Voluntary Sector Networking Event 8 February 2017

Bridget Cameron Assistant Director – Commissioning, Stoke-on-Trent City Council

Outline of the event • Welcome and housekeeping• Guest speakers - overview of service delivery,

patient experience and new initiatives• Opportunity to network• Any questions - please complete the question slip• Round table discussions• Summary of any questions and closing comments

Why are we here?• Challenges faced across the local health and social care

economy

• Ageing population - multiple co-morbidities being the norm rather than the exception

• Availability of care provision is a local and national struggle

• We need alternative ways to meet the needs of people with an assessed need and those who need early help and support

Funding Opportunity

Additional funding has been committed through the unique partnership arrangements with:• University Hospital North Midlands (UHNM)• NHS Stoke-on-Trent Clinical Commissioning

Group (CCG)• Stoke-on-Trent City Council

Purpose • We recognise the valuable support which the voluntary

sector provides to individuals in the city and need your help and support to continue to work collaboratively

• New opportunities to work together innovatively and creatively; two areas which we want to really focus on are:

• Preventing hospital admission • Supporting timely discharge from hospital

Current position

• Non planned admissions to hospital for the over 65 year olds accounted for 13,700 admissions, equating to 81,000 bed days at cost of £29.4 million (2015/16 full year)

• Annually the City Council deals with over 3,000 hospital based social care assessment referrals (equating to 60 per week)

Current position

• During the second half of 2016 the number of people affected by a delayed discharge doubled to 100 per month

• During 2016 delayed discharges were attributed as follows:• 57% - NHS• 26% - Social Care• 16% - both NHS/Social Care

• The biggest specific delay was awaiting the right care package and home set up (attributable to NHS and Social Care)

Enablement and Discharge to Assess

Ian Clarke – Age Well Commissioning ManagerAge Well Commissioning

Care and support provided by the City Council

• Increased enablement/long term support provided by the City Council to support the independent sector and meet unmet demand.

• Recruitment of 216 front line staff without destabilising other parts of the system to provide approximately 3,500 hours of support per week.

Care and support provided by the City Council

• Work with the Voluntary and Community sector to maximise individuals networks to provide a holistic offer to meet individual need.

• Enable introduction of Discharge to Assess and create new capacity into the system.

Discharge to Assess

Aligned with community health services in Stoke-on-Trent (Palliative Care and Intermediate Care) to:

1. Offer Enablement approach to people going home2. Maximise staffing resource and skill’s available3. Multi-Disciplinary Assessments outside of the hospital4. Duplication and cross referrals reduced5. Streamline home and bed based pathways – three Localities

(Leek/Moorlands, Newcastle and Stoke-on-Trent)6. Early identification of long term support options7. Provide admission avoidance

Domiciliary Care

Scott MacDonald –Commissioning ManagerAge Well CommissioningSally Woolliscroft – Acting Senior Commissioning Officer

Domiciliary CareRetender and Redesign

2017

Contact email:

“Domiciliary Care – Voluntary Sector Consultation” toelectronic.monitoring@stoke.gov.uk

Hospital DischargePaul Astley – Project OfficerFeb 2017

Context – Much Change in the Local Health Economy

• NHS Five Year Forward View;

• Proposed Sustainable Transformation Plan;

• Locally, proposes a community based model focussing on holistic (whole person) care including mental health;

• Patients increasingly treated at home rather than in hospital;

• Patients and staff as equal partners in care;• Increased community urgent care.

• My Care My Way (care closer to home);• Pressures on social care nationally;• Aging population.

Our Work related to Hospital DischargeProjects – • Hospital Discharge Project (2015);

• Investigated the experiences of frail elderly whilst being discharged;

• Big Conversation Events – (STP);• Workshops with the public exploring ways to implement STP’s’

• Community Hospital Beds Report;• Comments from the public about what they perceive as risks and benefits.

Frail Elderly Discharge (2015)

• 29% of respondents said they didn’t find it easy to talk to doctors and nurses about their care;

• 26.9% of respondents disagreed that staff spoke with them or their carer to discuss what would happen when they got home;

• 28.8% say they didn’t get clear instructions about their medication before they left hospital;

• 15% reported not knowing what would help they would receive when they got home;

• 5.5% reported not having support from friends and family when they got home.

Study completed in partnership with the Royal Stoke University Hospital.

Frail Elderly Discharge – Analysis

• Encouraging Patient Participation

• Use of Advocates;• Use of technologies such as ‘flo’- Increasing confidence in IT?• Understand the health literacy levels of patients;

• Check understanding of patients and carers;

• Social Prescribing – empowering patients;• Training for hospital staff;• Information hubs for things like LTC’s & Self Care.

