services in the right place so that people with
  learning disabilities whose behaviour challenges
  services can
• Live somewhere that is right for them and
• Have the support to help them to do this.

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Winterbourne Regional Response

• ADASS - Regional work programme to improve the
  way we work with providers to develop and buy
  services.
• DOH sponsoredDeveloping Care Markets for Quality
  and Choice.
• Personalised care for people with challenging
  behaviour is a priority for the region

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Winterbourne Norfolk Response

• Local Steering Group
• Oversee the movement of all people who will move
  by June 2014
• Develop a strategic plan that will ensure all
  people in, in patient facilities will be there no
  longer than necessary and
• Services are developed in the Community which
  will reduce the need for future admissions

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Commissioning Next Steps

• Plan to meet Winterbourne demand
• Continue moving forward together in the New
  Personal Budget Landscape
• Further enhance market intelligence
• Continue to encourage innovation
• New Models for Local Day Services
• New Models for Living in the community
• Further develop Community services to prevent
  hospital admissions and out of county placements

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Autism Act 2009.

• The Act made two key provisions
• that the Government produce an adult autism
  strategy by 1 April 2010
• that the Secretary of State for Health issue
  statutory guidance for local authorities and
  local health bodies on supporting the needs of
  adults with autism by 31 December 2010.
• Statutory guidance that local authorities and
  local health bodies have a legal obligation to
  follow

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National Autism Strategy

• The Autism Strategy has five areas for action
  aimed at improving the lives of adults with
  autism
• increasing awareness and understanding of autism
• developing a clear, consistent pathway for
  diagnosis of autism
• improving access for adults with autism to
  services and support
• helping adults with autism into work and
• enabling local partners to develop relevant
  services.

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Autism SAF

• The purpose of the Self Assessment Framework is
  to
• assist Local Authorities and their partners in
  assessing progress in implementing the 2010 Adult
  Autism Strategy
• see how much progress has been made since the
  baseline survey, as at February 2012
• provide evidence of examples of good progress
  made that can be shared and of remaining
  challenges.

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• Thanks
• for Listening