Leadership Resources for Strategic Transformation
A set of resources aimed at directors, senior managers, elected members, and representatives involved in Regional Partnership Boards. These resources cover various modules focusing on understanding duties and responsibilities under the Social Services and Well-being (Wales) Act, as well as tools for strategic transformation, good practice governance, decision-making, and managing stakeholders. Designed to be used flexibly, each module provides insights into the Act's principles, roles, and responsibilities, along with practical tools and guidance.
Download Presentation
Please find below an Image/Link to download the presentation.
The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author.If you encounter any issues during the download, it is possible that the publisher has removed the file from their server.
You are allowed to download the files provided on this website for personal or commercial use, subject to the condition that they are used lawfully. All files are the property of their respective owners.
The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author.
E N D
Presentation Transcript
Module four Strategic transformation Getting in on the Act
Overview A set of resources that can be used by strategic leaders, managers and Regional Partnership Boards to help them understand their duties and responsibilities under the Social Services and Well-being (Wales) Act and to make best use of that Act in their respective organisations and communities. 3
Aimed at Directors and senior managers in local authorities (including housing, education and social services) Elected members Senior managers for partnership in local health boards Lead board members in local health boards Senior managers in partner organisations and relevant third sector organisations Representatives of people with care and support needs, and carers involved in Regional Partnership Boards 4
They cover Module 1: Introduction to the Social Services and Well-being (Wales) Act 2014 Module 2: Part 9 Co-operation and What s required by the Act Roles and responsibilities Overview of the Act, its principles and intentions How it relates to other legislation Module 3: Making Regional Partnership Boards work Module 4: Strategic transformation Key themes of the transformation agenda Tools for transformation The leadership task Good practice governance Decision making Managing stakeholders Module 5: The Leadership Challenge Overview of the aims and principles of the Act Collaboration and integration agenda Opportunities for wider agencies to support this and the leadership challenge they face 5
Each Module is designed to be used flexibly with boards, partner agencies and their stakeholders Module 1: Introduction to the Social Services and Well-being (Wales) Act 2014 Overview of the Act, its principles & intentions How it relates to other legislation Module 2: Part 9 - Co-operation and What s required by the Act Roles and responsibilities includes PowerPoint slides with facilitator s notes and suggested discussion points includes supplementary materials such as checklists, self-assessments and examples Module 3: Making Regional Partnership Boards Work Good practice governance Decision making Managing Stakeholders Module 4: Strategic Transformation Key themes of the transformation agenda Tools for transformation The Leadership Task Module 5: The Leadership Challenge Overview of the aims and principles of the Act Collaboration and integration agenda Opportunities for wider agencies to support this and the leadership challenge they face
Additional resources Care Council for Wales Information and Learning Hub (http://www.ccwales.org.uk/getting-in-on-the- act-hub/) Social Services Improvement Agency Interactive Guide to Implementation of the Social Services and Well-being (Wales) Act (http://www.ssiacymru.org.uk/home.php?page _id=8914)
Module four Strategic transformation Getting in on the Act
Module objectives Understand the key themes of the social services transformation agenda in Wales, and your own regional and local arrangements Reflect on the challenges associated with transforming health, care and well-being support Explore the potential tools you have for leading transformation Develop an outline statement of strategic intent for your Regional Partnership Board 9
Contents Overview of the transformation challenge facing Regional Partnership Boards Key tools to address local area transformation challenges: Population assessment Integration New provider/service models and co-production Meeting outcomes and managing demand through prevention and early help 10
What is the Boards role in transforming care? Oversight and accountability for transformation across the region Strategic leadership and planning to improve efficiency and efficacy of services Assessment of need and the range of services available to meet that need Consider new service models to meet needs Establish pooled budgets to meet needs where required 11
What are the challenges? Significant changes in family and community structures Better use of technology Increasing financial pressure on public services Changing public expectations Increasing complexity of need Ageing population
Strategic transformation tools Population assessment Demand management Transformation Integration New service models and co-production 13
Strategic transformation tools Population assessment Estimates the nature and extent of a population s needs so that appropriate effort, resources and services can be planned where they are needed most Provides commissioning agencies with a range of information that feeds into and informs the planning stage of the commissioning cycle Looks at whole populations and the needs of vulnerable groups Considers the needs of people who fund their own care and those who don t Considers the legislation, research and best practice basis for services Maps and reviews current services across agencies range, quality, costs
Strategic transformation tools Population assessment Establishes a picture of total resource in the local area to map against priorities Provides a robust overview of the challenges facing local people with care and support needs, be they children, adults, people with disabilities or carers Improves understanding of the level of need in a given area, reviews the types of services which help address that need, and sets in place the strategic drivers for addressing that need
Population assessment Should include 1. National statistics, such as demographic data, risk factors, prevalence and incidence data 2. Local data collected by public bodies such as local authorities, GP practices or hospital performance data 3. Views of patients/service users and carers 4. National research findings
Population assessment Partnership Board s role A local authority, and any local health board whose area lies within that of the authority, must jointly assess the extent to which there are: people or carers in the area who need care and support people whose needs for care and support are not being met by the local authority, local health board or otherwise They must assess the range and level of services required to meet the care and support needs of people within the local authority s areas
Population assessment Focus on prevention How well do services: contribute to preventing, delaying or reducing people s needs for care and support (including carers)? promote the upbringing of children by their families, where that is consistent with the well-being of children? minimise the effect on disabled people of their disabilities? contribute towards preventing people from suffering abuse or neglect? encourage children not to commit criminal offences? avoid the need for children to be placed in secure accommodation? enable people to live their lives as independently as possible?
