Integration and the future

Better Care Support Team Thematic National Workshops in Bristol and Birmingham in March 2019

The Better Care Support Team (BCST), supported by the Social Care Institute for Excellence (SCIE), ran two national workshops in March. The focus of the workshops was ‘Integration and the future’. The events were held in London on 7 March and in Liverpool on 25 March. Both workshops were well-attended

Sessions

Welcome and introductions

The London event was chaired by Keziah Halliday, Director of Assessment and Regulation, NHS England, and the Liverpool event was chaired by Rosie Seymour, Deputy Director, Better Care Support Team.

The Long-Term Plan: Integrated care for older people

Presenter - London: Kath Evans, Head of Planning Delivery, Hospital to Home team, NHS England

Presenter - Liverpool: Emma Self, Community Nursing Lead, NHS England

Both national workshops opened with an overview of the NHS Long Term plan and how changes in the service model will affect care for older people. Supporting people to age well is a key priority. Commitments on integrated care include:

• faster referral times for some services
• upgraded NHS support to all care home residents
• better sharing of information between care homes and NHS services
• regular clinical pharmacist-led medicine reviews for care home residents where needed
• primary care networks to assess their local population by risk of unwarranted health outcomes by 1920/21 and to make support available to people where it is most needed.

The future of the BCF: looking forward to 2020 onwards: the BCF review

Rosie Seymour, Deputy Director, Better Care Support Team

The BCF review has looked at progress so far and will present options for BCF beyond 2020. The role of the fund is being considered with the aim of ensuring best value.

It looks highly likely that there will be an integration programme from 2020 onwards, although it may have a different name and a different approach. There may be more of a focus on several particular areas and metrics may change, although the DTOC metric won’t disappear. There will also be more emphasis on the experience of people who use services.

It is unclear if there will be an announcement about the BCF review before the 2019 3-year Spending Review (date yet to be confirmed). The BCST is aware of the frustrations felt by local areas about delays in the publication of key information.

BCF 19-20: Planning requirements, policy framework, planning and assurance

There has been a delay in the publication of the policy framework, but it is hoped that it will be published soon. There is not expected to be much change from the 17-19 framework. Matthew West, Strategic Direction Programme Manager, Better Care Support Team

There will be some changes to the planning template. The planning requirements for 2019-20 will be collected through a single template with reduced, targeted, narrative input rather than a separate plan. The aim is to minimise the planning burden, make information easier to find for assurers and ensure a consistent approach to planning for all local areas.

Workshops

In each workshop, delegates were asked to discuss a series of questions with colleagues at their tables and to write their answers on post-it notes. The answers have been collated and will be used to inform the development of future integration policy and any revised support programme starting in 2020. Both workshops were facilitated by Rosie Seymour and Matthew West.

Workshop 1: Integration: What should the future look like?

Integration of health, social care and housing remains high on the government’s agenda. Integrated services are believed to: improve outcomes for service users; make limited resources go further; improve people’s experience. Considering the current integration landscape please answer the questions below:

1. To what extent is integration helping to improve services and outcomes currently?
2. What has limited progress?
3. What are the outcomes that integration should support in the coming years? For example:
   • Prevention? – if so, at what point?
   • Personalisation?
   • Admissions avoidance?
   • Discharge and flow?

Workshop 2: Delivering integration from 2020

The Better Care Fund remains the only mandated programme to enable integration of health and social care. 2019-20 is a transitional year with national conditions remaining the same as the previous round.

1. What policy changes would help promote integration of health and social care services? What about housing and other services?
2. How could different priorities be better aligned?
   • What objectives for a future programme might help with this?
   • How could the impact of individual funding streams (such as DFG) be enhanced through an integrated programme?
3. Thinking about a future programme
   • How can national prescription and local autonomy be better balanced?
   • How could the impact of a future programme be measured locally?
   • How could processes be streamlined/improved?
4. How can we reshape support to enable areas to integrate health, housing, social care and wider services?