Agenda item

Caroline Drysdale, Managing Director of Stockport Neighbourhood Care will attend the meeting to discuss the work of the organisation.

A copy of the most recent Newsletter, published in January 2018 has been enclosed for information.

Officer contact: Jonathan Vali, 0161 474 3201, jonathan.vali@stockport.gov.uk

Caroline Drysdale (Managing Director) and Viren Mehta (Medical Director) of Stockport Neighbourhood Care (SNC) attended the meeting to provide an update on the work of the organisation.

A copy of the latest company newsletter was submitted (copies of which had been circulated) for the Scrutiny Committee’s information.

The presentation covered the following:-

·         SNC was operating under an alliance agreement that aimed toward integration of health and social care.

·         The primary focus was services for over 65s, the cohort that accounted for approximately 85% of NHS/ Social Care resources.

·         SNC were working to implement the four overarching Stockport Together business cases. The key element of these was to reduce pressure on the local hospital, preventing attendance and helping improving discharge. Delayed Transfers of Care rates from Stepping Hill Hospital were much improved and this reflected the measures partners had put in place.

·         SNC had a small re-ablement capacity to provide step down or step up support.

·         Much of SNC’s work centred around the Neighbourhood areas and providing wrap around care with enhanced case management that helped support people to staying their home.

·         SNC was implementing an ambitious 5 year transformation programme that was being closely monitored by GMHSCP.

·         The four partner organisations were coming together to work in a different way, concerned primarily with clients not the organisations. This was an important change in working culture.

The following comments were made/ issues raised:-

·         ‘Maureen’s Story’ set out in the newsletter was instructive of the new approach. In that example Maureen would in the past have had the same conversation up to 25 times, all of which reduces clinical contact time. There was now also greater focus on making decisions about treatment  together. The traditional approach was to seek to ‘fix’ people but during this process patients may develop another problem. The aim was now looking to optimise patients for discharge back home where they would be more comfortable. There was also a programme of community prescribing that had seen a significant decrease in antibiotic prescribing and was being held up as an exemplar.

·         Reducing repetitive conversations was welcomed. This would be achieved through enhanced case management and undertaking a holistic assessment on behalf of all professionals, assessed by a multi-agency team. Work was ongoing to ensure appropriate data sharing arrangements.

·         Concerns were expressed about patients not being able to access Mastercall IV therapy at home but being made to stay in hospital. Integration of commissioning would allow for tactical commissioning of services to meet such needs more effectively.

·         Stockport already had good experience of joint working but embedding this  would take time. Nevertheless, the progress already made was welcomed.

·         Given the financial challenges facing the partner organisation, were SNC’s savings targets deliverable? Stockport Together aim was to close the financial gap between projected available spending power and projected demand. The challenge of the savings targets were recognised, as was the need to ensure quality of services.

·         Engagement with staff was recognised as vital to the success of the partnership working, as was embracing digital communication. Staff engagement had been positive, with many emphasising the need for a quicker pace of integration and others welcoming the return to a more localised, person centred pattern of working.

·         Challenges in responding to ‘cross-border’ cases of patients residents in Stockport but registered with a Manchester GP were recognised, although Greater Manchester working may assist with resolving this.

·         The significant challenges facing the social care workforce locally were reflective of the wider, regional and national care workforce challenges. SNC was committed to its direction of travel and would need to work through the four organisations governance arrangements. The importanc of making effective use of volunteers and non-registered staff was acknowledged. A key element of the success of SNC would be the culture change of the workforce.

·         SNC was currently at Year 3 of its 5 year plan, and had Transformation Funding into 2018/19, but SNC believed transformation was an ongoing, iterative process that needed to respond to changing conditions. A review of functioning and effectiveness of all services had been commissioned to ensure compliance with partners regulatory frameworks.

·         Central to SNC’s work was prevention and early intervention to prevent escalation.

RESOLVED – That Caroline Drysdale and Viren Mehta be thanked for their attendance and presentation.