West Midlands Regional Workshop

West Midlands Regional Workshop
Health & Social Care Reform Regional Workshop West Midlands 24th October 2014 #SocitmHSC www.socitm.net/linkedin
Agenda Local introduction Jenny Wood, Warwickshire County Council Socitm Introduction Martin Ferguson, Socitm Video 1 – Statement of Purpose Roundtable session 1: The ‘future state’ – a view on social care Andrew Fenton, Department of Health Roundtable session 2: Infrastructure - systems architectural framework Julie Oxley, Leeds City Council Roundtable session 3: Financial and care record matters Richard Pantlin, ADASS IMG Health & Social Care Reform – West Midlands Workshop
Agenda Reflections on the sessions so far – open discussion. Roundtable session 4: Planning the practical steps - what we need to do Video 2 Restatement of the purpose of the workshop Roundtable session 5: Engaging citizens - the service user perspective Ian Swanson, ADASS-IMG & Julie Oxley, Leeds City Council Roundtable session 6: IG toolkit Roundtable session 7: Planning the practical steps - what we need to do Concluding comments Jenny Wood, Warwickshire County Council & Martin Ferguson, Socitm Health & Social Care Reform – West Midlands Workshop
Local Introduction Jenny Wood Warwickshire County Council #SocitmHSC www.socitm.net/linkedin
Care Act Readiness in the West Midlands Informatics and the second national Care Act Stocktake Survey
Care Act Readiness Stocktake Headlines • There is increased confidence nationally and regionally that councils will be able to deliver the Care Act reforms from April 2015. • Concerns about costs have increased nationally • Responses indicate a need for support around costs, information & advice, IT, market shaping and workforce • Other pressures on councils (e.g. funding shortfalls, Better Care Fund/Integration) compounded with uncertainty on key guidance and information has delayed or otherwise impacted upon preparations in a number of areas
Care Act Readiness Stocktake
IT and Finance Systems Nationally Regionally Confidence that financial and IT systems will be adequate to manage the statutory duties from 2015 has improved and is strongest in London and the East of England In the West Midlands twelve councils are ‘fairly confident’ and two are ‘not very confident’ Over 80% will engage with IT suppliers before Jan 2015 Twelve out of 14 will have engaged suppliers by November 2014 20% of areas are potentially behind with key changes to IT systems. In particular 55% anticipate having systems in place to cope with increased demand for carers between January and April 2015, with 30% before January and 15% after April. Most councils are planning for systems to be live by April 2015. Four councils will have systems in place to handle the anticipated volume of Deferred Payment Agreements by January 2015 and 2 will have a live system to cope with the anticipated increase in carers assessments and support planning by the same date. One council will not have a live system to support carers assessment volumes by the April 2015 deadline. 7% of councils either don’t know or will be rescheduling resources for changes after April 2015. Two councils (14.3%) don’t know when they will be rescheduling resources. 20% of councils are identified as potentially needing support Four out of 14 councils potentially need support in this area. This is nearly 30%.
IT & Finance Systems – Milestones & Tasks 2014/15 Programme Milestones Oct Nov Dec Jan Feb March April Regs & Guidance published for Apr 15 reforms Consultation on 16/17 Regs & Guidance Public Awareness Campaign Phase 1 Care Act Stocktake April 2015 reforms in place Informatics Implementation Tasks Oct Nov Dec Jan Feb March April Suppliers engaged re 15/16 changes Software upgrades released Install, test, configure Go live for 15/16 reforms Scope changes for case management systems for 16/17 Suppliers engaged re 16/17 reforms
Socitm Introduction Martin Ferguson Director of Policy & Research #SocitmHSC www.socitm.net/linkedin
Video 1 https://www.youtube.com/watch?v=OvQLBt3dACY
Information and technology - a key enabler of change . . .
