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The Workstream Lead at Hartlepool & Stockton on Tees CCG, one of nine sites putting the Integrated Personal Commissioning Emerging Framework into action, shares how the programme is beginning to transform services for older people with complex health needs:
As an area that had been part of the original pilot, commissioners in Teesside were already convinced how effective Personal Health Budgets could be.
They believed in how they could support people to manage long term health conditions, so, for them, committing to the Integrated Personal Commissioning programme was a natural development.
When looking at the needs of people with complex needs, it clearly makes sense to work together across health, social care and the voluntary and community sectors, so IPC offered a real opportunity to commit to making integration real – both at an organisational level, but importantly so that the experience for people was simpler and supported them to take a more active role in managing their health.
Within Stockton-on-Tees, the joint IPC bid was agreed by Hartlepool and Stockton on Tees Clinical Commissioning Group (CCG), North Tees Hospital Foundation Trust (NTHFT), Stockton on Tees Borough Council (SBC) and Catalyst. A key feature of IPC is better partnership across statutory and voluntary services, and we’ve taken that seriously by asking Catalyst to employ our local project lead which ensures voluntary sector colleagues are central to the programme.
Our primary aim is to improve care for people over 65 with multiple long term conditions, with an early focus specifically on those living with respiratory problems such as chronic obstructive pulmonary disease (COPD).
This was a group of people for whom existing services were not working well. There were difficulties accessing pulmonary rehabilitation with increasing numbers of people ending up in A&E or with unplanned hospital stays due to respiratory problems, and this had been identified as a key reason for rising acute care costs. There was also little else on offer, as we didn’t have local support groups for people to access peer support and help to proactively manage their condition.
During this first year of the IPC programme, we have worked hard to define what we want to achieve.
At the heart of IPC is the premise that with the right support, individuals with significant health and care needs are often better placed than statutory bodies to design and integrate their own care. In line with the five key IPC shifts we are introducing a care model which includes personalised care and support planning, independent advocacy, peer support and brokerage with a strong emphasis on co-production.
People will be able to take as much control as they want including a clear offer of integrated personal budgets for those who will benefit.
IPC is well aligned locally with work initiated under the Better Care Fund (BCF) which is targeting the same cohort of over 65s with long term conditions, referrals into the programme coming from multiple sources as well as the BCF funded Multi-Disciplinary Service.
The different conversations that health professionals are having with patients are already having a real impact, with a 50% increase in the number of people who have attended pulmonary rehab’. A peer support group is now established that allows individuals to come together and help each other in finding ways to stay well.
The additional flexibility of a personal health budget has meant people can access community resources such as swimming lessons and other physical activities to help with their managing their condition. People have acknowledged that through the care planning they feel listened to and have control of their care and they have enjoyed the experience.
It’s been really encouraging to see some of the more concrete differences the programme is already making. For example, one of our physiotherapists reported that our new approach to care planning has completely changed the way he carries out assessments. By trying to get a better overall understanding of an individual, their personal situation and the wellbeing outcomes they’ve identified, rather than simply looking at ‘physio outcomes’, he feels able to support people to creatively develop plans that really work for them. He’s now part of a team that’s working together to enable people to stay well, and thinking beyond his role as a physiotherapist.
While the numbers of people we’re actively working with at the moment remains low, the ambition is clear. We are working towards IPC being the mainstream model of care for people with highest health and care needs, planned and delivered in partnership with social care and the voluntary and community sector.
At the moment we are one of only nine areas putting IPC into action, but as other early adopters join us – momentum for change is growing.
- Integrated Personal Commissioning (IPC) is one of the pillars of the Five Year Forward View. It empowers people and communities to take an active role in their health and wellbeing with greater choice and control over the care they need.The IPC Programme will expand in 2016-17 through the early adoption of the model in new areas, representing the first stage of national roll-out. This will enable further testing and refinement and ensure compatibility with the New Care Models Programme, prior to national implementation by 2020-21.
- Areas that are interested in becoming an early IPC adopter can sign up for a webinar next Wednesday 22 June.