Changes to the Delivery of Adult Social Care and Health
06/02/2018 07:53:00.......Posted by Yvette Hopley
Many residents will know that Adult Social Care and Health services are undergoing a significant change. The total population registered across Croydon’s clinical commissioning group (CCG) is currently 377,570. The over 65’s represent 13% of this population, some 47,390 people, and is expected to grow by a fifth in the next ten years. In 2014, it was noted that there was a strong case for paying special attention to people who are aged 65 and over as the ageing population place an increased pressure on the health and care system. This was acknowledged in the work undertaken by the Conservative administration which approved the progression to Outcomes Based Commissioning for the over 65s.
Over the past few years the CCG, the council and its partners have been working to achieve integration between health and social care both in commissioning and at the point of service delivery. Recently this has been exemplified in the Better Care Fund (BCF) programme and through the establishment of multi-disciplinary health and social care teams.
Commissioning for outcomes rather than activity allows services to be delivered in a personalised way and is designed to focus on wellbeing. It enables providers to truly transform care: I and my colleagues are entirely supportive of this model of care, not least because we were the pioneers.
The most recent cabinet paper has taken this work a further step forward under the heading of the One Croydon Alliance, which includes an integrated Health and Social Care system consisting of the following partners: Croydon Council, the CCG, Age UK, GPs, The NHS and South London and Maudsley Mental Health Foundation Trust. It extends the original one year contract for a further nine years.
Part of this integrated model of care includes the LIFE services – Living Independently For Everyone and the Integrated Community Networks (ICN). As a result of the implementation of this service in the north of the borough the results have shown that 80% of regaining independence packages ceased within six weeks compared to 18% prior to the changes. This allowed the closure of 56 beds at Croydon University Hospital (CUH) – thus easing pressure on hospital beds. Intervention at an early stage with 180 people through multi-disciplinary working has prevented further pressure at CUH but more importantly allowed people to stay in the comfort of their own home. This work needs to take place in the south of the borough as not all residents access CUH. Many go to East Surrey, St Helier, Kings and St Georges Hospitals.
Whilst I am fully supportive of the model of care, my concern is that this system is not yet operational in the south of the borough. I have put forward a strong case for the residents of Sanderstead and those in neighbouring wards where the demographics are quite different. I am assured that the multi-disciplinary teams and huddles (proactive weekly case management teams working from GP practices) will be in place in the south soon. Currently only 30 out of the 57 practices have been implemented. The Personal Independence Co-ordinators are also not operational in our area. They will be employed by the voluntary sector independent of social services and the NHS. They will work intensively with people with long term conditions, if necessary on a one to one basis, and hopefully will reduce the number of people in hospital and facilitate discharge from hospital thus enabling more residents to remain independent in their own home.
I will continue to lobby the case for a model of care that is fit for purpose in the south, a place where I serve residents in a ward that has the highest percentage of elderly with the most complex health needs. I believe it would have been sensible to implement this model of care in the south first given the high percentage of residents that fall into the bracket of “over 65’s”.