15 . . . to Improve people’s lives
16 Demand = Opportunity?
17 Opportunity = Benefits?
18 DH priorities for 2014/15 1. Focus on delivery of the core social care national programmes and influencing broader national policy where appropriate 2. Working in partnership with other national and local agencies to develop the underpinning work that will enable future change and progress across the whole system 3. Supporting complimentary initiatives in which DH Social Care has strong interest but does not have the direct levers
19 Care Act implementation Integration & interoperability - Pioneers Economic case Citizen-focused technology Market development Achieving broader strategic objectives Current state Target future state Capability & leadership Our national work programme focused on two broad areas - 1) Delivery of core programmes Information Governance Transparency & Comparative Data Delivery of core priority programmes Integration & interoperability - Standards Integration & interoperability – IDCR & Tech Fund Infrastructure and systems 2) How we can start to develop a wider consensus around investment and change in this area? DH priorities for 2014/15
Developing a target ‘future state’ for social care informatics - and for delivering a holistic health and wellbeing enterprise
21 Where are we headed? Improved citizen outcomes and experience, the transparency agenda, integration across service domains, enabling citizen participation Transparency Transactional services Participation and self care Interoperability and trust Community and locality-led health and wellbeing
22 Numerous challenges Across services within local government and the community Across service domains – NHS, local government, social care, public health, voluntary sector • Identity management • Information standards – data and formats/ protocols • Common terminology and definitions • Open architecture and APIs • Customer focus • Communications infrastructure and culture • Creating benefits case for investment
23 Health and wellbeing outcomes focus We need to explicitly link the key elements and actions to how they will contribute to the delivery of Health and Wellbeing outcomes: • People will live longer and have healthier lives • People will live full, active and independent lives • People will enjoy the best possible quality of life • People are involved in decisions made about them • People will live in healthy and sustainable communities DH – Leading the nation’s health and care
24 Informatics scoping: Oct ‘14 – March ‘15 Continuing Care GP – Social Care Referrals Acute – Social Care Admissions & Discharge Strategic enablers Information Standards Client Level data Quick wins Secure email Identity Management (NHS Number) Infrastructure PSN/ N3 Digital Maturity Model Classification/ Terminology Metadata NIB Strategy: Delivering locally Capability & leadership
25 We need your help! To develop and establish in more detail and at a local level: • What is the target state for information and IT enablement and what are the steps along the way that we must prioritise – what would success look like for citizens and how must we change to deliver? • For each organisation; where we are now and what must we do first, second . . . and so on • To develop a social care/local government digital maturity model that embraces variation and innovation
26 Social Care - Digital Maturity Model Goals: 1. Fully automated business processes 2. User portals transacting online 3. Digitally enabled assessments, reviews and transactions 4. On-line access to health and social care record 5. Joined up health and care ecosystem, including independent sector 6. User in charge of their data 7. Wider use of bespoke apps to encourage self-care 26
27 Digital maturity model Information Standards, Tool Kits, Guidance Mainly paper based Partially Digital Fully Digital Partial Integration (within the organisation) Full Integration (across all care settings) Health and Social Care Information sharing: Secure email, encryption, structured messaging Information for Citizens made accessible in a format they prefer: paper, email, smartphone, portal etc. Integrated service models – locality based Measured improvements in citizen experience
28 Supporting the scoping study • What standards and what data would be valuable, why and for whom? • How and what needs to be done to collect / extract information with less burden? • What are the key barriers / challenges / blockages for interoperability at a detailed level – can we expose the priority issues / challenges that might be resolved by national standards and national support initiatives?
