To consider follow-up information in relation to the following:

·  Shared Services & Integration (Verbal Update)

·  Childrens Centres (Verbal Update)

Further to the Budget Options considered in November, The Committee received a verbal update from the Director of Adult Social Services and the Head of Target Support following a request by Member for further information in relation to Shared Services and Integration and Children’s Centres

Mr Graham Hodkinson, Director of Adult Social Services gave a short update on arrangements being put in place, and progress being made to deliver greater integration of health and social care services.

He reported that a Strategic Commissioning Group, reporting to the Health and Wellbeing Board, had been put in place by the Local Authority and Clinical Commissioning Group to ensure that key commissioning decisions support better use of resources and more effective outcomes for the people of Wirral.

He highlighted that Vision 2018 brought together commissioners and providers across the health and social care economy under the governance of the Health and Wellbeing Board to understand the implications of the financial challenge across the system and drive change around a set of defined work-streams, highlighting funding reform proposals which were an important lever in transforming change the Integration Transformation Fund.

The Resource

• For 14/15 made up of existing £900m s.256 transfer + additional £200m
• 2 year allocations, but
• For 2015 £3.8bn to ensure closer integration - £1bn linked to outcomes/performance measured.

·  Includes Clinical Commissioning Group carers breaks

·  Clinical Commissioning Group Re-ablement funding

·  Capital including DFG’s

·  Existing transfer as set out for 14/15

Performance element 50% paid at the beginning of 2015 contingent on H&WBB adopting a joint plan by April 2014

·  Arrangements for intermediate care and re-ablement

Part of 2014 plan includes £2.1M re-ablement grant transferred into the joint fund to make a total joint spend of £5.44M

·  35 IC beds

·  35 transitional beds

·  Re-ablement

·  Domiciliary Care

·  Efficiencies from current spend DASS 400k CCG 200k.

Operational Overview

Ms Chris Beyga, Head of Delivery gave an overview of operational developments indicating that Wirral were currently in a strong position regarding integration and strategic work lead by Graham Hodkinson and Clare Fish had been established and was progressing well.

Operationally several integrated teams were already in place so Wirral was starting from a positive position; work was underway to build upon work undertaken in last two years and develop plans for the Integration Transformation Fund (ITF) with CCG colleagues.

Update on operational integration

The implementation of the Integrated Care Co-ordination Teams was currently being rolled out across Wirral. There was a potential impact on the number of workers, and the terms and conditions of staff across Health and Social Care organisations, but this would depend on the extent to which those organisations need to change as we bring together working practices and standards. There were regular meetings with the union and staff side representatives and full time officers through the Workforce domain of the Programme Board, and the DASS Business link in HR was a part of this domain’s work.

Integrated Teams roll out - The delivery would begin where there was joint working already in evidence, building on this, working towards 8 community based integrated teams called ‘Integrated Care Co-ordination Teams’ (ICCT), one community gateway and one hospital gateway into the community (Integrated Discharge Team) covering all of the Wirral. Whilst DASS were starting where co-location is evident, it was acknowledged that these teams would be a mix of virtual and co-located dependent on the estates availability at the time. The phased roll out of these teams started in October 2013 as follows;

October 2013– bases agreed, teams identified

1.  Hospital Gateway - Building on the existing development of the pull project to develop a Hospital Gateway to the Community based at Arrowe Park Hospital covering the whole of the Wirral.

2. Wallasey East based at Victoria Central Hospital covering the area and GP surgeries in Liscard, New Brighton and Seacombe.
3. Wirral South East based at Eastham Clinic covering the area and GP surgeries in New Ferry, Bromborough and Eastham.

December 2013 – bases proposed, not agreed yet.

4.  Community Gateway - Developing a Community Gateway as a single place for referrals from the community to be managed – base to be decided, covering the whole of the Wirral.

5. Birkenhead South based at St. Cath’s Hospital covering the area and GP surgeries in Rock Ferry, Birkenhead and Tranmere and Prenton.
6. Birkenhead North based at Miriam Medical Centre covering the area and GP surgeries in Bidston and St James, Claughton and Oxton.
7. Wirral Central based at either the Warrens or Arrowe Park Hospital covering the area and GP surgeries in Pensby and Thingwall, Upton, Greasby, Frankby and Irby.

January – April 2014- bases not identified yet

8.  Wirral West covering the area and GP surgeries in Hoylake and Meols, West Kirby and Thurstaston.

9. Wirral South West covering the area and GP surgeries in Heswall, Clatterbridge and Bebington.
10. Wallasey West covering the area and GP surgeries in Moreton, Leasowe, Wallasey, Saughall Massie and Moreton.

Composition - Initially these teams will work to the revised protocols and utilise the newly developed referral, screening and assessment methodology. Members of the ICCT’s will include Social Work staff, District and Community Nurses, and Therapists from the Council and Community Trust. A Care Co-ordinator model will be adopted so there is one professional responsible for co-ordinating the support to the individual. This multi-disciplinary group is responsible for the assessment, support and care plan for all the cases considered. These teams will have access to a broad range of professionals who can support people to remain at home, such as links to CPN’s, staff working in the Admissions Prevention initiatives, GPs, Domiciliary Care Providers, Voluntary, Community and Faith providers of support, Housing, Community Safety, Day Centres, Speech and Language, Alcohol and Drugs agencies, and Psychiatric Liaison to name but a few. The size and make up of each of the eight Community teams will depend on the needs of the populace, infrastructure, estates and the resource re-alignment work to support this is being completed.

Structural change will only take place if it supports an improved customer journey, but based on integration models in other parts of the country and the potential for improvement, structural changes are likely if the increased demands of a growing populace of adults are to be met within the shrinking resources available.

Children’s Centres

Ms Deborah Gornik, Head of Targeted Services gave an overview of the Option regarding the Children’s Centres, indicating that some of the Borough’s primary schools had expressed an interest in the 2-4 years offer, and that a tender process and invitations of expressions of interests were currently on going.

Ms Gornik reiterated that the Children’s Centres would still be utilised but used in a different way to meet the demand. She indicated that the statutory guidelines had been relaxed therefore services could be targeted for Children and Families based on their needs.

In relation to shaping the preventative services, Ms Gornik indicated that schools had shown a keen interest in working with the department on this.

In response to Members, it was reported that needs would be measured using various data for e.g. receipts of free school meals, those registered with special educational needs and those families in receipt of benefits.

In relation to the day care provision, Ms Gornik indicated that focus would be on the full day care offer, the department would be working together with private providers who were currently providing this service with the priority to secure the same service parents had historically been used to; there was also the need to sustain and strengthen the relationship between the third sector providers that currently worked within the children’s centres.

RESOLVED:

That the Director of Adult Social Services and the Head of Targeted Services be thanked for their updates.