Taking Charge of Our Health and Social Care System
23 May 2018
Noreen Dowd, Interim Accountable Officer of NHS Oldham Clinical Commissioning Group (CCG) met with Kevin Hardy and Paul Ingle in April this year in London and shared some of her early experiences of Local Care Organisations in Greater Manchester. Noreen is our guest HGinSIGHT contributor this month. What she shares provides great food for thought and shows a Primary Care system being creative and taking charge of health and social care spending and service delivery decisions.
The New System Design
The NHS Oldham Clinical Commissioning Group (CCG) is made up of every GP in Oldham and is led by a Governing Body that includes GP’s, health professionals and community representatives.
All the NHS organisations and local authorities in Greater Manchester signed a landmark agreement with the Government to take charge of health and social care spending and decisions in the Greater Manchester City Region.
As part of the Greater Manchester approach to Taking Charge, ten localities across Greater Manchester are looking to transform our health and social care systems so that we adopt a sense of place focused upon achieving better outcomes for people, rather than a focus on organisations. Our new system design pulls services together by integration around people’s homes, neighbourhoods and towns. By working together, this means that plans are designed to make the economy financially sustainable, whilst delivering better outcomes and the best quality services.
Oldham Cares is now one of the ten Local Care Organisations which has come to life this year across Greater Manchester and we are seeing radical changes at neighbourhood level as we are beginning to break down the barriers that prevent the integration of care around the needs of individuals. We are focusing on prevention and early intervention and building on the assets of individuals and their communities.
We have developed an outcome’s framework focused upon12 outcomes developed with a population health focus connecting health to the wider determinants of health and to inform commissioning priorities.
Oldham’s Outcomes Framework
Oldham’s commissioning framework is underpinned by social value. A Single Commissioning Function with a Commissioning Partnership Board and joint team has been established between Oldham Clinical Commissioning Group (CCG) and the Oldham Council for pooled/aligned budgets of circa £400m by 20/21. Our ambition is to join our budgets so that we can buy health, care and support services once in a joined-up way at pace.
By bringing together our health and care budgets we are moving away from the silos that have previously impeded our ability to deliver genuine place-based commissioning.
Working with an alliance of partners, we will agree how we do things once collectively to make our current and future services work better for the people of Oldham. Our people and place focused transformation strategy is aligned to the prevention, early intervention agenda and is bound by a common narrative and approach with a stake for each organisation.
Within the context of the local community, it will support people to remain at home as long as possible and prevent the need for unnecessary presentation or admission in an acute environment. When a person needs acute care, our acute transformation program is focused upon service re-design which aims to ensure a prompt discharge to the right place of care as close to home as possible.
Our system redesign is seeking
- To establish a primary care cluster system (5 geographical clusters based on localities of 30-50, 000 population) across the locality, completing the establishment of integrated health and care teams and the creation of single structures at a GP cluster level
- To creating and implement a more effective urgent and emergency care offer on the Royal Oldham Hospital site
- To redesign Oldham’s community re-ablement, rehabilitation and community bed services (including a rapid response facility)
- To further develop Oldham’s approach to community resilience, branded as ‘Thriving Communities’
How are we changing?
Oldham’s proposal to the Greater Manchester Transformation Fund is a central part to the borough’s plans to increase the pace and scale of delivery of our Locality Plan which will close the forecasted financial gap of £70.8m by 2020/21 through:
- Supporting people to be more in control of their lives
- Having a health and social care system that is geared towards wellbeing and the prevention of ill health.
- Providing access to health services at home and in the community
- Providing social care that works with health and voluntary services to support people to look after themselves and each other
What outcomes are we looking for?
Across Greater Manchester
Across Oldham
What are the early indicators/learnings?
- Agreeing and settling on neighbourhood geographies between the local authority and local NHS is key
- Agreeing a model 30-50,000 population – including permissions and accountabilities down to neighbourhood team level.
- Defining the operating model for integrated neighbourhood teams (INTs) and working arrangements.
- Connecting the INT’s into the wider Local Care O
- Establishing a single leadership/management structure for the LCO and SCF with integrated provider and commissioner board functions.
- Pooling of budgets (some range from ‘pooled’, ‘aligned’ to ‘in view’), and establishing integrated commissioning arrangements.
- Translating the transformation into several core programs.
- Extending the integration into wider public services and the VCSE sector.
- Early investment of time and resource into support programs for organisational development for front line staff and teams to build relationships, trust and a deeper appreciation of roles as a key enabler towards culture shift and accelerating local progress.
Noreen Dowd would be happy to respond to questions:
contact jfagan@hardygroupintl.com m +61412390724
Noreen Dowd’s BIO:
Noreen Dowd is the Interim Accountable Officer of NHS Oldham Clinical Commissioning Group (CCG) in the UK. Noreen has global experience and extensive understanding of different health markets. She worked in Australia over several years at senior levels in Victoria and Western Australia.
She has comprehensive understanding and knowledge of acute, sub-acute and community health services and is highly experienced in strategic commissioning and service planning as well as system-wide reform. She is a highly skilled purchaser and commissioner of health and social services.