29 Discussion “95% of the audience at the National Summits were in favor of developing a Digital Maturity Model” Q. How ready is your local heath and care stakeholder environment to begin developing and implementing a collaborative plan? a) Not ready at all b) We've begun the process but have barriers to overcome c) We are well on the way and have effective partnerships
30 Discussion Q. What are the strengths, weaknesses, opportunities and threats of a social care informatics maturity index and road map? • Strengths: https://viz.polleverywhere.com/free_text_polls/Ore9ElTheulAwmp • Weaknesses: https://viz.polleverywhere.com/free_text_polls/c92WDFrzxHjZdal • Opportunities: https://viz.polleverywhere.com/free_text_polls/CRVivtWF0HrjHOt • Threats: https://viz.polleverywhere.com/free_text_polls/PDNylTqET2WB1tI
Developing a city ‘blueprint’
FIRST Joined up governance……… (circa 2012)
Leeds Informatics within the governance for Health and Social Care transformation Leeds Informatics Board Commercial and Academic links City-wide Leadership Office City-wide Clinical leader Chair – Dr J Broch CCG North, Chair Informatics Director LTHT Executive ASC Senior Officer Children’s Senior Officer LYPFT Executive LCH Executive CCG Senior Officers Variable resources inc. Project Management, expert advisors/specialists, admin, Finance City-wide Programme Management Group Programme Manager Senior Reps from Local departments Local Informatics departments and resources Health and Wellbeing Board via Health and Social Care Transformation Board LCC IT Local Authority CTO Primary Care Senior GP/s Partners: - CCGs x 3 - Leeds Teaching Hospitals - Leeds Community Healthcare - Adult Social Care - Leeds City Council - Leeds and York Partnership FT - Primary Care
‘Blueprint’ 1 (circa 2012)
‘Plan on a Page’ - Building blocks to achieve the Leeds informatics ‘Vision’ Provider organisations Between organisations Improved Contract Mgt Needs assessment Improved needs assessment Improved health intelligence Event linkage Costing analysis Contract and additional data flows Data Protection/Caldicott/Sharing Risk Stratification Pathway Management/Visibility/Clinical Decision Support Telecare and Telehealth e-messaging Order Communications Risk Stratification Summary Care Record (SCR) Programme/Project Management Business Analysis and process re-design IT Infrastructure linkages inc. LCC city-wide facilities e.g. ‘superfast cities’ Interoperability standards Paper-light processing inc. Digitised/e-records NHS Number Wireless technology Mobile working Primary Care Hosted nationally compliant systems LTHT Full range of integrated clinical systems LYPFT Full range of integrated clinical systems LCH Full range of integrated clinical systems IG Toolkit Social Care Full range of strategic systems Knowledge Management Monitoring/ commissioning system Patient/client access to records Independent and 3rd sector systems Leeds Care Record Integration Engine Data Warehouse Research YAS
This common framework enabled……..
‘Plan on a Page’ - Building blocks to achieve the Leeds informatics ‘Vision’ Provider organisations Between organisations Improved Contract Mgt Needs assessment Improved needs assessment Improved health intelligence Event linkage Costing analysis Contract and additional data flows Data Protection/Caldicott/Sharing Risk Stratification Pathway Management/Visibility/Clinical Decision Support Telecare and Telehealth e-messaging Order Communications Risk Stratification Summary Care Record (SCR) Programme/Project Management Business Analysis and process re-design IT Infrastructure linkages inc. LCC city-wide facilities e.g. ‘superfast cities’ Interoperability standards Paper-light processing inc. Digitised/e-records NHS Number Wireless technology Mobile working Primary Care Hosted nationally compliant systems LTHT Full range of integrated clinical systems LYPFT Full range of integrated clinical systems LCH Full range of integrated clinical systems IG Toolkit Social Care Full range of strategic systems Knowledge Management Monitoring/ commissioning system Patient/client access to records Independent and 3rd sector systems Leeds Care Record Integration Engine Data Warehouse Research YAS
Allowed Informatics to be a key part of joined up ‘transformation’ ……… (circa 2014)
