Presentation of One Croydon Alliance Vision
In the officer’s introduction, the Panel were informed that there had been rapid improvements in changes over the past 6 months and thus the presentation was a broad overview of where the One Croydon Alliance was at the time.
The Outcome Based Commissioning (OBC) Alliance One Croydon had been agreed as the brand for the Alliance and was starting to be used. The Health Care Partnership agreed the brand and there had been a strap line around the vision of ‘Working together to help you live the life you want’.
One Croydon Alliance had been articulating their ambition to be able to communicate their vision in three main ways:
· Personal Outcome Improvements
· Improved financial sustainability
· Activity Shift – right place, right time, which means to only go to hospital when the resident needs to and they are discharged into the community as soon as practical.
As seen in the report, One Croydon Alliance had five outcomes domains. There were previously 77 revised to now 44 outcomes within the performance dashboard. These were proxy indicators to measure the outcomes, to ensure the outcomes that the residences wanted the service to achieve were being met.
Officer’s informed the Panel that over the last two to three months, they had been working on the transformation plan which covered 10 years in total. The One Croydon Alliance was currently in the first year, which was the transition year. There was a 144 page document which had six chapters that outlined the system change initiatives in the transformation plan which would introduce system savings and improved outcomes, including a move away from acute activity.
The Panel were informed that in financial reporting next year there would be a £26.6m gap across the Alliance. They aimed to close the gap by at least 50% through the work of the Alliance, and as work continued over the years the expectation was for increased savings.
The Panel queried about the Clinical Commissioning Group (CCG) as their focus was not on over sixty-fives year olds but rather on all ages.
The officer highlighted that the McKinsey Report had been published, and the One Croydon Alliance would need to review the outcome of the review and what it could mean for them.
The Chair informed the Panel that the transformation plan was pertinent to the Alliance. There had been fine tuning to review the risks and the financial model. The Panel were further informed that the mental health sector would be considered to be an area for the transformation model.
The view from the officer was that the model was a ten year vision. Each organisation needed to review and consider what the opportunity would be as a discussion would need to be made across all decision makers. The voluntary sector would also be considered within the model, as the integration of acute and primary health services had been more fragmented. The Panel learned that organisations wanted the partnership to work and not be diluted, and thus the possible move towards mental health or learning disabilities.
The Panel wanted to understand what the Alliance was working towards. The Officer fed back that the Transformation Board may need to be brought forward to review what would be beneficial for residents, as it would be a challenge to design a level of care for just one age group when it applied to all.
There was a ten year plan for Multi-Agency Working and Huddles that would bring in synergy and savings, and improvements to the way the organisations delivered their services. The business case had to be taken by the end of November 2017 in regards to how the service would work; how the service would meet financial gaps; the strategic case of “why’; governance; contracting options; and strategic vision. The data received had shown significant deductions. The integrated community network was being worked on including Huddles, which had seen benefits from this work.
The organisation was being supported by the Complex Care Support Team and on set for a full roll out with the aim of having a Huddle in every General Practice by end of March 2018.
One Croydon Alliance had gone live with the integrated Discharge to Assess service, This was where clients had visited the health services and within two hours of discharge an assessment was conducted at home. The six weeks reablement had significant impact on care packages with a significant packages being stopped.
The Panel heard that so far there had been thirty people discharged to assessment stage and only a few had gone back into hospital. This was a positive system impact as the hospital had met its A&E target. Officers informed Members that the long term goal would be to have operability across the health service and social service IT systems, as it was essential to receive referrals and communicate in the correct form. Officers were starting to track activity and performance including individuals through the social care services and framework, on a life to life basis.
The Panel discussed the issue of coordination between services for ensuring that the individual had the right support and equipment, as it was known that it was difficult to get coordination, and clarity was required to ascertain what services were to be provided. The officers stated that there was a process that needed to be reviewed. It was suggested by the Chair that appointing coordinators may resolve these issues. However, the Panel contested that the coordinators would still be impacted by the same issues as it was the departments and agencies who were unable to work together.
The officer informed the Panel that every morning there was a multi-disciplinary meeting to discuss those patients who were to be discharged, and all patients would receive the same service rather than a review of social care need.
The Panel stated that there was an issue of care agency quality and the need to ensure that agencies are delivering.
The Chair requested for a follow-up report and update at a future meeting of the Panel.