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Integrated Resource Framework Report by Head

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Integrated Resource Framework Report by Head West Lothian Community Health and Care Partnership INTEGRATED RESOURCE FRAMEWORK Meeting of 12 January 2010 REPORT BY HEAD OF HEALTH SERVICES AND HEAD OF COUNCIL SERVICES Agenda Item 9 SUMMARY The purpose of this report is to further update the Board on actions taken and progress towards the establishment of a test site across Lothian, for the Scottish Government’s Integrated Resource Framework (IRF). RECOMMENDATION Board is asked to note progress and content of the attached Project Initiation Document (PID) (third draft). BACKGROUND Demographic pressures (particularly the projected rise in the number of older people), workforce issues, the need to continually improve health and social care outcomes; and the increasing cost of institutional care means that current patterns of care delivery are not sustainable. Shifting the balance of care is therefore a strategic objective for the Scottish Government, NHS and Local Authorities. The Better Health, Better Care: Action Plan (December 2007) commits the Scottish Government (SG) to develop a Integrated Resource Framework (IRF) that will… “…support strategic joint commissioning and collaborative contracts to deliver local shifts in the balance of care. The approach may include the development of collaborative contracts, programme budgets and transitional funding as enablers of change”. In essence the IRF is recognised as a way to assist Community Health Partnerships (CHPs) and councils to shift the balance of care (and improve access, manage demand, reduce unnecessary referrals to specialist services and provide better community care services) through having, “a broader range of delegated resources and greater flexibility of decision making.” As outlined in a previous paper to Board (13th October 2009) IRF is being jointly developed by the Scottish Government, NHS Scotland and COSLA, through the National Shifting the Balance of Care Delivery Group. NHS Lothian, East Lothian, Midlothian, West Lothian and the City of Edinburgh Councils were successfully accepted as 1 of four Phase 2 Pilots. Finance has been made available nationally to support the Pilots and by the end of 2010/11, decisions are expected to be made locally which demonstrate the movement of resources. The four phase 2 pilots (Test site areas) - (4 Health Boards and 12 Councils) are as follows: x Highland test site: NHS Highland with Argyll & Bute Council and NHS Highland and Highland Council; x Tayside test site: NHS Tayside with Angus Council, Dundee City Council and Perth and Kinross Council; x Ayrshire test site: NHS Ayrshire and Arran with East Ayrshire Council, North Ayrshire Council and South Ayrshire Council; x Lothian test site: NHS Lothian with City of Edinburgh Council, East Lothian Council, Midlothian Council and West Lothian Council. Currently services provided within the four CHCP/CHP/Council areas by each of health & local authorities are funded on a historical basis, year on year. Information in relation to current levels of service provision vary by CHP, provider & service type. Quality of information available to describe current service provision & costs by health & local authority providers is variable and to date has been incomplete. Attempts to re-direct services within localities to meet areas of identified unmet need have been limited. Any service developments have been reliant on funding via the annual prioritisation process or the release of spare capacity elsewhere within services across the NHS and councils. Referral patterns to secondary/tertiary care vary by GP practice and locality. The Programme Brief Through the IRF Project Board, NHS Lothian and its four Local Authority partners (by delivering the capabilities of programme) will develop a transparent Integrated Resource Framework which will provide the information required to strategically plan and review services more effectively. This will provide information about the cost and service implications of proposed resource realignments to support shifts in clinical/care activity within and across health and social care systems. When combined with other collaborative and strategic programmes of change across the partnerships in Lothian, the IRF can facilitate improvement in health and social care services and the healthcare and wellbeing of our local populations. IRF will provide a mechanism for Demand management by making explicit the link between Clinical decisions and their financial consequence which will allow 2 scrutiny at Practice and Locality level of the resources committed by Clinical decisions in Primary care. It will also provide a mechanism for collaboration between CHCP/CHPs and hospitals to determine and agree required activity for respective population areas (a capacity plan). The Framework will be based on the principles that it will be outcomes focused, patient centred, evidence based, integrated and sustainable. The aim will be to improve the outcomes for the targeted population segments and effect a change in profile of resource. Desirable outcome measures will focus on: x Reduction of waste and variation x Shift the balance of care between care types and settings x Service user satisfaction x Alignment of resources with care pathways within a jointly agreed governance and financial framework x Improved equity of allocation of resources x Identification of service improvement opportunities x Targeting of resources to where they can add most value Central to the success of the above is the need to ensure that any implementation is underpinned by organisational development support which will take cognisance of a range of development principles: x Shared vision and values x Leadership x Communication x Customer focus x Culture and behavioural change x Partnership and team working x Training skills and development x Introducing new ways of working through technology and systems. To this end funding will be provided from Scottish Government. In summary, by integrating resource in CHCP/CHPs a closer link will be established between local communities and the care services provided for them from within limited resources. CHCP/CHPs will then be better placed to actively shape local services to meet the respective long-term priorities and improved outcomes of their communities from within this Integrated Resource envelope. West Lothian CHCP is ideally placed to become the driving force for change and determining and resourcing services for its population, whether this be in a primary, community or an acute setting. 3 PREVIOUS CONSIDERATION BY THE BOARD Initial briefing paper to Board - 13th October 2009 It is proposed to advise the Board of ongoing progress relating to IRF on a regular basis. IMPLICATIONS Equality/Health N/A Financial/Resource The Scottish Government is providing Pilot/Test sites with financial support in the region of £200k each in 2009- 10, and a similar amount in 2010-11. This will be used primarily to support organisational development activities and effective project management as well as freeing up local staff/professional time to implement mechanisms that will facilitate resource realignment. Legal None REFERENCES None APPENDICES None CONTACT/DATE OF REPORT Ian Quigley, Head of Council Services 01506 281908 [email protected] Marion Christie, Head of Health Services 01506 281011 [email protected] 14 December 2009 4.
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