TRANSFORMATION PROGRAMMES West Yorkshire Workstreams Leeds Health and Social Care Transformation ‘Portfolio’ Board Children’s Urgent Care Cancer Stroke Identification and risk stratification Primary prevention Pathway development Integrated system change HWB Growing up in Leeds Nigel Richardson/ Matt Ward Elective Care Simon Stockill/ Susan Robins Adult Integrated Care and Prevention Andy Harris Ian Cameron Urgent Care Nigel Gray/Jason Broch Effective admission & discharge Phil Corrigan/ Sandie Keene Goods & support services Chris Butler Operational group Population management System development Emergency admission avoidance Improving hospital discharge Community beds service In-patients Cancer Best Start Family support Emotional and mental health Complex needs Best transition into adulthood Estates Supplies ICE Strategy Group ENABLING GROUPS PMO Self-management Prevent entry into Care Finance Task Group (DOFs) Julian Hartley Informatics Board Jason Broch Workforce Phil Corrigan/Bryan Machin Quality Improvement with Leeds University Gordon Sinclair Estates Group Chris Butler Communications and Engagement Group Rob Kenyon/Phil Corrigan/ Primary Care Gordon Sinclair Pioneer Rob Kenyon BCF Matt Ward/Dennis Holmes Outpatients including diagnostics
Simplification and refinement: 3 TIERS of delivery: Clinical Integration Clinical Support Tools Business Intelligence Tier 1 Tier 2 Tier 3 ‘primary’ use’ of data ‘secondary use’ of data Time
Strategic requirements for transformational change.…….. 6 features of a transformational Informatics platform: • Centred around patients or individuals • Common data definitions • Covers all types of care • Relevant parts of the clinical record can be accessed by all parties involved in care • Templates and expert systems to support appropriate and consistent quality of care • Information collected and extracted to support holistic analysis and intelligence
Overlay: Clinical Integration Clinical Support Tools Business Intelligence
‘Blueprints’ 2 and 3 have enabled: - Case to establish a city Intelligence Hub - Case to progress citizen-driven health agenda - Strengthened the city PSN case - Recognition that more is required than ‘simply’ integration - Formed part of our ‘Tech Fund 2’ bid [LCC led] - Forms our dialogue with other Pioneer cities - Dialogue around Better Care Fund - Basis for a more formal exploration on end-user compute opportunities
Recommend the use of shared (and evolving) models/blueprints to form the basis for: - Common language (internal and external) - Common goals - Engagement across sectors - Development of business cases - Programme of delivery - Governance framework
1. Governance – have you established the appropriate governance to support and enable the right conversations and decisions at the right time by the right people? AND is your governance linked into the right governance framework – i.e. Health and Wellbeing? 2. Have you set out a clear blue print/ vision? Has this been signed up to by all key stakeholders? Do you have a plan which sets out how you will achieve your blue print/vision?
Discussion Q. What are the strengths, weaknesses, opportunities & threats to/of a whole place informatics model? • View the Strengths: https://viz.polleverywhere.com/free_text_polls/zNAyK3UygjIPrqd • View the Weaknesses: https://viz.polleverywhere.com/free_text_polls/1P60Zb2OeVRvnbi • View the Opportunities: https://viz.polleverywhere.com/free_text_polls/m6dVN5JMwLFh1bY • View the Threats: https://viz.polleverywhere.com/free_text_polls/HsH8DGERCsHUdit Health & Social Care Reform – West Midlands Workshop
Core requirements of the Care Act for ASC case management & finance applications Information Management Group West Midlands IMG / SOCITM workshop Friday 24 October Richard Pantlin
Changes for April 2015 – local configuration Requirements • New eligibility, assessment & care plans – incl. recording non-eligible Information Management Group needs • Personal Budgets for carers & residential care – RAS? • Carers asssessments, support plans – charging? • Financial assessments including batch re-calculation • Transitions from Children’s Services, Safeguarding, Prisoners Questions  Have your Care Act Leads indicated extent of process changes required?  Have you estimated staff time required to reconfigure and test systems?  Do you have the necessary skills?  How much end-user re-training is required?
April 2015 – New / upgraded software? Requirement • Deferred Payment Agreements – new interest Information Management Group calculations • Optionally: Continuity of Care – info transfer Questions • Have you assessed expected volume? • What is your current process? • Will you use a specialist system? • Whose & when available? • Will you need to load existing DPA data or only use for new DPA’s?
