Learning from the experiences of Local Authorities and Integration - - PowerPoint PPT Presentation

Learning from the experiences of Local Authorities and Integration

Carole Burgoyne Strategic Director for People Plymouth City Council

The vision for our city

Local Challenges

The Joint Local Plan

Health and Wellbeing Board

• How we established the Health and Wellbeing Board

– T

• not look or feel like a Council Committee

– Membership – Meeting in development session

• Jointly working on the Director of Public

Health’s Thrive Plymouth initiative

• Systems Leadership activity
• Sofa engagement for the Plymouth Plan
• The home for driving transformation in Health and Wellbeing
• Creating a new culture for collective work

Setting the Integration Ambition

• The Health and Wellbeing Board set the level of ambition and timeline for
• ur Integrated Health and Wellbeing Programme
• Through working in development session, we ended with a very high level
• f collective ambition – everything is in
• The Board set the strategic ambition, but stayed out of the operational

detail

• Delivery of the

programme was ahead of the Health and Wellbeing Board timeline

We Created One System

• Livewell Southwest – An integrated health and

social care CIC for the city

• Integrated governance arrangements

– Integrated Commissioning Board

• Four Commissioning Strategies and action

plans – with System Design Groups involving stakeholders, service users and carers

• Co-location in one building; deliberately one

Mixed team

• Integrated System Performance

We Created One Budget

Plymouth Integrated Fund The net total of the Pooled and Aligned Fund £462m Net Pooled Fund “Any pooled fund established and maintained by the Parties as a pooled fund in accordance with the regulations” £241m Net Aligned Fund “Budgets for commissioning prescribed services that the Regulations specify shall not be pooled, but which will be managed alongside the Pooled Fund” £221m

• Section 75 agreement between NEW Devon CCG and

Plymouth City Council

• Integrated funds £638 million gross (£462 million net)
• Risk share and financial framework

Political Consensus

• Work started under Labour control
• Continued under a Labour/Conservative working arrangement
• Continued in year 2 with a Conservative/UKIP working arrangement and

then a Conservative majority.

• Officers and members through H&WB, Cabinet, Shadow Cabinet and

scrutiny achieved complete consensus on integration ambition

• Maturity of political discussions
• Real sense of ‘putting the City first’

Scrutiny

• Pre-scrutiny
• A thorough examination of all of the structures and processes of

integration, both in provision and commissioning

• Special attention to the integrated fund and risk share processes
• ‘Positive Scrutiny’
• Presenters helped by making complicated

issues simple

• Scrutiny made recommendation to Cabinet

to support the proposals

Creating a New T emplate

• GPs and Elected members – a new rulebook
• The importance of Elliot Terrace sessions
• Building trust
• The importance of relationships
• City events – MTV Crashes, Fireworks

Getting to Know You

• Purposeful visits
• A&E
• Glenbourne Acute Psychiatric Unit
• Reaching out beyond formal Council roles to build relationships
• Change in mind and attitude to the NHS

Different Leadership Roles

• Political Leadership
• GP Leadership
• Executive Leadership
• Press – political & GP quotes
• Everyone Bound together by a clear and shared purpose – critical to

success

• The CCG Governing Body

One Building

• Co-location critical
• But not just tenants in a building
• Teams split to drive cross pollination
• No petty conversations about money
• Desks mingled – but IT still not completely shared!
• Joint social events
• The sign, the opening
• Share all resources – each other’s buildings, spaces,

people, expertise

Integration is a Journey- Next Steps

• Despite significant progress challenges remain with

improvements driven through System Improvement Board

• Commitment to System Integration Remains

– Development of Integrated Care Organisation – Integration of Acute and Community – Integration of Primary Care and Community Services – No health without Mental Health – Integrated Children and Young People Services – Integration of Wellbeing Services around Network of Hubs

• Integrated Commissioning Remains Driver for

Integrated Care

Carole Burgoyne

Strategic Director for People

Summary

City Vision Political Culture Relationships Development Structure