Wigan Integrated Workforce Social Care Institute for Excellence 24 th April, 2018

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1 Wigan Integrated Workforce Social Care Institute for Excellence 24 th April, 2018

2 Welcome Nicola Lowe Adult Social Care Service Manager Customer Journey Vikki Morris Service Manager -Integrated Community Services

3 Making it Happen: it s simple but profound

4 The Partnership

5 Integrated Model of Working Wider public & voluntary sector services Police Fire & Rescue DWP Housing MASH Live Well Key Workers Others

6 Service Delivery Footprints 30-50,000 population Co-terminus GP Clusters SDF Managers as convenors Named capacity for each SDF Schools Profile for each SDF Community Assets mapped Estates Strategy by SDF SDF multi-agency huddles Sub SDF neighbourhood teams in areas of greatest demand

7 As with many journey s Madagascar Escape to Africa Dreamworks

8 The Case for Change Social Care 2011/12 projected overspend of 6.9million, with rising demand for services A traditional service model - care management focus Lack of leadership and direction Accountability issues throughout the service Disengaged and risk averse staff; multiple assessments; bureaucratic processes

9 Opportunity to do things differently The Response Social Care Wigan one of six to be awarded Creative Councils funding to test new ideas about how public services are delivered A new relationship with residents and communities People at the Heart of Scholes - integral to this thinking supported by NESTA and the LGA Work in Scholes - powerful impact and challenged the way we work with services users and the wider community Commitment to invest at scale

10 Making it Happen: it s simple but profound

11 Workforce Reform at Scale New permissions and roles - Sustained Service Manager Leadership. - Community Knowledge Officers; Quality Performance Officers; Lead Provider Managers; Social Care Officer and Primary Assessor roles Housing with Care - 2.3m saved through the redesign of supported accommodation around shared models of support, and community connection. Stronger relationships with providers Reformed model of Extra Care to deliver a more personalised, strengths based offer of support whilst securing 0.35m of cost efficiencies (37%). Working with the right providers Transformation through Technology new care management system and 400 frontline workers equipped with agile devices. 0.8m saved.

12 Workforce Reform at Scale Ethical framework an asset based commissioning market focusing on quality and sustainable care at home. Scaled Up Reablement pump prime investment secured through GM Transformation Funding which supports Home First approach Co-location of front line teams in multi service centres joint working on cases with a holistic approach Operational reconfiguration around the customer journey. Integrated Hospital Discharge Team established with health, partners home first ethos

13 The Case for Change Health NHS will be 70 years old in New treatments for a growing and aging population mean that pressures on services are greater than they have ever been Waiting times are rising and health services are struggling to cope with demand Up to 3 million A&E visits could have been better dealt with elsewhere. There are difficulties admitting sicker patients into hospital beds and discharging them promptly back home Little investment in community health services as acute s continue to suck in money and resources. Significant shortages in key roles that support community response such as District Nurses, Advanced Nurse Practitioners, Consultant Geriatricians, Primary Care/GPs etc.

14 The Response Health An integrated health approach to community provision Bridgewater Community NHS Trust and Wrightington, Wigan & Leigh Trust service lines and 500+ nursing and therapy staff from across three organisations Looked at both international and national examples of how to do things differently Wigan Council a critical friend in the transformation.now part of the integrated journey Focus on three levels of healthcare: Rapid keeping people out of hospital or getting them home sooner Complex those who are unstable or with multiple conditions Active routine and planned community care

15 Workforce Reform at Scale Getting workforce together through co-location - shared resources, oxygen, milk, strengths and skills Preventing people from being admitted to hospital by supporting them to live in their homes Applying asset based approach Re-designing of work in teams to make it easier to see improved outcomes for residents & patients

16 Workforce Reform at Scale Joint appointment of health and social care senior team Major reconfiguration of IT systems and agile working 500+ staff accessing same system and electronic referrals between services Clinical daily huddles in community to discuss unstable and complex patients Clinical staff attending SDF huddles for patients that need in-put from wider services Integrated health and care duty teams to prevent health and care crises

17 So what have we learnt? Front line staff just get on and do it..if managers get the right support mechanisms in place Staff say they remember why they came into the job. a feeling that this is the way they should be working Patients are benefitting from telling their story once and a feeling of support in their community Public and wider services are starting to really understand their communities. and are working together to achieve the same aims

18 What are the challenges? Information sharing across organisations.information governance can feel more of a barrier than an enabler Different organisational cultures and attitude to risk The pressure from the system to measure activity and not outcomes Are we there yet? pressure to make a difference right now!

19 Thank you for listening Questions?