Population assessment Focus on prevention How well do services reduce the need for: care proceeding or supervision orders under the Children Act 1989? criminal proceedings against children? any family or other proceedings that might lead to children being placed into local authority care? proceedings under the inherent jurisdiction of the High Court in relation to children?
Population assessment Do we know ? Where are the services? Are there differences in activity, cost or outcomes for similar services? Does what we have represent good practice? Current provision What do patients say about services? How accessible are services? How many people use services, for how long, at which times? What is provided by the different sectors? 20
Population assessment Can we find out ? What will local people want in the future? What is the budget available over the next three years? Where do services need to be located in the future? Future provision Who can or will provide what is needed in the future? How vulnerable is the market? How much do providers value our business? 21
Population assessment Discussion Examples of effective joint population analysis and service planning? Based on your current knowledge of your local population: 1. What do you think are the key areas of need? 2. What services are there to meet this need? 3. What might be required to prevent, delay or reduce demand? What arrangements do you need to put in place to ensure you have a robust population assessment by April 2017? How does the work on population analysis need to drive your joint commissioning priorities?
Strategic transformation tools Integration Partnership Boards will need to prioritise integration of services for: older people with complex needs and long-term conditions, including dementia people with learning disabilities carers, including young carers integrated family support services children with complex needs due to disability or illness care homes pooled budgets Population Assessment Demand management Transformation Integration New service models and co- production 23
Integration What does the evidence say? Positive impact of integrated care programmes on the quality of care Improved health outcomes Improved patient/service user satisfaction Uncertainty about the relative effectiveness of different approaches and their impact on costs 24
Integration What does the evidence say? Important to have sufficient time to prepare for integration: to build governance and performance management systems that provide incentives for integration to make and develop the local business case for integration to change attitudes and behaviours to develop the necessary infrastructure, including IT, and establish supportive financial systems and incentives Areas where initiatives have been less successful have evidenced clashes in culture and insufficient preparation and commitment 25
Types of integration Systemic: Co-ordinating and aligning policies, rules and regulatory frameworks Normative: Developing shared values, culture and vision across organisations, professional groups and individuals Organisational: Co-ordinating structures, governance systems and relationships across organisations Administrative: Aligning back-office functions, budgets and financial systems across integrating units Clinical/Professional: Co-ordinating information and services, and integrating patient care within a single process. For example, developing extended clinical roles, guidelines
Integration Pooled funds To be established by Partnership Boards where appropriate. Partnership Arrangement Regulations require pooled funds in relation to: the exercise of care home accommodation functions the exercise of family support functions functions that will be exercised jointly as a result of the population assessment carried out under Section 14 of the Act
Integration Care homes Undertake a population needs assessment and market analysis to include the needs of self-funders Agree an appropriate integrated market position statement and commissioning strategy, specifying the outcomes required of care home and range of services required Agree a common contract and specification Develop an integrated approach to agreeing fees with providers Develop an integrated approach to quality assurance Adopt a transparent approach to the use of resources
Integration Care homes Pooled funds should encompass both local authority placements and NHS funded placements (funded nursing care and continuing NHS healthcare) Short-term interim placements to facilitate transfers of care from hospital and choice of accommodation Intermediate care beds (step up and down) Long-term placements Respite care and any other services partners wish to commission from care homes
Integration Pooled funds It is expected that the same approach will be adopted with long-term domiciliary care and reablement services Partners will retain statutory responsibility for their functions under all pooled fund arrangements and therefore good governance arrangements will be key Comprehensive monitoring arrangements will need to be put in place Staff identified in the agreement will be able to access and make decisions about the use of resources in the pooled fund, in accordance with the process agreed locally with the pooled fund manager
Discussion Type of integration Act priorities 1. What examples do you have of successful integrated services? Older people with complex needs/ long-term conditions, including dementia People with learning disabilities Carers Integrated Family Support Services Children with complex needs due to disability or illness Systemic Normative Organisational Administrative Clinical/Professional Pooled funds and commissioning 2. Consider the areas the Act requires Boards to prioritise 3. What might be your options for further integration, and why?
