The Gathering 23 February 2011

Mike Martin

Partnership Improvement and Outcomes Division

Doing it right – getting it wrong!!!

WHY we need to ‘Reshape’ Care:

Sustainability – Rapidly ageing population

– Declining public finances

Desirability – Promoting independence not dependence

PAUSE FOR THOUGHT:More of the same will cost an extra £1.1 billion

by 2016 – where will this come from?Over 1/3 of all money spent on health/social

care for over 65’s is on emergency hospital admission [£1.4 billion out of £4.5 billion each year]

89.5% of people over 65 yrs are not in the ‘care system’ [97% of people between 65-74 yrs]

3,000 people 65 yrs+ receive more than 20hrs paid care per week

40,000 people 65 years+ provide more than 20hrs unpaid care per week

How do we spend the £4.5 billion …

Other Social Work

Care Homes

Home Care

FHS

PrescribingCommunity

Other Hospital care

Emergency admissions

£1.4bn

£0.8bn£0.4bn

£0.4bn

£0.4bn

£0.3bn

£0.6bn£0.2bn

Current service provision by service type

People aged 65 and over

hospital est

care home

home care

all others

Current service provision by age group

75-84

85+

65-74

97%

88%

60%

The challenge of change – more HOW than WHAT?

WHAT:A new philosophy of care – partnership and co-

productionA shift of focus – enablement, empowerment,

responsibilityA shift of resources – from institution to

communityA conducive infrastructure to promote rather

than prevent integration

HOW

Build an enduring consensus for the long haul Clarity of ambition – what will success look like? A decommissioning strategy – will impact on the acute

sector A commissioning strategy – coherent service redesign

and development Mutually reinforcing national and local strategies Building Community Capacity – the ‘spine’ for re-

shaping care

HOW – THE CHANGE FUND

£70 million for 2011/12 [circa £300 million over 4 yrs]

Subject to Change Plans – developed/agreed by Council/Health Board/3rd sector/Independent Sector

To invest in community based provision – preventative and anticipatory

To impact on Core Budgets to promote de-commissioning

To promote effective partnership working

Reshaping Care for Older People – A Programme for Change 2011-2021

Publish on 4 March 2011 Our commitments:

Double proportion of spend on care at home – from 6.7% to 13.5%

Build capacity of community/3rd sector to support/grow “supported self care”

Change Fund introduced - £300m over 4 yrs Reduce unnecessary variation – potential to take out 11% of

hospital beds Reduce bed days for 75+ due to emergency admissions by

10% by 2015 No discharge direct from hospital to care home All over 75+ to be offered a telecare package based on

assessed need

OVERVIEW: COMMUNITY CAPACITY AND CO-PRODUCTION WORKSTREAM

CONTEXT

> DEMOGRAPHY/ECONOMY

> RESHAPING CARE FOR OLDER PEOPLE

> WORKSTREAMS

> CHANGE FUND

> OPPORTUNITIES/CHALLENGES

COMMUNITY CAPACITY AND CO-PRODUCTION WORKSTREAM (1)

> Values the capacity, skills, knowledge connections and potential in a community…sees citizens and communities as co-producers of health and well being (and) instead of doing things for people shares power and helps a community to do things for itself’

(Improvement and Development Agency, 2010)

COMMUNITY CAPACITY AND CO-PRODUCTION WORKSTREAM (2)

> Older People are an asset not a burden> Community capacity building is working with the

voluntary and community sectors to build a philosophy of care based on co-production principles and to develop new community driven models of care provision.

> A partnership between those providing care and support and those providing it.

COMMUNITY CAPACITY AND CO-PRODUCTION WORKSTREAM (3)

> Success has as much to do with shifting attitudes and expectations as it has about shifting resources, care institutions, providers and workforces.

> Change Fund/ Change Plan – Opportunity and Challenge!

OUR ROLE

> General Support for Partnerships> Developing the Knowledge and Evidence base> Building Networks and Communities of Practice> Sharing Good Practice> Signposting/Developing Guidance> Link to Scottish Government

Contact Details

Scottish Government leads for Community Capacity Building & Co-production

> Gerry Powergerry.power@scotland.gsi.gov.uk0131 244 2374

> Andrew Jacksonandrew.jackson@scotland.gsi.gov.uk0131 244 5424

Co-production

> Delivering public services in an equal and reciprocal relationship between professionals, people using services, their families and their neighbours. Where activities are co-produced in this way, both services and neighbourhoods become far more effective agents of change.

National Endowment forScience, Technology & the Arts (NESTA)

& New Economics Foundation (NEF)