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High Level Integrated Commissioning Intentions 2008-2011

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support our service users/patients to design and plan their future service(s) in order High Level Commissioning Intentions & Priorities 2008-2011 14

    Health & Social Care Commissioning Priorities & Intentions

    2008-2011

    Personalisation of Services

Adult Integrated Commissioning Unit

Foreword

It gives us great pleasure to introduce Health & Social Care commissioning priorities

    and intentions 2008-2011, “Personalisation of Services on behalf of Liverpool

    Primary Care Trust and Liverpool City Council prepared by the Integrated Adults

    Commissioning Unit. It outlines the commissioning priorities and intentions for all

    client groups including:

    ? Older People

    ? Mental Health

    ? Learning Disability

    ? Disabled People with Physical and or Sensory Impairment

In addition, it outlines priorities within other key strategies including:

    ? Intermediate Care

    ? Advocacy

    ? Carers

The document shows the increasing integration and move towards personalisation

    across Health and Social Care, evidenced by our joint priorities and indicates which

    of the new set of National Indicators will be utilised to measure our success in these

    areas at a local level. It is hoped that this document will facilitate a clearer

    understanding and overview of the future Health and Social Care commissioning

    landscape in Liverpool over the next 3 years.

We also hope this will be a useful tool for all provider organisations and particularly

    those from within the third sector in order to support our service users/patients to

    design and plan their future service(s) in order to inform and shape the integrated

    commissioning future.

Published draft 30 June 2008 2

Contents

Foreword 2

Introduction, Background and Context 4

Liverpool City Council Corporate Aims & Priorities 5

Liverpool Primary Care Trust Strategic Priorities 5

Local Performance Framework 6

Integrated Adult Commissioning Unit (IACU) 7

    ? Future Commissioning landscape 8

    ? IACU Achievement 2007/8 9

Commissioning Strategies 2008-2011 11

    ? Seven Common Priorities 12

High Level Commissioning Intentions & Priorities 2008-2011 14

    ? Intermediate Care 14

    ? Older People 15

    ? Disabled People with Physical & or Sensory Impairments 16

    ? Learning Disability 18

    ? Mental Health 20

    ? Advocacy 22

    ? Carers 23

    Appendix 1 National & Local Performance Indicators 24

Published draft 30 June 2008 3

1. Introduction

Purpose of this document

This document attempts to draw together the various integrated commissioning

    priorities and intentions for 2008 to 2011 for all vulnerable people in Liverpool. It outlines the commissioning priorities and intentions for all client groups including:

    ? Older People

    ? Mental Health

    ? Learning Disability

    ? Disabled People with Physical and or Sensory Impairment

In addition, it outlines priorities within other key strategies including:

    ? Intermediate Care

    ? Advocacy

    ? Carers

The document shows the increasing integration and move towards personalisation

    across Health and Social Care, evidenced by our joint priorities and indicates which

    of the new set of National Indicators will be utilised to measure our success in these

    areas at a local level. It is hoped that this document will facilitate a clearer

    understanding and overview of the future Health and Social Care commissioning

    landscape in Liverpool over the next 3 years.

    It outlines the plans at a “high level” which have been taken from the individual commissioning strategies that are now available on our commissioning website.

    Other strategies will emerge in the summer of 2008, including:

    ? Stroke

    ? Falls

    ? Dementia

    This document is work in progress and will be regularly revised and updated as our strategies, priorities and customer‟s needs and expectation change over time.

2. Background & Context

2.1 Liverpool City Council & Primary Care Trust Joint Priorities

The diagram over the page illustrates the relationship between Health and Social

    care in Liverpool and how the respective National and Local plans and drivers from

    each organisation can facilitate joined up delivery, care pathways and integrated

    commissioning activity that benefits customers and citizens.

    Published draft 30 June 2008 4

    Liverpool City Council & Primary Care Trust

    Integrated Commissioning

    Comprehensive Spending Review

    Public Service Agreements

    Local Area Agreements

    National Indicators

    Integrated Commissioning

    Joined Up Services

    Seamless Health & Social Care Pathways

     Vital Signs

     NHS Operating Framework2.2 Liverpool City Council Corporate Aims & Priorities PCT Operational Plan

    LCC Corporate Performance Plan 2008-11

    Liverpool City Council three Corporate Aims are:

     Grow the City’s Economy

     Empower our Residents

     Develop our Communities

The Priorities flowing from the 3 key aims are- :

Ensure safeguarding & inclusion of most needy & excluded groups providing

    equality & real opportunity for improvement & enhanced quality of life

Confront barriers to employment & training through lack of access, deprivation,

    discrimination & poor health to ensure provision of a highly skilled workforce

Increase peoples' sense of influence in decisions affecting their lives and

    communities through open, fair & accountable neighbourhood-driven processes

Provide sustainable communities through access to decent homes & best practice

    in environment management including recycling, street cleansing and

    environmental enforcement against dereliction and environmental detractors

2.3 Liverpool Primary Care Trust Operational Plan

Liverpool Primary Care Trust Operational Plan for 2008/9, a new Health Service for

    Liverpool have developed the following strategic priorities:

     Improving Health and Well being

     Improving Services

     Enabling ‘NHS Liverpool’ to improve continuously

Published draft 30 June 2008 5

One of the key priorities for PCT under improving health and well being is a

    commitment to “Joined up Services” (Priority 8)

The Primary Care Trust emerging Priorities, Immediate Service Improvement &

    Cross Cutting Themes flowing from the Operational Plan are:

     High Quality Primary Care

     High Quality Prevention/Rehabilitation Services

     Continuing Care

     End of Life Care

     Improving access to Primary & Secondary Care

     Equality of access according to need

     Sexual Health and GUM Services

     Maternity Matters / Early Years

     Psychological Therapies

     Cancer Services

     Smoking/Exercise/Diet/Alcohol

     Effectiveness of Primary Care Intervention

     Impact of Secondary/Tertiary Interventions

     Self Care

     Moving to Wanless „Fully Engaged‟ scenario (see securing good health for

    whole population) D Wanless Feb 2004

     Supporting people at home in the community

     Reducing unnecessary admissions

     Enabling timely discharge

Both Health and Social Care Commissioners have a key role to play in ensuring

    these priorities are met.

