Reshape Reshaping Care for Older people in Glasgow
Welcome Welcome to Reshape, the first in a new series of e-briefings, on Reshaping Care for Older People (RCOP). GCVS, its partners and members have been working hard to help inform and shape the changes being made to older people’s health and social care services in Glasgow, responding to the Scottish Government’s RCOP agenda. The Third Sector has been leading the way in engaging with older people, commissioning new approaches and robustly evaluating these to develop an evidence base which illustrates the return on investment that new thinking and new ways of working can achieve for older people and the public purse. We’ve been busy, but we have grasped this opportunity to develop a coherent, holistic and positive response to the big changes we face as a sector and a society – it’s too important not to.
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In this issue
RCOP: What has GCVS and the Third Sector been doing? Joint Strategic Commissioning: What do older people & the Third Sector want? Evidence for change: Recognising the value of the Third Sector Transformation Fund: Progress and learning Health and Social Care Integration: The state of play
RCOP - What has GCVS and the Third Sector been Doing? A lot! We’ve been working hard to make sure the voices of older people, carers and third sector providers are heard by: 1. Representing the Third Sector at the RCOP Strategy Group and other meetings, including workforce planning and development and Health and Social Care Integration discussions. 2. Ensuring the consultation on the Draft Joint Strategic Commissioning Plan was as comprehensive, inclusive and accessible as possible and the Plan reflects the opinions expressed. 3. Managing the Transformation Fund as part of the Change Fund. Progress and initial learning on this is reported in the Year One Evaluation report. 4. Promoting new and innovative ways of working, a key principle of Reshaping Care, via the Transformation Fund and by developing a Community Connectors model.
Reshape aims to share progress with you, what we plan to do next and encourage you to get involved in our work. If you have any questions or comments, please don’t hesitate to get in touch on 0141 332 2444.
5. Commissioning the Yunus Centre for Social Business and Health to gather evidence of what models, services and approaches are effective and illustrate the return on investment delivered by the Third Sector. This will help inform how the increased spend on prevention can be used to make a positive impact on the health and wellbeing of older people and reduce the strain on public services.
Best regards, Helen Macneil
The progress and achievements made, key learning and challenges to come of each of these are outlined in more detail below.
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Reshape Joint Strategic Commissioning Plan: What do older people and the Third Sector want?
targeted re-designing
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involving
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needs joint working
recognising
home care
choice
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carers
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better
information sharing
networking
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Stronger assets planning good practice
Support
housing options
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Improving
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building capacity accessibility tners par l a equ quality
preventative
Creative, person-centred solutions
end of life care
The summit confirmed that the Third Sector priorities should be community food; community transport; community centres, information and advice; arts and physical activity; befriending; housing based initiatives and support for carers & respite, but also flagged up a number of other concerns. Read more....
Creative, accessible, person-centred solutions. Improving choice and quality, particularly in home care. Targeting work at those who need it most. Greater focus on things like nutrition, dementia, carers, end of life care. Involving and building capacity of older people. Better information, networks and joint working. Strengthening the Third Sector to respond to increased need.
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Secondly, GCVS held a summit of 30 Third Sector organisations in May 2014 to update them on progress and gather final feedback on the Joint Commissioning Strategy, to make sure it realises the Scottish Government’s vision.
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People agreed with the vision outlined in the draft plan but were concerned about the lack of detail on how services would shift to deliver that vision, particularly doubling the spend on preventative services when budgets are being reduced. Read more...
What do older people and the Third Sector want?
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Firstly, GCVS helped the Draft Joint Strategic Commissioning Plan 2013-16 to be one of the most widely consulted issues last year, with more than 500 stakeholders (older people, including over 200 older disabled people at an event organised by Glasgow Disability Alliance, carers and third sector practitioners) giving their views.
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Reshape Evidence for Change: Recognising the value of the Third Sector Background: A key aspect of RCOP and health and social care integration is taking a fresh approach to delivering services. At GCVS, we feel this means recognising and valuing the role the Third Sector already plays, particularly in terms of preventative activities, and trying new things to plug gaps, join services up better and improve the health and wellbeing of older people. Robust evaluation of the impact of these new approaches is vital to help shift the balance of care to more preventative work and ensure that proven support is provided for older people to be well and cared for in their own homes and the community. What are we doing? To help develop the evidence base, GCVS.. • has commissioned Glasgow Caledonian University’s Yunus Centre for Social Business & Health to evidence the contribution of the Third Sector and housing activity to the health and wellbeing of older people; • is strengthening academic links with Glasgow Centre for Population Health (GCPH) and the Institute for Research and Innovation in Social Services (IRISS), using case studies from local housing associations; • has commissioned Voluntary Action Fund (VAF) to support and evaluate each of the Transformation Fund projects; and • is nurturing and measuring the social capital built with 6 of the Transformation Fund projects, in partnership with Assist Social Capital. This will provide a robust evidence base, along with our recent research around Community Transport and mapping Third Sector service provision to older people (here), to specifically inform the RCOP Strategy and Reference Groups in planning and resourcing decisions around the Joint Commissioning Plan. The evidence will quantify the impact of the Third Sector in preserving and maintaining good health and wellbeing of older people, and (we hope!) help to make the case for greater recognition of the actual and potential contribution of the Third Sector within the city in planning and resource allocation.
