This document summarizes a meeting about integrating care in Eastern Cheshire. It introduced the Caring Together model of integrated care, which aims to coordinate and manage patient care through community and local services. The model was presented and participants broke into groups to discuss their experiences and how to move from the current model to the envisioned integrated model in the future. Next steps include analyzing the group discussions, developing conclusions to shape the next stage of the model, and inviting participants to further provide input into improving integrated care.
6. Integrating Care in Eastern Cheshire
What’s Today About?
Principles
What
does this
mean to
you?
Identify
Focus
Review
the
Model
Discuss
and
enhance
Next
Steps
7. Integrating Care in Eastern Cheshire
What Happens Today?
• We will give you information in bite sized
chunks as presentations
• Followed by discussion groups
• Insight captured and reported
8. Integrating Care in Eastern Cheshire
We’re Here to Deliberate
• What’s deliberation?
– Open discussion
– Look at the issues
– Discuss the facts
– Understand different people’s points of view
– Listen to other people without bias
– Give time for people to have their say
9. Integrating Care in Eastern Cheshire
Your Comfort
• Natural break whenever you like
• Water on tables
• Ask if you need anything else
• Finish around 9pm
10. Integrating Care in Eastern Cheshire
Caring Together Principles
Dr Paddy Kearns
12. Integrating Care in Eastern Cheshire
Quite simply it is about
organisations and people such as
patients, carers, volunteers and
staff all working together to make
care as straightforward and
integrated (joined up) as possible
14. We need to have a
single front door to
urgent care services
We need investment
in community
services
We need to have
a single budget for
social and medical
care beds
We need
dieticians
to work
with Care
Home
chefs
We need
geriatricians
working closer
with GPs
We need to
help carers
prepare for
dementia
We need to be able access
patients records on the Ward
We need to plan
social care before
admission
We need to
stop telling
our story to
every
professional
We need listen
more to our
patients
We need to know who to talk
to and when
15. Integrating Care in Eastern Cheshire
In Eastern Cheshire
This means
joint
working
23 GP
Practices
16. Integrating Care in Eastern Cheshire
This is reflected in…
• The NHS Constitution
• Better Care, Higher Standards Charter
• Cheshire East Council Three Year Plan
17. Integrating Care in Eastern Cheshire
The National Principles
http://www.youtube.com/watch?feature=player
_embedded&v=YrG8x3XimSM
18. Integrating Care in Eastern Cheshire
First Group Discussion
• Do you agree with the Principles?
• Where are the gaps?
• What works and what doesn’t?
• What makes you frustrated?
20. Integrating Care in Eastern Cheshire
Identify the Focus
Place key points
raised on Post-It
Notes
Place dots on
points you
agree with
21. Integrating Care in Eastern Cheshire
The Caring Together Model
Dr Paddy Kearns
22. Integrating Care in Eastern Cheshire
Supported by
Community and
Local Services
23. Integrating Care in Eastern Cheshire
Co-ordinates
and manages
care
Principles
Supported to
co-ordinate and
manage own care
Encouraged to live
independently
Include community and
voluntary sector
Include all local
communities
24. Integrating Care in Eastern Cheshire
Co-ordinates
and manages
care
How
Community information
Prevention services
Supported housing
Exercise services
Day care
Assistive technologies
Multiagency team -
Assessment and
signposting
Volunteer signposting
Information, support,
signposting and
technology
25. Integrating Care in Eastern Cheshire
Co-ordinates
and manages
care
Services/Interventions
Community exercise
Prevention campaigns
Regular health checks
Telehealth & telecare
Man in a Van
Dentists, pharmacists and
opticians
Patient programmes
Screening
Signposting
Information, support,
signposting and
technology
Checks,
screening and
other services
26. Integrating Care in Eastern Cheshire
Community
Provided Care
Community Care
This is targeted
Town based
(within 5 miles)
Provides 75% of care
27. Integrating Care in Eastern Cheshire
Community
Provided Care
Targeted
within 5 miles
Principles
Care in person’s home
Services targeted to
need
Focus on prevention
Less admissions to
hospital
Collaborative working
Relationship building
Accessing different kinds
of solutions
28. Integrating Care in Eastern Cheshire
Community
Provided Care
Targeted
within 5 miles
How
Population profiling
Care co-ordination
Neighbourhood Teams
Link with other localities
Integrated pathways
Federations of providers
Intermediate care service
Assessment & signposting
Out of hours
29. Integrating Care in Eastern Cheshire
Community
Provided Care
Targeted
within 5 miles
Services/Interventions
Single assessment
Case management
Range of preventions
Care planning
Rapid response
Screening
Respite and support
Shared decision making
Outpatients
Transition care
30. Integrating Care in Eastern Cheshire
It’s about
empowering
people to
provide and
receive
integrated
support locally
31. Integrating Care in Eastern Cheshire
Second Group Discussion
• Firstly as individuals read through the model
• Note down using the form given how that
model relates to your experiences
• As a group then discuss these experiences
• Agree a way to move from the model ‘Today’
through to the model of ‘Tomorrow’
32. Integrating Care in Eastern Cheshire
Next Steps
Sam Nicol, Caring Together Director
34. Integrating Care in Eastern Cheshire
This is an evolving process
• Designed with you
• Creating momentum to deliver change
• Challenging assumptions and behaviours
• Caring Together as Champions
35. Integrating Care in Eastern Cheshire
From Today
• Analyse for common themes
• Draw conclusions to inform next stage
• Send you a summary of insight
• Invite to shape the next stage