2.4. Local Performance Framework

The new Local Area Agreement (LAA) which is an agreement between Central

    Government, Local Authorities and Key Partners outlines priorities for 2008-2011

    relating to service improvements and the quality of life for customers/citizens of

    Liverpool.

This also includes a set of indicators/measures (National/Local Indicators) that will be

    used to check how the partners have performed against their agreed priorities. The

    Indicators that will be used to measure integrated commissioning priorities are listed

    in Appendix 1.

These will be monitored and reported upon regularly (at least quarterly) and

    published in our annual plans and on our website.

Published draft 30 June 2008 6

3. The Integrated Adult Commissioning Unit (IACU)

The Integrated Adults Commissioning Unit is made up of Senior Managers and

    Commissioners from Liverpool City Council and Liverpool Primary care Trust working

    under the direction of the Director of Integrated Adult Health and Social Care. In

    order to achieve the delivery of gold standard world class commissioning they have

    set themselves the following priorities and objectives for 2008-2011:

    ? Develop and implement commissioning strategies based on joint strategic

    needs assessment of the population, knowledge of the market/market

    management and aims of national guidance and policy

    ? Develop and remodel services based on the priorities identified in

    commissioning strategies ensuring Equity and Equality (redistribution)

    ? Continuously evaluate services to improve outcomes and inform

    decommissioning decisions that ensure capacity for new services

    ? Comply with EU and UK procurement and contracting law, and adhere to LCC

    and NHS/PCT commissioning regulations.

    ? Ensure commissioners have the right skills to undertake the work and identify

    opportunities for joint training and development.

    ? Develop value for money (VFM) outcome based services and create

    opportunities to invest in preventive and community services

    ? Provide information & effective communication to facilitate better

    understanding of self care, disease prevention and how to stay well (Self

    Directed Care)

    ? Commission evidence-based interventions and services that increase life

    expectancy and reduce health inequalities

    ? Develop open / transparent processes designed to maintain good long-term

    relationships with service providers, to enable effective integrated care

    pathways

    ? Commission collaboratively with our partner commissioning agencies where

    appropriate.

    ? Tackle inequalities and target high risk vulnerable groups

    ? Develop Neighbourhood Services as close to home as possible

    ? Develop Partnerships for integrated care, acknowledge dependencies

    between children‟s, adults and other services

    ? Develop Individual Budgets & Self Directed Care

    ? Embed independence with support ethos & culture rather than dependence Published draft 30 June 2008 7

    3.1 The future Health and Well Being Commissioning landscape

    It is important that we articulate what service users and patients tell us what they

    would like to see in the future (through our various communication and

    information gathering forums) in a clear, consistent and timely manner in order

    that our partners can help facilitate the changes that are required to make this a

    future reality. The following figure represents our future commissioning landscape.

    Future Health & Well Being Commissioning

    Landscape

Fig 1 Source: IACU Liverpool City Council (2008)

The above landscape will only be achieved by ensuring we follow the ethos outlined

    in NHS World Class Commissioning (2006) and Putting People First -Personalisation

    & Individual Budgets (2007). The day to day work of the IACU follows a typical

    analyse, plan, do and review model as depicted in fig 2. Published draft 30 June 2008 8

Fig 1 Source: CSIP 2006

3.2 Integrated Adult Commissioning Unit Achievements in 2007/8

As well as setting ourselves stretching targets and objectives for the next 3 years, it

    is important to note the IACU achievements over the last 12 months that built upon

    the excellent joint working arrangements established in 2006/7. These will give an

    idea of the unit‟s baseline position, how far the unit has come and its current direction

    of travel. In 2007/8 the IACU was responsible for:

    ? Development of overarching Memorandum of Agreement between LCC/PCT

    ? Draft of Section 256 agreement/arrangement

    ? Development of Section 75 (Mental Health integration)

    ? Review of Mental Health Day Services and Mental Health Grant

    ? Establishing closer links with MH provider Merseycare with strengthened

    service specifications

    ? Designing and publishing the Integrated Commissioning Framework

    ? Development of Independent Provider Forums & Social Care Champions

    ? Setting up New Chief Executive Group (Third Sector)

Published draft 30 June 2008 9

    ? Established Health & Well Being Beds in community and Assessment staff

    within Accident and Emergency to assist throughput

    ? Reduced delays & Length of Stay in Acute services and waiting lists for

    therapies

? Setting up of Quality Assurance Team & Care Brokerage

    ? Establishment of joint Nursing and Residential Care Home Contracts

? Review and implementation of new Panel process

    ? Implementation of Joint Commissioning of Home Care with PCT

    ? Joint commissioning of Community Services with Supporting People/PCT

    ? Approved joint contract manager post to work across LCC/PCT

    ? Approved joint finance officer post to work across LCC/PCT

    ? Development of client specific commissioning strategies (see over page)

? Establishing the Local Involvement Network

    ? Developing service specification for health and care for people living with

    learning disabilities

    ? Reviewed the needs of 3000 service users residing in a community and care

    setting

    ? Agreeing the section 75 agreement for Integrated Community Equipment

    ? Developing the care pathway for intermediate care including the service

    specifications

    ? Development of Health and Social Care pathways including:

    o Intermediate Care

    o Stroke

    Published draft 30 June 2008 10

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