Delivering true integration and transformation

The Managing Director for Nottinghamshire Health and Care Integrated Care System looks at the common ground for partnership across health and social care:

It’s exciting times in Nottingham and Nottinghamshire as we build on the history of collaboration and innovation seen in the county over the last few years.

As one of the 14 Health and Care Integrated Care Systems (ICS) in the country, we have been given the opportunity and freedom to transform the way our health and care is delivered through the greater integration of our services. And one of the areas that we are seeing real transformation is in personalised care.

Personalised care gives people more choice and control over the way their care is planned and delivered, and results in better health and wellbeing outcomes for them plus more effective and joined-up services.

Our work is already demonstrating the benefits of this when health and social care is integrated in a very real and tangible way. And Integrated Personal Commissioning (IPC) is a key platform for delivery, which has allowed us to join-up personal budgets across health and social care whilst working alongside people and our local voluntary and community sector.

This has resulted in us being able to provide services that focus on what people want in order to stay healthy and maintain their independence.

People we are working with are now more empowered than ever to set their own health and social care outcomes; create their own plans to meet those outcomes; and to identify the support they need regardless of sector or organisational boundaries. And it can often be very simple changes which have resulted in a major change in their life.

The results speak for themselves as people have really responded positively to this new way of working – we have gone from 85 having Personal Health Budgets 18 months ago to now having more than 2,000 – with more that 25% being joint health and social care budgets. That’s some achievement and it is only the beginning.

So, how do people experience this new way of working and how can it help transform a person’s life?

I was recently struck by the experience of one of our local residents Eric, who is 73 years old and has Multiple Sclerosis. He was reliant on carers to support him with his daily health and social care needs and had spent over three years in residential care following a hospital admission. But Eric desperately wanted to return home. He spoke to his social worker and she looked at how social services and health care could work together to explore the options available to him.

After consulting across his multi-disciplinary team, which included social care, Occupational Therapy, the Clinical Lead from the residential unit and a Nurse Assessor from Continuing Healthcare, it was established that for Eric to live at home it would be best for him to have his own team of PAs to support him at home. Eric was very happy with this option and was involved in the process from the beginning and played an active role in recruiting his PAs. The PAs shadowed staff in the residential home and got to know Eric before he moved home. Now Eric is happier and healthier and living back at home with his support team in place.

But personalised care doesn’t just benefit patients. I’ve seen how this approach supports local authorities and the NHS deliver increased resilience and make the best use of resources by helping patients stay well for longer.

Our integrated primary care teams are a good example of this, where they have managed to lower social care costs between £3,000 and £4,000 per patient and reduce hospital admissions, whilst also delivering better health and wellbeing outcomes for older people by keeping them at home and out of hospital.

And finally, our personalised approach can also be seen in some of our key partnerships, with a recent example being where NHS services and Age UK joined forces to launch the Living Well service.

Living Well aims to support individuals who are at risk of unplanned hospital admission and are in frequent contact with their GP Surgery. They mostly have a long term condition and, or, experienced a recent change in circumstances or reduced social contact. Living Well works with these people to identify their personal goals and objectives by promoting self-management techniques. It connects with other community support services with the aim to helping them to avoid unnecessary emergency admissions.

A key future priority for us will be to help prevent ill-health and promote good health.

If this is going to happen, then we must rebalance the relationship between people and public services, and using a personalised care approach will be a key way to make this happen.

Wendy Saviour

Wendy Saviour is Managing Director for Nottinghamshire Health and Care Integrated Care System.

Before this Wendy was the Area Director for Birmingham, Solihull and the Black Country Area Team and between 2010 and 2012 was the Director of Commissioning Development for the NHS East Midlands, where she was responsible for ensuring the development and implementation of new commissioning arrangements across the East Midlands.

Wendy continues to deliver the NHSE regulatory function for the commissioning system in Nottinghamshire as part of her role as Managing Director.

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