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NHS England and local councils announce radical power shift as first 10,000 high-need services users gain control of their own integrated health and social care budgets

NHS England and the Local Government Association yesterday named the first eight sites that will, for the first time, blend comprehensive health and social care funding for individuals and allow them to take control of how it is used.

The first wave of the Integrated Personal Commissioning (IPC) programme will go live on 1 April 2015, providing some 10,000 people with complex needs with greater power to decide how their own combined health and social care budget is spent. The start of the programme is a key first stage in the delivery of the NHS Five Year Forward View that was set out in October 2014.

Four groups of high need individuals – older people with long term conditions, children with disabilities and their families, people with learning disabilities, and people living with serious mental illness – will be able to take control of their budget to deliver an agreed care plan. As part of the programme, local voluntary organisations will help patients with personal care planning and advocacy.

The creation of an IPC programme was announced by NHS England chief executive Simon Stevens at the LGA Conference last summer, and the initiative is jointly led by NHS England and the Local Government Association, working alongside other partners including Association of Directors of Adult Social Services (ADASS) and Think Local Act Personal (TLAP).

Last summer local partnerships made up of NHS bodies, councils and voluntary organisations were invited to submit innovative plans to transform the care of some of England’s most vulnerable people. After a rigorous shortlisting and interview process, eight demonstrator sites have now been selected for the first wave, which will be subject to careful independent evaluation.

Simon Stevens, Chief Executive of NHS England, said: “Our aim in this radical initiative is to end fragmented like-it-or-lump-it health and social care, by giving high-need individuals the power for the first time to decide on the blend of support they themselves want. Integrated Personal Commissioning gives families the chance to make a reality of person-level health and social care integration, as the NHS moves beyond just asking “what’s the matter with you?” to “what matters to you?”.

Cllr Izzi Seccombe, Chairman of the Local Government Association’s Community Wellbeing Board, said: “Councils have made great strides in introducing personal budgets for people, who through personalised care and support are able to live independently.

“People are best placed to decide what support they need to enable them to live full and independent lives. Through our work with the integrated personal care programme, councils will be able to join up health and social care budgets, offer support to help people navigate the system and have their voice heard and give the best information and advice.

“As co-sponsor of the programme, the LGA will now be working with the demonstrator areas to see how this works in practice and share any valuable lessons with all health and care commissioners.”

Sam Bennett, Director of Think Local Act Personal Director said yesterday: “We welcome today’s announcement of the eight integrated personal commissioning sites. TLAP will be supporting the programme by ensuring that with integration, comes personalisation, so that people living in these areas can expect the same focus on their independence, the same regard for their dignity and wishes and the same opportunities to make choices and take control, whether they have a long-term health condition or a social care need, a mental health problem or a learning disability.”

The successful sites are now working on refining their project plans ahead of the launch in April. Further demonstrator sites will be identified later this year.

Successful demonstrator sites include:

  • Barnsley: partners will be working together to develop the IPC model to support people with complex diabetes. This new approach will help people who have lots of contact with services, especially acute services, to take more control of their own health and wellbeing.
  • Cheshire West and Cheshire: the focus will be on people with learning disabilities, including those who have mental health problems or autism. The programme will focus on people who have high support needs, are in institutional settings or at risk of being placed in these settings, and/or are children and young people aged 14 and with complex/learning disability needs. Working together, the local NHS, council, voluntary sector and families will ensure more people with learning disabilities in Cheshire can be supported to live more independently in the community.
  • Luton: through the development of the IPC model, people with dementia will be offered more choices about their care with the goal of being able to stay independent for longer. Local leaders estimate enhanced personalised care plans will be in place for 60 per cent of dementia sufferers, with local support and treatment services better aligned to the needs of individuals and their carers.
  • Stockton on Tees: organisations will work with older people with long-term conditions. Their aim is to develop a model for the management of long-term conditions for the older people. Effective promotion of self-management will be at the heart of their new care model.
  • Tower Hamlets: partners aim to expand the offer of personal health budgets to include: people with long-term conditions, particularly adults and children with more complex health needs including significant mental health problems; and people eligible for jointly funded continuing healthcare, for whom providing a seamless service aligned with the local authority is important.
  • Hampshire: partners will work with children and young people in transition (14-25 years old) with complex needs such as learning disability, mental health problems and physical conditions, as well as adults with a learning disability, including those in, or at risk of entering, an institutional setting.
  • Portsmouth: this area will be supporting older people with multiple long-term conditions who are most at risk of avoidable hospital admissions. Pooled health and social care budgets and the increased use of personal health budgets will enable Portsmouth to continue to breakdown organisational barriers between health and social care and provide more joined up personalised care for older people.
  • South West Consortium: partners in this large consortium will be working to improve care for people with a range of multiple long-term conditions; including mental health issues; learning disabilities and children with complex needs.  The focus will be on embedding the culture change needed to deliver personalised care using personalised care plans, and an emphasis on crisis prevention.

 

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