DH – Leading the nation’s health and care

1. Social Partnership Forum’s Staff Passport MeetingMonday 18th AugustGlen Mason Director of People, Communities and Local GovernmentDepartment of Health DH – Leading the nation’s health and care

2. Care and Support affect a large number of people Many people need some extra care and support during their adult years to lead an active and independent life. Three-quarters of people aged 65 will need care and support in their later years… • Who needs care? At age 65, what are your chances of • needing different types of care within your lifetime? 19 per cent of men and 34 per cent of women will need residential care 48 per cent of men and 51 per cent of women will need domiciliary care only 33 per cent of men and 15 per cent of women will never need formal care DH – Leading the nation’s health and care

3. Drivers for Change in the English Care System • Demographic pressure • Unprecedented financial challenges • Raising expectations • Technological Change • Systems failure eg: Mid Staffs Hospital and Winterbourne View • A drive to integrate services DH – Leading the nation’s health and care

4. The Care and Support Act – our vision • We will change care and support in two fundamental ways: 1. The focus of care and support will be to promote people’s independence, connections and wellbeing by enabling them to prevent and postpone the need for care and support. 2. We will transform people’s experience of care and support, putting them in control and ensuring that services respond to what they want. DH – Leading the nation’s health and care

5. A shift in the care and support system DH – Leading the nation’s health and care

6. Choice, control and quality In the new, person-centred system... People can choose between a range of high quality options, or create their own i People’s views are heard and help improve services People have clear information to make good choices about care People develop their own care and support plan People are in control of their own budget DH – Leading the nation’s health and care

7. The Care Act is built around people • Promoting the diversity and quality of the local care market, shaping care and support around what people want • Ensure that no one goes without care if their providers fails • Puts adult safeguarding on a statutory footing for the first time • Young adults receive care and support during transition • Reforms what and how people pay for their care and support DH – Leading the nation’s health and care

8. The Better Care Fund Benefits of integrated care Coordinated approach Better use of resources Organised around users Services 7 days a week Bring skills together around the user Reduction in need to go to hospital Better outcomes for users

9. What is Government doing to support this? The Better Care Fund Autumn Statement December 2013: Pooled budgets will be an enduring part of framework in future years Local authorities and NHS Clinical Commissioning Groups must agree a joint plan to deliver better, person-centred care before receiving funding Part of the £3.8bn allocated to local authorities includes a payment for performance element to incentivise ambition and real change June 2013 announcement: £3.8bn to be deployed locally in 2015/2016 on health and social care through pooled budget arrangements DH – Leading the nation’s health and care

10. The Better Care Fund (BCF) narrative • The Better Care Fund (BCF) will accelerate the local integration of health and care services to deliver better outcomes for people There is consensus that to respond to this care should be organised around the person who needs it, and that person’s care team should work together to keep them better for longer. The Better Care Fund is one of the most concrete steps ever towards making this change happen everywhere. This is the start and pooled budgets are here to stay. Areas put in draft plans in April, and local areas are now revisiting these to make sure they are as clear and strong as possible to kick start the change we need from next April. NHS and social care services are now caring for people with increasingly complex needs and multiple conditions. As ever with system transformation – success depends on the people who are leading it to make it happen locally – people taking bold steps to move away from their old ways Now we want this to happen everywhere and we are committed to support local areas to achieve this. Local areas teams and local government regions will have a crucial part to play. The BCF has accelerated and made happen conversations that have never happened before about joint working across agencies. It is challenging, and will undoubtedly get harder before it gets easier – but we have seen in small pockets the immense value of the prize for patients, users, families, carers and staff. DH – Leading the nation’s health and care

11. The Better Care Fund Examples of where it’s happening Greenwich – avoided 2000 patient admissions with a joint emergency team South Devon & Torbay – reduced physio waiting times from 8 weeks to 48 hours by bringing professionals together Northamptonshire - targets have been exceeded by 14% on preventing emergency inpatient admissions- targets on preventing excess bed days exceeded by 4% Tri-borough in London have produced new joint model to help people manage chronic conditions In Greater Manchester 10 local authorities and 12 CCGs have joined forces to support a large scale reconfirguation of hospital services

12. Better Care Fund Details of the Better Care Fund Better Care Fund

13. Better Care Fund Next Steps Assurance process Support available for all areas up until 19th September Local areas to develop/agree plans and submit by 19th September 2014 Ministerial final assurance of plans By end of October Additional £200m NHS transfer to LAs 2014/15 £3.8bn pool to be deployed locally 2015/16 • Better Care Fund

14. Adult Social Care Workforce • NHS Workforce • Community 251,000 • Healthcare • scientists • 31,173 • Allied health • professionals • 74,902 • GP providers 26,886 • Other scientific, therapeutic • & technical staff 47,490 • Other GPs 8,898 • Residential 675,000 • GP registrars 4,426 • GPs 40,265 Scientific, therapeutic & technical 153,472 • Consultants 40,394 • Doctors • 146,075 • Estimated number of adult social care jobs by employer type in England, 2011: • 1.85 million • Qualified ambulance • staff 18,645 • Registrars 39,404 Professionally qualified clinical staff 687,810 • Other doctors in training and equivalents 13,952 • Other medical and dental staff 12,302 • Day 96,000 • Qualified nursing, midwifery & health visiting staff • 346,410 • Nursing • 369,868 • Right Capacity • Estimated number of NHS hospital & community health service and general practice workforce as at 30 September 2012: • 1.36 million • Managerial/supervisory 31,700 • GP practice nurses 23,458 • Domiciliary 831,000 • Infrastructure support 215,071 • Central functions • 106,696 • Other 18,400 • Hotel, property and estates 71, 242 • Manager and senior manager 37,314 Support to clinical staff 343,927 • Other GP practice staff 113,832 • Direct care • 776,200 • Professional 4,300 • Support to doctors & nursing staff 269,714 • Support to scientific, therapeutic • & technical staff 61,345 • Support to ambulance staff 13,451 DH – Leading the nation’s health and care

15. DH – Leading the nation’s health and care

16. Challenges to the Workforce of Integration • Staff need to develop new skills and to work across traditional boundaries • Growth in personal assistants with individual care and health budgets • Development of new roles • Systems leadership • Practical issues – TUPE etc • Developing one culture DH – Leading the nation’s health and care

17. Thank you and any questions? Glen Mason Director of People Communities and local Government Department of Health DH – Leading the nation’s health and care