Strategic transformation tools New provider/service models User-led services Social enterprises Co-operatives Third sector Partnerships Population Assessment The Act places a duty on local authorities to explore different models of service provision Demand manageme nt Transformatio n Integration New service models and co- production 32
New provider/service models Partnership Board role? Sets strategic direction for services transformation in their area Oversees analysis of current and future provision which identifies opportunities for alternative provider/service models Ensures the market sufficiency statement required by the Registration and Inspection of Social Care (Wales) Act 2016 is useful and effective Scrutinises arrangements for truly co-produced services, challenging partners and providers to involve people in the design and delivery of care and support services Identifies opportunities for funding such initiatives
New provider/service models The role of co-production In the past we have seen the development of health, social care and education services on the basis of professional rather citizen need Led to the undermining of individuals control and their perspective Need an approach based on partnerships, and equal relationships between practitioners and those who need care and support, including carers The starting assumption is that the state should only provide services when it is clear that without them, an individual cannot function effectively now or in the future Co-production supports people to achieve what matters, empowers communities and puts services on a sustainable footing 34
Discussion What examples do you already have of effective new service models? What examples do you already have of successful co-production? Where might you need to focus your efforts in the future?
Populati on Assess ment Demand manage ment Integrat ion Transfor mation New service models and co- producti on Managing demand through prevention More well-being support Increased level of early intervention/prevention services Intensive Preventative Better access to information, advice and community resources Less need for intensive managed support 36
A range and level of preventative services To help prevent, delay or reduce needs for care and support To promote the upbringing of children by their family To minimise the effect of people s disabilities To help prevent abuse or neglect To enable people to live as independently as possible To reduce the need for: care or supervision orders; criminal proceeding against children; taking children into local authority care or secure accommodation 37
Demand management vs greater efficiency? By changing the nature of the council s role and relationship with customers, local authorities are seeking alternative mechanisms to meet customer needs and thereby better manage demand. Changing behaviours of frontline practitioners, managers and customers often features as a critical enabler of demand management. LGA (2013) Managing customer demand Understanding and changing behaviours to help meet the financial challenge
Demand management What s involved? Service design Assessment, and care and support management systems Planning and commissioning
Demand management What s involved? Starting with wellness Now Self-management and community empowerment Public health Self-management and community empowerment Primary care Public health Social care and community health provision Primary care Social care and community health provision Acute provision Acute provision Future Starting with crisis
Demand management Service design Focusing on improving outcomes and promoting greater independence Delivering care in ways that create less dependency on the services Helping people with long-term conditions to self-manage those conditions including dementia care A philosophy to support practice that offers progression for customers with long-term needs
Demand management Planning and commissioning Good quality population assessment, service mapping and gap analysis Jointly developing commissioning strategies which: Support recovery after a medical intervention and developing out-of-hospital care services to support this aim help individuals to better manage long-term conditions with clearer advice and support. This links to physiotherapists and OTs supporting front line care staff give priority to managing conditions which put older people at risk of admission to residential care Service investment and development to draw resources out of acute and substitute care provision, and into more effective community prevention and early help Rewarding providers for delivering outcomes that promote independence
Demand management Approach to assessment The first help anyone should be offered is to see how the problem they have presented can be solved without recourse to formal care For those who do need care and support, this should be based on looking to offer recovery-based services or more specialist services to assist them to live with their condition while maximising their opportunities for independence Assessments for long-term care should normally be carried out at home, except in exceptional circumstances. No assessments for longer term services should be made in a rush before a range of appropriate interventions are considered People who need a longer term care package should still receive this with a focus on working towards outcomes that are likely to help the person become more independent
Demand management Role of the Partnership Board Community leadership Recognise that demand is political and transformative change requires political buy-in. Vital that local politicians lead a new, more collaborative conversation with citizens Building insight Create the methods to get closer to communities and recognise that demand cannot be understood purely through the lens of services currently provided Changing the system Think whole system, whole place and work collaboratively across agencies and sectors
Demand management Role of the Partnership Board Creating shared value Forthcoming EU procurement changes offer an opportunity to manage demand through more targeted and collaborative commissioning, focused on community benefit and value, as well as price Building community resilience Engage the community in co-designing and commissioning services and build coalitions between business, public services and society
Discussion What examples have you already got in the local areas of successful joint demand management through prevention and early intervention? Where might you need to focus attention next?
Establishing the Boards strategic intention? Analysis of need, demand, services, resources, legislation and policy Statement of Joint Strategic Intent Market position statements Commissioning strategies Business plans 47
Statement of Joint Strategic Intent Specifies key strategic change priorities that all partners agree Framework to help test specific plans and priorities against Focused on future service model for all partners Commitment to help hold each other to account
Discussion Prepare a short statement proposing the Board s strategic intention over the next three years in the following areas: Changes in how people experience health, well-being and care services Changes in the balance of resources and quality of services and support in the community, and provided by health and social care Desired impact on outcomes for the population needing care and support What level and types of integration and pooled budgets you aspire to What preferred service models you aspire to What changes in the workforce you need to make 49
Discussion What is the leadership role in driving forward the transformation of services required by the Act? What are the major strategic challenges you face in delivering change? Where are your current strategic opportunities? What should your shared strategic intent be in the next period? What does each strategic partner need to focus on? 50
