Macclesfield 16th July

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Integrating Care in Eastern Cheshire

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Strategic PlanPublic Engagement

EventMacclesfield, 16 July


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Agenda

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‘10Welcome and intros

‘25International case examples

‘30Vision of integrated care

’50Look and feel of integrated care

Next steps ‘5


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Thank you for joining us on the continuation of our journey toward Caring Together in Eastern Cheshire

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July - August September - DecemberJanuary - June

Objectives • Informing strategic plan• Helping to design the

look and feel of the integrated care model

• What is most important to change

• Informing vision of 4 pillars

• Understanding how care is currently experienced

• Informing and assessing the business case

• Providing input and feedback on implementation plans

Agreedactions/next steps

• Building the four pillar vision

• Communicating plans

• Incorporating input into design of integrated care services

• Amending and improving business case based on feedback


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Objectives for today

Today’s session aims to:

1. Feedback what we have heard from previous engagement events

2. Update you on where we are on the journey toward integrated care

3. Push forward thinking on tangible aspirations for integrated care

4. Review international best practice on what care could be provided under integrated care, and how it could be delivered


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As a reminder, there is a strong case for change for integrated care in Eastern Cheshire

SOURCE: Caring Together PIDs; Interviews ECCCG and stakeholders; McKinsey analysis

Coping with an ageing population

Fragmented services across rural area

Severe financial challenges

• A population older than the England average

• The fastest growing population of over 65s and over 85s in the North West

• A declining number of informal carers

• Dementia morbidity significantly above the national average

• Hospitals still at the centre of much of the health care provision

• A rural geography meaning many people struggle to access services

• Poor infrastructure, with IT systems unable to access single patient records

• £12-15 million per year needed for next 5 years

• £36m savings needed over next three years

• Local Authority and CCG amongst lowest funded in country

• Acute trust needing a 6.9% CIP

• Mental health and community services in the lowest national quartile for investment

These factors have strongly affected your relationship with the health system

We are keen to address these challenges through Caring Together


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What we heard on patient experience. . .

SOURCE: Participate Ltd. engagement report

“There is a lack of integration within organization, let alone across organizations”

Patient experience“I want simple,

accessible information about my own care, through a single point of contact”

“Staff are overworked and don’t have the time or opportunity to develop a personal relationship with patients”

“We want more care in the community so that we can keep our independence”

“Sharing of the necessary patient information does not always happen because of a lack of communication”

“We waited 2 years for a referral to the right specialist. I don’t want my son to be constantly in hospital”


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What we heard on clinician experience. . .

“There are too many teams and too little information on what they do” Clinician

experience

“Patient experience and outcomes should be a driving force”

“There is too much fragmentation. We need a better dialogue between primary and secondary care providers”

“Many individuals come to our service in a crisis situation and are already known to other services. Sharing information and getting support in these situations is essential”

“We need better communication and IT systems that can speak to each other”

“I do not know who I am supposed to be talking to. It would be easier if there was one person or one department to handle everything involving the patient”

“There is a lack of understanding, and perceptions of organizations that may not reflect the reality, especially about the voluntary and community sectors”

“Providers are willing to co-operate, but work pressures, poor communication and a lack of technology sometimes get in the way”

SOURCE: Participate Ltd. engagement report


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Based on your input, our vision centres on four pillars

SOURCE: Caring Together: A Framework for Designing, Planning and Delivering a New Integrated Health and Social Care Model for Eastern Cheshire;1:1 Interviews

Pillar 1: The empowered person

• Individuals empowered and supported to take responsibility for and manage their own health

• Support provided by network of community and voluntary providers

• Key interventions include health prevention and promotion, screening, community exercise, short term assessment and signposting and expert patient

• Universal and town based (0-5 miles)

Pillar 2: Community provided care

• Fully integrated multi-professional team providing community-based care centred around patients with a single line of accountability

• 24 hour care anchored in GP practices

• Key interventions include single assessment for health and social care, case management/ coordination, specialist input and carers support

• Targeted and town based (0-5 miles)

Pillar 3: Local specialist care

• High quality specialised care delivered at scale within a reasonable distance from people’s homes, including health and social care beds

• Acute specialists and community teams work in partnership to address patient needs

• Key elements include general hospital services, rapid discharge team and daycase centre

• Complex but local (15 miles)

Pillar 4: Regional specialised care

• World class specialist centres delivering highest standards of care at scale

• Highly-trained specialists delivering complex care, often using advanced technologies in regional specialist centre

• Specialist may require travel (up to 30 miles)

Precise interventions yet to be established/finalised – with focus on more investment in pillars 1 and 2


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Group exercise – What does this mean to you?

Based on the areas for improvement that you have identified, think about what an improve-ment would look like in practical terms

Write your ideas on post-its and stick then on your group’s poster

In groups, spend 20 minutes discussing what changes you would like to see on a day-to-day basis, if the issues identified were resolved


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Gallery Walk – integrated care case examples

Read the posters and think about what elements you like about the case examples

Put a sticky dot on anything you particularly identify with

Take 20 minutes to walk around the room

We will then spend 30 minutes in groups, discussing our vision for integrated care


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Group exercise – Our vision for integrated care

What is our vision for integrated care?

Going back to the four pillars of our vision, piece together the elements you liked from the case examples, along with the feedback from our discussions on what integrated care would look like to you

In groups, use the posters to write down your ideas for how integrated care could look


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What are you willing to commit to over the next few months to help drive integrated care forward?

Alexi Ness – Clinical Project Manager

To discuss/share and champion Caring Together in the projects I work on, and with the people I work alongside

Helen Weston – community Matron

Share principles of Caring Together through workstreams of integrated care/neighbourhood teams. Attach logo to emails

Paul Bowen – GP chair

I’ll ensure I allow the aspirations set out by the Clinical Commissioning Group to motivate the rest of the programme into action/progress. We need to be sure the progress of service design keeps up with the promises of the campaign

Andrew Tester – Health and Wellbeing Officer Plus Dane Group

1. Attach the link onto the bottom of my emails.

2. Work with Comms Group to raise awareness in the neigh-bourhood we serve (internal and external)

3. Share with partners I work with


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How might this change your personal thinking and actions in the near future?

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This week Next 6 months

Using the wall poster, let’s create a group commitment board for both time horizons


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Examples of previous personal commitments


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Next steps

• We can all contribute to communicating the vision and getting the word out about Caring Together

• We will take your input today and incorporate them into our plans for designing integrated care services

• We look forward to reviewing our initial plans with you at our next meeting (August)

Macclesfield 16th July

Health & Medicine

Transcript of Macclesfield 16th July