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Caring Together in Eastern Cheshire

Year: 2015
Type: article
Abstract: Introduction: Background and ‘Problem Statement’ Eastern Cheshire has the fastest growing ageing population in the North West of England which is increasingly affecting health and social care provision locally. We’re living longer, many people want to be treated in their own homes, and medical advances mean that the way hospital services are provided is evolving. Our need to change is highlighted below: • On average a woman living in Macclesfield Town South is expected to die almost 13 years earlier than a woman living a couple of miles away in Tytherington; • There are some 1,517 people in Eastern Cheshire with serious mental health problems such as schizophrenia; • An estimated 8,238 primary carers live in Cheshire East, with 1 in 3 receiving support from social services with some receiving a carer specific service; • Over 22,000 bed days (at an estimated cost of £5.5m) in Macclesfield District Hospital could be avoided. Local organisations responded to this rising challenge by setting-up the joint Caring Together initiative, a transformation programme designed to streamline, coordinate and innovate health and social care and empower local people to take responsibility for their own health and wellbeing. The Caring Together programme began by working with our partners alongside the citizens of Eastern Cheshire to draw up a vision, and accompanying values and principles. It did this in order to provide a framework for developing proposals for local service changes, using new technologies/innovations and continuous service improvement to positively influence the experience and outcomes of care. The Caring Together vision is underpinned by robust clinical, quality and financial standards, whereby local people will be supported to live well and stay well because they can access joined up care and support when they need it. Policy Context, Objective and Targeted Population: A joint health and social care strategy was agreed by all partner organisations in 2013 that is designed to coordinate services, initially targeted at the 20% of the population who use 70% of health and social care resources . A robust care system was co-designed which led to the development of 19 care components using an evidence-based robust process that will not only ensure accountability across the system but will also offer best practice examples from other geographical areas. 15th International Conference on Integrated Care, Edinburgh, UK, March 25-27, 2015 1 International Journal of Integrated Care – Volume 15, 27 May – URN:NBN:NL:UI:10-1-117094– http://www.ijic.org/ At the heart of the programme is the development of eight ambitions supported by a new Caring Together outcomes framework uniquely focused on a new type of integrated care model. The ambitions and outcomes are being co-designed by local communities, patients, carers and local care professionals. Whilst the outcomes framework draws on existing national measures, the Caring Together programme is committed to new innovative measures that are truly meaningful to our local population. Highlights (Innovation, Impact, Outcomes): As part of this strategy, we have aligned other programmes of work locally to begin transforming the working culture amongst our workforce in order to fully embrace the Caring Together principles. One mechanism to practically start to deliver this cultural transformation is through our introduction of CQUIN-based payments to enable local providers to integrate care whilst achieving our commissioning objectives. This is one of many service-improvement based commissioning initiatives which reflect our commissioning intentions over the next three years, in order to achieve the changes we need for local service provision. Other commissioning intentions include the embracement of innovation through a pan-Cheshire Shared Care Record and the introduction of a Risk Stratification Tool. But it doesn’t stop there. Eastern Cheshire is one of the fourteen UK-wide Pioneer Sites, recognised by the UK Government as an essential enabler to achieving new ways of delivering coordinated care. The Pioneer Sites were selected by a renowned panel, including international experts drawing together global expertise and experience of how good joined up care works in practice. The aim of the Pioneer process aligns perfectly to the Caring Together ambitions of transforming health and social care services in order to provide better support at home and earlier treatment in the community. We are hopeful that working as a Pioneer Site that we will achieve the following outcomes, which all link to our overarching Caring Together aspirations and integration agenda: • Working in partnership across the pioneer partners to commission and implement a new Integrated Digital Shared Record, which will positively shape the way care is delivered and received moving forward; • Establishing a local infrastructure and the investment required for our aspired Caring Together integrated community teams, integrated rapid response services and improved capacity and access to primary care; • Working with Cheshire East Council as the lead partner to ensure the Caring Together “Empowered Individual” ambitions and work programme is developed and implemented across the pioneer footprint; • Complete and implement new public and care professional co-designed commissioning frameworks for standards and outcomes for the new integrated care model; • Complete and implement across Cheshire a new improved model of care for patients with Continuing Healthcare needs. One of the key learnings across the pioneer programme is understanding and evaluating the opportunities and risks of developing integrated care models across a large geographic footprint involving multiple health and social care organisations verses localising and ensuring that integration remains meaningful and connected with local communities. Conclusions and Comments on Transferability: The Caring Together Initiative will dramatically shift care from reactive, acute care to proactive care closer to home with improved patient experience and outcomes. A key lesson learned is that new ways of delivering care have to be created by local clinicians and patients. We believe the success of achieving our Caring Together initiative will be a real turning point in the way health and social care services are delivered – not just locally but on the national stage too. Our success will undoubtedly be used to help other health and social care economies achieve wide-spread integration. We will learn along the way and will share that learning with our health and social care colleagues both regionally and nationally. Our combined journey has begun.
DOI: 10.5334/ijic.2171
Language: English
Open Access status: gold
Estimated APC paid: $1,839
OpenAlex ID: W1593196754
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