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Unprecedented level of joint working is transforming lives of older people Unprecedented level of joint working is transforming lives of older people
(about 2 months later)
Robert spent the best part of 11 months in hospital after suffering shortness of breath and rapid weight loss. He lost his wife during that time and the outlook for the 77-year-old seemed bleak. But now he is living independently with help to maintain his home and garden, advice on benefits and tips on healthy living.Robert spent the best part of 11 months in hospital after suffering shortness of breath and rapid weight loss. He lost his wife during that time and the outlook for the 77-year-old seemed bleak. But now he is living independently with help to maintain his home and garden, advice on benefits and tips on healthy living.
The transformation in Robert’s life reflects the evolution of health and care services in Croydon, south London, where the local council, the NHS and charity Age UK Croydon have come together to support people like him.The transformation in Robert’s life reflects the evolution of health and care services in Croydon, south London, where the local council, the NHS and charity Age UK Croydon have come together to support people like him.
The One Croydon Alliance was given the green light in March to develop its work for the next nine years, after demonstrating early benefits, including a 20% reduction in length of hospital stays, up to 14% fewer hospital referrals by GPs and cash savings of at least £12m a year.The One Croydon Alliance was given the green light in March to develop its work for the next nine years, after demonstrating early benefits, including a 20% reduction in length of hospital stays, up to 14% fewer hospital referrals by GPs and cash savings of at least £12m a year.
Jo Negrini, Croydon council’s chief executive, says: “This unprecedented level of joint working between council staff, the NHS and other alliance partners has meant better health and social care outcomes for residents who might otherwise have continued to [be] in and out of hospital.”Jo Negrini, Croydon council’s chief executive, says: “This unprecedented level of joint working between council staff, the NHS and other alliance partners has meant better health and social care outcomes for residents who might otherwise have continued to [be] in and out of hospital.”
Shifting care closer to home will ease pressure on hospitals | Ewan KingShifting care closer to home will ease pressure on hospitals | Ewan King
The alliance was set up last year for an initial 12 months during which it focused mainly on people aged 65 and over. The two principal strands of its approach have been a Living Independently for Everyone (Life) programme – an integrated reablement and rehabilitation service for older people on discharge from hospital – and an Integrated Community Networks (ICN) scheme based on weekly “huddles” of professionals from all disciplines to discuss people at risk of going into hospital.The alliance was set up last year for an initial 12 months during which it focused mainly on people aged 65 and over. The two principal strands of its approach have been a Living Independently for Everyone (Life) programme – an integrated reablement and rehabilitation service for older people on discharge from hospital – and an Integrated Community Networks (ICN) scheme based on weekly “huddles” of professionals from all disciplines to discuss people at risk of going into hospital.
These huddles, with support from an Age UK personal independence coordinator, are critical to keeping Robert living at home.These huddles, with support from an Age UK personal independence coordinator, are critical to keeping Robert living at home.
Rachel Soni, the alliance’s programme director, says the whole-system initiative stemmed from a realisation by care commissioners that expecting care providers to work together was only half the battle – it was “throwing stuff over the fence” for other organisations to deal with.Rachel Soni, the alliance’s programme director, says the whole-system initiative stemmed from a realisation by care commissioners that expecting care providers to work together was only half the battle – it was “throwing stuff over the fence” for other organisations to deal with.
Key to the first-year success of the alliance has been the strong commitment at the most senior levels of all the partner organisations, bottom-up co-design of the programmes and neutrality of the coordinating team, says Soni. “I report to the chair of the GP collaborative [a grouping of family doctors] but I am a council employee and I am on secondment to the [NHS] clinical commissioning group.”Key to the first-year success of the alliance has been the strong commitment at the most senior levels of all the partner organisations, bottom-up co-design of the programmes and neutrality of the coordinating team, says Soni. “I report to the chair of the GP collaborative [a grouping of family doctors] but I am a council employee and I am on secondment to the [NHS] clinical commissioning group.”
The alliance is responsible for services worth £180m a year and has been able to show it is returning £1.44 for every £1 spent on the ICN programme and £2.67 for every £1 invested in Life.The alliance is responsible for services worth £180m a year and has been able to show it is returning £1.44 for every £1 spent on the ICN programme and £2.67 for every £1 invested in Life.
Now, with a guaranteed 10 years of support, the alliance intends to extend its work to services for younger adults which are falling behind outcome targets. Soni admits that pressures on the health and care system over the winter inhibited planned development. “My job is keeping everyone on board so that when we hit roadblocks we get through them as quickly as we can and come out the other side still friends,” she says.Now, with a guaranteed 10 years of support, the alliance intends to extend its work to services for younger adults which are falling behind outcome targets. Soni admits that pressures on the health and care system over the winter inhibited planned development. “My job is keeping everyone on board so that when we hit roadblocks we get through them as quickly as we can and come out the other side still friends,” she says.
The techniques and challenges of transforming public services will be discussed at a conference in London on 24 May, billed as the first event of its kind.The techniques and challenges of transforming public services will be discussed at a conference in London on 24 May, billed as the first event of its kind.
The conference, supported by the Guardian Public Leaders Network, is being organised by the Public Service Transformation Academy, which runs the Cabinet Office’s commissioning academy. Presentations will cover national and local government, the NHS and the voluntary sector.The conference, supported by the Guardian Public Leaders Network, is being organised by the Public Service Transformation Academy, which runs the Cabinet Office’s commissioning academy. Presentations will cover national and local government, the NHS and the voluntary sector.
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