“How can care be patient centred without patient

participation?”

Com Hosp Beds Survey - Story“We thought that the care arranged for my father was more than adequate. I needed a break. We went on a three night holiday. Two hours after arriving we had a call from Care Call to say that my father needed support. We were 93 miles away. It was a Friday night and therefore Care Call contacted the over-stretched ambulance service to attend and help him back into his bed. This was fine until he needed to use the toilet again later in the night. 

The carers attended and sorted out the issue on Saturday. Between Friday night and Saturday 10.00pm I had made or received 34 phone calls. There was no-one available to add an extra visit at 10.00pm. The emergency duty team could not locate any help. I phoned the care company who I was paying privately - they couldn't send anyone because they needed authorisation. The Emergency Duty Team finally said they had a solution and I was to phone the District Nurse administrator who very kindly said they 'would do me a favour' and send out two district nurses to put him back into bed. They were unable to get him into bed, sent for the ambulance and he was taken to A and E. He spent one night in A & E followed by two nights in Leek. We cut our holiday short. On Tuesday he was sent home - no improved care facilities and the same pattern followed one day later . . . . . . . ”

Com Hosp Beds Survey - Story

Services Involved-----------

Informal Carer/Family (Mediator);Dom Care Workers;

Care Call;Ambulance Service;

Emergency Duty Team;District Nurse Administrator;

District Nurses;Accident & Emergency; Community Hospitals.

Where does the VCSE Sector fit within this?

Finally . . .Essential Reading . . . • My Care My Way;

• http://www.northstaffsccg.nhs.uk/my-care-my-way

• Sustainable Transformation Plans• http://www.twbstaffsandstoke.org.uk/

• Stoke-on-Trent Clinical Commissioning Group - Frail Elderly Care Strategy• http://www.stokeccg.nhs.uk/strategies

• Big Conversation Events Report – (STP);• http://www.healthwatchstokeontrent.co.uk/wp-content/uploads/2016/12/Big-

Conversation-Events-Report-FINAL.pdf

• Community Hospital Beds Report;• Forthcoming - Comments from the public about what they perceive as risks and

benefits.

Voluntary Sector Grant Funding

Rebecca BowleyStrategic Manager – Age Well Commissioning

Stacy Sharman, Local Matters Team Manager

Prevent hospital admission / support hospital discharge

Prevent the isolation of older people & people with

disabilities

Funding Purpose

New Voluntary Sector Grant Funding Programme

Existing Small Grants Scheme (£450)

Proposed – Community Investment Fund

Supporting FamiliesThriving Places

Strong Communities

New Voluntary Sector Grant Funding Programme2017 - 2018

• Partnership between LA, CCG and UHNM.• Specific aim of supporting admission avoidance &

timely discharge from hospital.

Scheme 1Grants up to £10k

(Indicative pot £100k)

Scheme 2Grants up to £100k

(Indicative pot £400k)

Criteria – Voluntary Sector Grant Funding Programme

• Demonstrate how the initiative will prevent hospital admissions and/or support timely discharge from hospital. New idea or expansion of current service.

• Describe how the initiative will be delivered - particularly interested in collaborative and partnership approaches and 7 day services.

• Demonstrate what contribution your organisation(s) will make to the initiative e.g. funding, staffing, transport, use of buildings.

• Describe the expected impact e.g. added value, geographical area covered, number of people supported.

• Explain how outcomes will be measured and how the key learning from the initiative will be shared.

Timescales - Voluntary Sector Grant Funding Scheme

Activity Expected Timeframe

Launch date By end of February 17

Closing date for submissions

31 March 17

Decisions communicated 29 April 17

Proposed Community Investment Fund

Fund objective Minimum and maximum award

Maximum funding period

Start-up –local project that will lead to a lasting legacy in the community

£2,000 - £10,000 Plus training & support from the Local Matters Team to develop the idea

1 year

Large project –larger scale project which has the potential to deliver significant improvements in an area and reduce demand on council services

 £10,000 - £50,000

 3 years

Proposed Themes

Supporting families to fulfil their potential:

Play & learn activities for families with children under 5

Thriving places & communities: Investing in strong, thriving communities & sustainable local economies

Strong communities where people live their lives well: 

Building strong community networks & prevent loneliness

Contact Details

rebecca.bowley@stoke.gov.ukstacy.sharman@stoke.gov.uk