Care Accounts Requirement • Accepting applications from late 2015 • Processing Care Accounts after April 2016 Questions • Have you planned system upgrades with your application provider according to their roadmap? • Do you have confidence that your application provider will engage with representative customers and DH / IMG from Jan 15 in order to design appropriate software enhancements? Information Management Group • Are you clear on commercials?
Handling increased volumes Requirement • The combination of Care Accounts and higher capital thresholds is likely to lead to a significant increase in needs assessments & financial assessments Questions • Has your council assessed local impact? • Are you planning other process changes? E.g. Information Management Group • More flexible working • Using third sector / delegated functions • Online self-service – more on this later
Roundtable Discussion Q. How prepared are you in your locality to implement the changes required to meet the requirements of the Care Act? View the results: https://www.polleverywhere.com/free_ text_polls/Lzm9B6dCgvdBypm Health & Social Care Reform – West Midlands Workshop
Planning the practical steps Q. Taking into account the discussion so far, what do we need to do? View the results: https://www.polleverywhere.com/disc ourses/GP0cVWiZ0JVgTR2 Health & Social Care Reform – West Midlands Workshop
Video 2 https://www.youtube.com/watch?v=3Fd- S66Nqio
ADVICE AND INFORMATION RESOURCES WITH LINKS • ADASS resources – Initial business case headings http://www.adass.org.uk/AdassMedia/stories/Standards_and_Performance/Business_case_factors_v1.pdf – A&I online report (guide to many more in refs.) http://www.local.gov.uk/care-support-reform/-/journal_content/56/10180/6516198/ARTICLE • TLAP resources http://www.thinklocalactpersonal.org.uk/Browse/Informationandadvice/ – Most recently 3 reports about creating a strategy, and a draft strategy tool coming • Socitm Insight reports http://www.socitm.net/research/socitm-insight/health-and-social-care-reforms/health-and-social- care-reforms-ict-and • WHICH report http://www.staticwhich.co.uk/documents/pdf/which_report_the-care-maze_jun14-372280.pdf Ian Swanson ADASS Informatics Network Support Officer Ianswanson.home@gmail.com 07906 333799
Ways to speedy service 2016 Person with needs Quick check Eligibility questions Financial check Use tools and find services in directory Eligible? Needs eligible, finance not Needs assessment Outcomes to be planned Personal budget (IPB) Yes/maybe to both Care Account application Financial Assessment Charges No Yes Colours Services Care Accounts – then normal assessments Old procedure Eligibility triage Items in italic as candidates for self-service tools Support Plan
Engaging Communities and Citizen Driven Health and Care Tim Straughan Programme Director Smart Cities – Health and Wellbeing @timstraughan
Citizen Care in 2070 • In 2070 we will have our first Leeds citizen reach the age of 120 years old • She is 64 years old now and about to retire with 56 years still to live • She lives in North Leeds • Linda will be continually monitored by wearable devices and sensors in her home • Her care will be coordinated using an app on her smart TV • Her life plan will be based on her ‘riskogram’ DNA profile • Medication will be ‘pharmogenicially’ designed just for her • Most of her care will be provided by her local community
Infrastructure
Citizen Engagement • Bottom up not top down • Use of existing networks and communities • Co-production- ‘doing with’ not ‘doing to’ • From passive to active • Providing tools to helping people take control • Building outcome evidence through prototypes
Citizen Driven Health One example of Citizen Driven Health is about connecting the people involved in the circle of care around the individual, so they know who each other are, can connect and be aware of what each other are doing, across the whole Neighbourhood Network and beyond and therefore hopefully become more effective at supporting the health and wellbeing of the individual.
What is a Neighbourhood Network ? • Neighbourhood Networks are community based, locally led organisations that – enable older people to live independently – pro-actively participate within their own communities by providing services that reduce social isolation – provide opportunities for volunteering – act as a “gateway” to advice/information/services promote health and wellbeing and thus improve the quality of life for the individual.
