Investing in Stockport

Preventative Commissioning Strategy

What we’ll cover

• The context

• The rationale for change - why are we doing this?

• The strategy

• The implications for the voluntary and community sector

• Wider implications

Two main drivers

Demand is growing•An ageing population•Longer life expectancy•Dementia and other LTCs will increase •Multi-morbidity•More adults will have caring responsibilities•Focus on self-health and self-management

Pressure on public funds

•Unprecedented reduction in resources•Significant reductions for Adult Social Care •NHS budgets largely static•Integrated health and care – new models

For Stockport, that means…

Prevention Investment

Adult Social Care and Public Health

2014/15 2015/16 2016/17

£17m £14m £13m

Why change preventative services?

• Prevention has a new and vitally important role in health and social care delivery and under new legislation

• Preventative services must make a focussed and tangible contribution to the local care and health economy (prevent, reduce, delay)

• We must identify, target and go on to support in a holistic way Stockport residents who most need help to stay living safely, independently and well in their own homes and communities

Why change preventative services?

• To preserve the preventative offer preserve the preventative offer and demonstrate value

• Because what we have commissioned to date is now historic and not generally fit for future purpose

• Optimise what we can provide to a wide range of vulnerable adults - address unmet need

• Secure value for money in the use of limited public funds

Preventative Strategy

Levels of need• Universal Prevention for

everyone. Access to digital information and advice, supported by families

• Supported Prevention to people at risk. Some services but more about guided support and enabling, identifying and growing the solutions people need

• Targeted Prevention to people with complex/multiple needs. More services but still making the very best of an individual’s capabilities. Motivating and supporting.

Doing it differently

• Less ‘services’, more about identifying the support people need & finding solutions

• Valuing and optimising lived experience

• Maximising community, family & individual capacities

• Focusing limited resources on those who most need support

Preventative Strategy

• Treating separate adult commissioning budgets as a single preventative pot

• Adult Social Care, Supporting People, MGS • Also elements of public health, children's services

budgets, community safety etc• More focused on vulnerable people at risk;

complex and multiple needs • Comprehensive approach to addressing risks to

independence across our population (not for individual groups)

In practice…Something like this:Short-term – next 6 months•Some immediate decommissioning•Some immediate recommissioning – building on existing services but a new model of access and support for vulnerable people•Some transitional arrangements to help manage the change – renegotiations & transitional fundsMedium-term – next 6-12 month•Review some specific areas to ensure that we commission the right services to meet future need – then recommission

Implications for the VCS

• The Council is changing fundamentally - we need you to adapt with us & contribute actively

• Commissioning budgets are smaller• A period of uncertainty and challenge – but there

will also be new opportunities to address needs• An inevitable reduction in the number of

voluntary sector organisations working in Stockport and those remaining working more collaboratively

• A willingness to foster new ideas and approaches

Implications for the VCSHow can we help with:•discussing the changing funding and delivery landscape with your Boards/Trustees or parent organisations?•adapting your current business models?•diversifying, collaborating, sharing skills and experience, trading with each other….? •considering your fullest range of future options and opportunities as voluntary organisations? •what you could do differently whilst maintaining your core values and purpose?

Wider implications

• Some existing services will end

• There will be both fewer and different ways for people to access support

• But a more integrated approach

• Managing people’s expectations – realism

• Formal care & health services are there when really needed, as a safety net

• Need to generate and sustain social action

• Work towards more resilient and concerned communities

• Individuals and families supported to self-manage

• Vulnerable adults feel part of their community

• Contributing in small ways creates daily purpose and motivation – a win/win

Questions and comments welcomed