Transformation Fund: Progress and learning Background: The Scottish Government’s Change Fund has encouraged partners to explore different, more preventative ways of working to improve the way in which we care for older people. Part of the Change Fund was ring-fenced specifically for the Third Sector - the Transformation Fund - for initiatives which enhance community connections and/or improve health and wellbeing for older people in a community setting, reducing the demand on public services. The Transformation Fund is being managed on behalf of GCVS by Voluntary Action Fund (VAF). 49 projects have been supported in two rounds of funding, including 12 continuing from the first programme. £2.1million has been invested since November 2012 in a diverse range of activities, targeting very different beneficiaries. More here... Learning what makes the difference One of the key successes of the first programme was how well and quickly small, locally based projects were able to engage with local people and their carers and facilitate access to support. Many of the volunteers are older people themselves, and projects recognised the contribution they have to make to others whilst also gaining personal benefits. Lessons learned, including unanticipated outcomes, can be found in the evaluation report. What happens next? Learning from the first wave of funding has helped define more realistic targets and GCVS has already commissioned more support from VAF for projects, encouraged greater partnership working and improved referral routes. GCVS’s role in providing intermediary support has also added value as we have facilitated joint working, resourced this programme of work and championed evidence gathering. We will report more fully on this in due course.
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Reshape Health and Social Care Integration – The state of play
What is Health and Social Care Integration about? The Scottish Government’s 2020 Vision is that by 2020 everyone is able to live longer, healthier lives at home, or in a homely setting. This means... • more person-centred care; • a greater focus on prevention, anticipation and supported self-management, with people taking more responsibility for their own health; • more treatment locally as a day patient, with fewer and shorter hospital stays; • integrated health and social care services. Integrated health and social care is now in play following the Public Bodies (Joint Working) (Scotland) Act 2014, which was passed by Scottish Parliament in February and given Royal Assent in April 2014. Alongside this, the Scottish Government is also reviewing the National Care Standards. There are 23 sets of standards, tailored to different services but based around the six principles of dignity, privacy, choice, safety, realising potential and equality and diversity. The proposals seek to simplify this, with a common set of human rights-based quality standards across all care and health services, plus specific standards for particular aspects of care or need. This aims to improve the quality of care, protect vulnerable people, make institutions more accountable for delivering on these standards by respecting, protecting and fulfilling people’s rights in the way they provide services and make people more aware of their rights, empowering them to make informed choices about their care. What’s been happening? NHSGGC and GCC have agreed that integration will apply to all adult and children’s services in Glasgow (an option rather than a requirement in the Act). This relates to a combined budget in Glasgow of £1.2billion and 10,000 staff, so getting services to the point that they are properly integrated is a massive task and there is a lot of work still to do. A shadow board has been established to take forward interim business and GCVS is keen to be involved in these discussions. Third and Independent sectors are already involved in shadow boards in other parts of the country, where progress is much more advanced so we had better get moving in Glasgow! GCVS and the Third Sector want to be ready for integration and to help it happen appropriately and well, as this agenda will have such a significant impact on individuals and service providers in the city.
In February the Scottish Government provided £7million nationally for organisational development resources for the transition. GCVS is keen to receive funding to properly support the sector’s awareness and involvement in integration planning and delivery. The Third Sector is extremely diverse and cannot genuinely be represented unless there is funded two-way engagement to support this. Fortunately, the Act specifically allows for appointments to be made to facilitate such support and the Scottish Government is seeking greater public engagement on integration. GCVS would be delighted to assist with each of these issues if resourced to do so. The Act also requires consultation and involvement at locality level, with at least two localities, although three may be a better fit in Glasgow. Edinburgh is pursuing 12 local partnerships on the basis that the more local decisions are made the better, so they can be tailored to need, all the players know what is happening, what the issues are and who to work with. The Transformation Fund pilots illustrated the benefits of the bottom up, well-networked approach. The balance needs to be struck between top down issues for Glasgow as a whole, for example as identified via the Single Outcome Agreement, and responding to local issues with local solutions. On October 8th the Scottish Government hosted an event on Integration Joint Strategic Commissioning Plans 2015-16, where the guidance was launched. What happens next? Integration goes live and CHPs will cease to exist on 1st April 2015, with all integration arrangements in place within 12 months. A summary of responses to the recent consultation on implementation is expected very soon to inform the process. Next time in Reshape, we’ll update you on ... • Developing a Community Connectors model for Glasgow • Workforce development activity for a successful transition to RCOP • Health and Social Care Integration progress For more information on our Reshaping Care for Older People work please contact Gillian McCamley, RCOP Strategic Co-ordinator on 0141 332 2444.
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