Neighbourhood Networks - Some facts • 32 NNs currently support over 21,900 older people • Volunteers doing this fantastic work have gone up by over 200 in last 12 months, rising to 1,910 • Prevented 1,450 older people from going into hospital and supported 617 being discharged from hospital. • 26 safeguarding referrals have been made to Leeds Safeguarding Units. • As a measure of how the Networks are appreciated by users, families and friends, a massive 2,427 compliments were received over the past 12 months, with just 4 complaints!
Some Examples
Coordination of Care
Yecco
Healthpump
The process of social innovation Young Foundation – Engaging Citizens in Social Innovation June 2013
Q. What are the strengths, weaknesses, opportunities & threats to the online aspect to extending help to all citizens, not just those applying for council care • View the Strengths: https://viz.polleverywhere.com/free_text_polls/uE62RO6 Lp26xnW0 • View the Weaknesses: https://viz.polleverywhere.com/free_text_polls/Rukxifb vFX5yb1t • View the Opportunities: https://viz.polleverywhere.com/free_text_polls/sJsTU p83yINEGrj • View the Threats: https://viz.polleverywhere.com/free_text_polls/v44OjuXSO 7EbEhk
IG Toolkit Information Governance Information sharing for direct care • Proposed private Member's bill on information sharing and use of the NHS number for direct care purposes; • Data sharing guidance for front line staff; and • the information governance alliance Information sharing to support commissioning functions regulations to support and regulate the use of information for • case management, and • essential functions (e.g. invoice checking, risk stratification) Information sharing for other purposes, e.g. research • care.data programme, • the package of measures, some legislative, announced by the Health Secretary in March 2014 Governance and accountability • robust oversight and assurance of national and local information governance practice. Health & Social Care Reform – West Midlands Workshop
IG Toolkit Information Governance Information sharing for direct care • Proposed private Member's bill on information sharing and use of the NHS number for direct care purposes; • Data sharing guidance for front line staff; and • the information governance alliance Information sharing to support commissioning functions regulations to support and regulate the use of information for • case management, and • essential functions (e.g. invoice checking, risk stratification) Information sharing for other purposes, e.g. research • care.data programme, • the package of measures, some legislative, announced by the Health Secretary in March 2014 Governance and accountability • robust oversight and assurance of national and local information governance practice. Health & Social Care Reform – West Midlands Workshop
Open Discussion Q. How well-prepared are you in your locality for the information governance arrangements needed to enable the new and different approaches: • ways of working, • delivery, • co-creation, • integration, • personalisation, etc. required by the health and social care reforms? View the results: https://www.polleverywhere.com/free_ text_polls/90dhmHOdGX1hkEH Health & Social Care Reform – West Midlands Workshop
A framework - one suggestion • User needs • Governance • Infrastructure • Service redesign • User Experience • Intelligence Martin Greenwood Socitm Insight Programme Manager Health & Social Care Reform – West Midlands Workshop
Agenda 12:00 Reflections on the sessions so far – open discussion. 12:15 Roundtable session 4: Planning the practical steps - what we need to do Health & Social Care Reform – West Midlands Workshop 12:45 LUNCH 13:30 Video 2 Restatement of the purpose of the workshop 13:35 Roundtable session 5: Engaging citizens - the service user perspective Ian Swanson, ADASS-IMG/Julie Oxley, Leeds City Council 14:05 Roundtable session 6: IG toolkit 14:35 Roundtable session 7: Planning the practical steps - what we need to do 15:05 Concluding comments Jenny Wood, Warwickshire County Council/Martin Ferguson, Socitm/Pete Jackson, West Midlands I EP 15:10 Close
Planning the practical steps Q. Taking into account the discussion throughout the day, what do we need to do? View the results: https://www.polleverywhere.com/disc ourses/EMSkqGv7zZ8qniL Health & Social Care Reform – West Midlands Workshop

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