Anne Hagan Head of Commissioning Contracts Brighton Hove

Anne Hagan Head of Commissioning & Contracts Brighton & Hove City Council

Council Budget

Adult Social Care Budget ASC Current Gross Budget £ 105. 3 million (Savings delivered: £ 16 m over 5 years) n n Savings target 15/16: £ 7. 14 m ¨ over next 4 years: £ 22 m n 90% of services purchased in the independent sector

Current Spend in the City n Spend on health and social care services: approximately £ 420 m n CCG - just under 50% of budget is spent on acute services (£ 316 million per year) n Adult Social Care - 50% of budget is spent on care homes ( £ 105 m per year)

Changing Demand Ageing population Resource intensive More people with complex needs

Local Care Market People have increasingly complex needs n Costs are rising n Providers exiting the market n New Providers: LA can’t place n Home Care providers: volatility in the market n The Living Wage n

Care Market - A plan n Demand n Capacity n Fees

Influencing the Direction…… n Better Care: Integration with health n The Care Act n Value for Money – Opportunities for smarter commissioning

The Vision n Prevention: Keeping people well n Personalisation n Core Business: Safeguarding/ Helping people maximise their independence n Joined up services - maintain quality

Doing things Differently Build on existing partnerships: Integration with Health n Prevention n Emphasis on reabling care n Coordinated care – less duplication n 24/7

Better Care Umbrella

Priority for Brighton & Hove: Frailty n Frailty- not just about age n Reflects Brighton and Hove demographics& complexity of need – mental health & substance misuse, homeless, more people with multiple health conditions n Test out in one GP Cluster

Brighton and Hove Current Configuration of Services

Brighton and Hove Future Configuration of Services

The vision – A ‘primary care home’

The bigger picture Services working together around the whole person Focus on self management, early intervention and prevention Better population health and well being. Improved happiness.

Why integrate? Better outcomes for individuals • Early interventions with a focus on self management • Seamless, coordinated care – bespoke and personalised Population health improvement • Reductions in health inequalities, multiple morbidities and risk of premature mortality More cost effective • Joined up systems increase efficiency • Wise stewardship of resources to ensure high value care

The vision – What matters to you? Proactive and preventative – focus on wellbeing, staying healthy and encouraging self management Responsive, coordinated and integrated care – available whenever the person needs it Person centred – care and support designed around the individual Shift of focus from ‘What’s the matter? ’ to ‘What matters to you? ’

What does it mean for people using services? I am in control and self managing, where possible I know my early warning signs and am confident that I will receive the care I need in a timely fashion People act on what matters to me I have 1 point of access, 1 assessment and 1 care plan. I do not tell my story twice. I have had a whole person holistic needs assessment which focuses on my health and wellbeing

What does it mean for adult social care? Meeting needs of population at cluster level Far greater triangulation and ability to ensure safe support of clients Meaningful integration with community teams Greater harm reduction with a more cohesive and flexible team Access to key information to help guide service delivery

Support for providers n Involved in MDTs n Involvement in decision making n 7 day working n Level of need: support required

Improving health and wellbeing: the new architecture………. Sometimes it feels like. . . .

Health and Wellbeing Boards Nice, see you in three months n Key leaders work together to improve H&WB n The public should experience more joinedup services n The Board will encourage commissioners to work in a more joined up way

Partnerships: Why Bother? Better outcomes for people n Better use of resources n n n We are in this together - transparency Work with providers/ community & voluntary sector Build relationships, agreed ways of working Challenge current processes Engagement with wider partners/ co-production