Integration and the Better Care Fund: news from West Sussex

Featured article - 25 April 2017
Rachel-Louise Hughes, coordinator, West Sussex Better Care Fund

Head-shot of the author, Rachel-Louise Hughes, coordinator, West Sussex Better Care Fund

When making a large purchase, such as an expensive pair of shoes, the last thing on your mind would be the return on investment they represent, or whether they’re value for money. What you might be thinking, however, is what they will go with, justifying the cost by the high quality and craftsmanship and how often you might wear them!

Taking that analogy for schemes focused on integration and funded through the Better Care Fund, the biggest challenge we face can be demonstrating the value for money (VFM) of a scheme, as some are focused on cost avoidance and can’t be easily quantified. So how do we measure success and evidence the need for continued investment? There is a need to link the national metrics down to the schemes’ performance measures to evidence the performance and impact at a local level. It is also the challenge of reporting county-wide services at a Clinical Commissioning Group level, and managing the impact of different organisation’s financial pressures.

How do we go about capturing the evidence?

The opportunity is to think wider than the Better Care Fund as a financial vehicle, and really consider the outcomes for people. What are you trying to achieve, how might you go about doing that and who can help you achieve the goal?

For me the building blocks for measuring success are Transparency, Collaborative working and most importantly Trust. Combining these three means you can have the difficult conversations, but from a shared understanding and a common goal. A key lesson for those working on integrated care is it requires patience, effective leadership and ownership at a senior level.

What we are doing locally in West Sussex?

  • Used the self-assessment toolkit as a survey for key stakeholders to evaluate schemes and stimulates discussion and challenge
  • Produce a monthly performance and finance report and a supplementary system Delayed Transfers of Care (DTOC) Report
  • Applying the logic model methodology to all schemes, identifying gaps in measures and ensuring links to the core BCF metrics
  • Holding Star Chamber style events for all schemes to consider their impact and benefits
  • Using the results from these initiatives to hold the challenging conversations

So, going back to the big purchase, the principle of value-for-money is the same if you took the total price and divided it by the number of wears planned; you could justify the cost in that paying a bit more for something that is built to last is good financial sense. Demonstrating value and measuring success in BCF is challenging, but worth the time and effort. Integration is a long-term investment, and won’t be going out of fashion anytime soon, so be the trendsetter.

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