homecare within n. ireland’s integrated health & social care structures an overview martin...
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Homecare within N. Ireland’sIntegrated Health & Social Care
Structures
Homecare within N. Ireland’sIntegrated Health & Social Care
StructuresAn Overview
Martin McGeady
Head of Homecare Services
An Overview
Martin McGeady
Head of Homecare Services
N. Ireland – Some FactsN. Ireland – Some Facts
Population 1.7 million 5,400 square miles 6 Counties 26 District Councils NI Assembly – devolved government since
1998
Derry D.C.
Limavady D.C.
Strabane D.C.
Omagh
District Council
Fermanagh D.C.
Coleraine D.C.
Moyle D.C.
Ballymoney D.C.
Ballymena D.C.
Magherafelt D.C.
Cookstown D.C.
Antrim D.C.
Dungannon D.C.
Armagh D.C.
Newry & Mourne D.C.
Banbridge D.C.
Craigavon D.C.
Down D.C.
Lisburn D.C. Ards D.C.
Castlereagh D.C.
Belfast D.C.
North Down D.C.
Newtownabbey D.C.Carrickfergus D.C.
Larne D.C.
MAP OF NORTHERN IRELAND
Western AreaPopulation 295,192Area (Hectares) 484,080Population Density 0.58
Northern AreaPopulation 449,623Area (Hectares) 435,567Population Density 0.98
Eastern AreaPopulation 671,579Area (Hectares) 175,124Population Density 3.80
Southern AreaPopulation 342,754Area (Hectares) 318,768Population Density 0.98
N. Ireland AssemblyN. Ireland Assembly
Power-sharing Executive since 2007, dominated by DUP & Sinn Fein
Health Minister – Edwin Poots, DUP Health Committee – Joint Chair Block grant determined by Westminster [Barnett
Formula] allocated to priorities by the NI Executive Policy and legislative authority in N. Ireland for
almost all health and social care issues
Evolvement of N. Ireland’s Health & Social Care StructuresEvolvement of N. Ireland’s Health & Social Care Structures
1948 – 1972 Tripartite Arrangement 1972 HPSS (NI) Order – 4 Boards 1991 creation of 19 Hospital & Community
Trusts By 2000 NI had 48 H&SC Institutions 2002 – 2007 review of Public Administration 2012 – Today’s Integrated Structures
N. Ireland’s H&SC StructuresN. Ireland’s H&SC StructuresCurrent Health and Social Care Structures
Minister of Health
Assembly Health Committee
DHSSPS Department of Health, Social Services and Public Safety RQIA
Regional Health and Public Health Patient Client Business Services Social Care Board Agency Council Organisation
LOCAL Commissioning Groups 5 Trusts: Northern, Southern, Co-Terminus with the 5 Trusts Western, Belfast and South & Areas 17 Members on each, with an identified Commissioning lead.
DHSSPS has strategic, policy role
Minister held accountable by Health committee
Minister & Committee supported by DHSSPS
Commissioning Services
Providing services
Community & Voluntary Sector
Roles & Responsibilities of the Various BodiesRoles & Responsibilities of the Various Bodies
DHSS & PS • Policy• Legislation
H&SCB• Commission Services• Deploying & Manage Funding• Work with Trusts to ensure public needs are met• Performance Management
Health & Social Care Trusts
• 6 Trusts [N, S, W, SE, Belfast & NI Ambulance• Provision of health & social services to local
population
Patient Client Council • Listen and act on the public’s views• Encourage & facilitate user involvement• Advice & information
Business Services Organisation
Central support to all H&SC bodies on a range of business functions, e.g. procurement, legal services
Cont’Cont’
Public Health Authority• Promote improvement in health
and social well-being• Health Protection
Local Commissioning Groups• 5 LCG’s co-terminus with Trust’s• Commissioning Health & Social
Care for local population
RQIA• Regulation• Inspection• Service Improvement
Community & Voluntary SectorComplementing the work of the other bodies
An Overview of Homecare in NIAn Overview of Homecare in NI
Home Help – Home Care – Reablement In-House (42%) : Independent Sector (58%) Estimated 23,000 service users 86% Service Users 65+ Annual Spend £200m Estimated 10,000 staff employed 283 Providers* [likely less than 100] Regulated since 2009*RQIA – significant double counting of multiple site providers and supported living facilities
Integration in Action - ISDIntegration in Action - ISD
Integrated Service Delivery Formalised approach mid 2000’s Standardised Approach [RPA] Co-location [Health & Care Centres] Overcoming professional and organisational boundaries Fully [?] integrated multi-disciplinary working Locality sensitive approach Single Assessment Tool [NISAT]
.
The TeamThe Team
Locality Services Manager [WHSCT 2x Nurse,1xSW & 1xOT]
Primary & Community Care Co-ordinators [13 staff – professional mix]
Social Workers Community Nurses AHP’s – Aligned Homecare – Aligned Admin Support
ISD – The BenefitsISD – The Benefits
Co-location Improved Communication Better understanding of each other’s roles Easier Access to other professionals Shared patient / client input Single Assessment Tool Improved Service
Actual or Virtual? Actual or Virtual?
“Could do Better”! Examples where staff are co-located but not
necessarily integrated Challenges – Facilities, other change
processes Good Examples
Best PracticeBest Practice
Dementia Team
Reablement
Community Rehabilitation
The FutureThe Future
Transforming Your Care Integrated Working Re-visited and
Re-emphasised Health & Care Centres Importance of GP engagement
