Supporting Voluntary Action Bromley Third Sector Enterprise How

Supporting Voluntary Action Bromley Third Sector Enterprise: How Collaboration led to Successful Bidding Colin Maclean, Chief Executive (and former Chair of BTSE) 16 October 2018

Key Presentation Themes Foundations, context and strategic direction (2014 -16) Integrated Care Networks: the role for BTSE (2016 -17) New Commissioning leading to ‘Bromley Well’ (2016 -18) Learning through Experience

What were the Foundations? VCSE Conference as part of CLB’s 50 th Birthday with Council/CCG CEOs Full ‘Asset Mapping’ (State of Sector) research commissioned by CCG/Council Conference agrees to new VCSE Strategy; now completed

Direction of Travel JUN 2014 OHSEL Draft Strategy Published OCT 2014 Five Year Forward View Published JAN 2015 Bromley System commissions i. MPOWER to detail the local task and solution SEP 2015 Bromley CCG publish Out of Hospital Strategy for Integrated Care Networks APR 2016 Bromley System sign Memorandum of Understanding (MOU) on back of co-designed Proactive Care Pathway OCT 2016 First Proactive Care MDT Meeting held FEB System Leadership Programme 2017 ICNs fully operational with all capacity delivered AUG 2017 Alliance Contract for Virtual MCPs

Out of Hospital Strategy Priorities Reductions in emergency admissions (acute and mental health) Reduction in DTo. Cs (relating to the participating providers) Reduction in A&E attendances Delivery of planned reduction in emergency readmissions

Integrated Care Networks Core ICN Providers • GP Alliance • Bromley Healthcare • King’s/Hospitals • Oxleas NHS Trust • BTSE • St Christopher’s Hospice

Bromley Third Sector Enterprise New venture for the sector led by Council’s ‘strategic partners’ Driven by CCG to ensure sector is a partner in the new Integrated Care Network initiative Open to other VCOs involved in health and wellbeing to join as Associate Members

BTSE Model Associate Members Bromley & Croydon Women’s Aid St. Christopher’s Refugee & Migrant Network Bromley Healthcare Charity Bromley Y Magpie Dance Kent Association for Blind Welcare mcch Autism Core Members CLB Age UK B&G Bromley Mencap Bromley & Lewisham Mind CAB Advocacy for All Deaf Plus Bromley X by X Advocacy First Living Well Bromley Headway SE London/Kent Life Education Centres Bromley Community Counselling Association Links to local VCOs through Social Prescribing

Proactive Care & Frailty Pathway Pilot The Pathway is a way of supporting people with long-term conditions or complex health and social care needs Transform the way that the Frail Elderly are supported 1 year pilot/£ 1 m additional funding Additional Performance Fund -£ 35, 000 investment in BTSE development

Proactive Care & Frailty Pathway 1 2 3 4 5 6 PROACTIVE CARE PATHWAY 1. Patient Identified for Proactive Care Pathway - referral managed by MDT liaison Core MDT members 2 & 3. Initial holistic assessment and creation of care plan by community matron and Care Navigator (when required) GP Chair 4. Care plan assessed and ratified by MDT 4 hours duration (70% of patients will require discussion at a 2 nd MDT) Community Matron 5. Appropriate clinician identified as clinical lead for patient. Care Navigator established as point of contact for patient 6. Implementation of care plan - overseen by clinical lead and coordinated by the care navigator with support from MDT liaison. This may include signposting to social prescribing Interface geriatrician Mental Health Professional ACCESS TO SOCIAL PRESCRIBING AND SELF MANAGEMENT via an IT portal managed by third sector Care Navigator MDT Liaison Other professionals as required various

BTSE Initiatives 1. Care Navigators Delivered by Age UK B&G (£ 172, 000). Manager and 3. 5 posts. Key responsibilities include: • Member of the MDT and named point of contact for individual patients • Contribute to care and support plan • Work alongside the individual to explore goals that they have identified as most important for them • Facilitate access to the social prescribing portal

2. Social Prescribing Delivered by CLB (£ 43, 000) New Connect Well Bromley portal commissioned through VC Connect/launched July 2017 SP Administrator coordinates Portal has 62 organisations running 216 activities. CNs have made 267 referrals

New Commissioning Stages May 2016: Council align strategic contracts September: Council Executive agree to commission all 6 services through one partnering vehicle November: Tender issued for new ‘Primary and Secondary Intervention Service’ January 2017: Council selects BTSE as preferred provider July: Council awards contract to BTSE

New service co-commissioned by Council/CCG Contract for £ 2. 1 m p. a. /up to 5 years awarded in July 2017. Includes Innovation Fund of 15% Bromley Third Sector Enterprise CIC was officially set up in October 2017 Service launched on 2 October 2017

A Single Point of Access to the services (via 0300 3309 039 or spa@bromleywell. org. uk): Older People Adults with Long Term Health Conditions Adults with Learning Difficulties Adults with Physical Disabilities Adults needing support with their Mental Wellbeing Carers Support Young Carers Support Employment and Education Support to the Sector Universal form filling service Bromley Well also provides impartial information, advice and guidance on other social determinants of health such as housing, debt, benefits etc. which are crucial to a person’s wellbeing.

Achievements Developing and setting up a Single Point of Access (SPA) BTSE Core Members and sub-contracted partners working effectively and efficiently together and sharing best practice High numbers of Bromley residents contacting the SPA with c 1, 200 contacts being made each month By end-March 2018, the Bromley Well service was actively supporting over 4, 000 Bromley residents

Tensions and (non-medical) Trauma! Health professionals have inbuilt barriers to partnership working: • Think they are already doing it • Not receptive to new ways of working/challenge • Resistant to ‘nonmedical’ models BTSE CEOs have to balance their partnership input with feedback/ communications expectations from peers, whilst still doing day job Disparity between managerial styles e. g. JDs expanded x 3 when shared with CCG

Importance of Relationships CCG CEO unequivocal in support of sector Council Director/Commissioning Team – absolute supporters! Strong connections at all levels from Health & Wellbeing Board to local communities. Asset Mapping funded because alignment with Market Position Statement needs and CLB role/expertise

Supporting Voluntary Action Questions? colinm@communitylinksbromley. org. uk 020 8315 1903