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The newly appointed Director of Integration leading on the personalisation agenda across Gloucestershire explains how local organisations are working more closely together than ever before in the national Integrated Personal Commissioning programme.
Gloucestershire is excited about strengthening its commitment to personalised care as part of the national Integrated Personal Commissioning (IPC) programme.
Building on the work happening throughout the South West region, we have been ensuring our commissioning arrangements focus on the outcomes that are important to individuals needing our support.
This means working across the clinical commissioning group (CCG), the county council, and with our local providers and voluntary sector partners. The IPC programme is helping to break down some of the barriers that prevent this joint working, such as differences in legislation, staff availability, different contractual arrangements and how governance of individual funding is managed across organisations.
Currently, Gloucestershire is integrating the commissioning and brokerage arrangements across community healthcare so that Gloucestershire County Council and the CCG are working more closely than ever before. We hope this will enable us to align our operational processes to make personalisation and joint working business as usual – offering a responsive and customised joint care plan for individuals who are supported by both health and social care.
This is already working well for people with learning disabilities who receive joint funding – where the service user is offered a joint assessment, care planning and review. The individual and their family are an integral part of the planning process, fulfilling all the ambitions of personalisation.
IPC is also influencing Continuing Healthcare (CHC) funding in Gloucestershire – where a personal health budget is now the default offer as new patients are identified. We are working with all existing CHC patients to ensure that everyone receiving care in their own home has a direct payment, a notional budget or third party managed budget according to their preference.
Over the past four months, Gloucestershire has also been working intensively with the local wheelchair service to facilitate cultural change and ensure the offer to wheelchair users reflects their needs and wishes. This is part of a national test programme, and training has been carried out with the wheelchair service on personalised care planning and health outcomes to provide an increasingly interactive experience for those using the service.
Through the wheelchair work it has become apparent that we have various services, such as postural management, specialist seating, and community low use wheelchair provision, where we are duplicating and confusing service users, and by reviewing these pathways we can streamline and personalise our offer. The aim for all these services will be to offer a wider care plan, encompassing all their needs and personal outcomes.
One of our main challenges as we consider the future for IPC in Gloucestershire is how to scale up IPC to be offered beyond the cohorts where pre-identified funding is in place. However, by focussing on the offer of personalisation, and trying to address an individual’s needs across any health or social care setting, we hope to find solutions to these issues.
As we become a full demonstrator site, we are now working to embed IPC as the default model of care, so that eventually anyone in Gloucestershire with a long term or complex condition is able to create a personalised care plan with their care and support team and have access to a range of support services that work for them.
We want to join up our offer especially around community connectors and social prescribing, and how we can enable people to self-manage their own condition and circumstances, recognising that the individual is the expert in their own care.