AGENDA ITEM 6

COMMUNITY SUPPORT OVERVIEW GROUP

8 FEBRUARY 2007

REPORT OF THE HEAD OF ADULT SOCIAL SERVICES COMMISSIONING PARTNERSHIPS FOR OLDER PEOPLE PROJECTS (POPP)

1. / Purpose of Report:
To update Members on the progress of the Partnership for Older Person Project.
2. / Decision Required:
To note the contents of the report.
3. / Background:
Members received a report on 22 November 2005 informing them of the successful bid made by the Borough of Poole. This brought £798,000 (£394,000 p.a. for two years) of new money into Adult Social Services ringfenced for spend on older peoples services in the electoral wards of Poole Town and Parkstone.
4. / Progress To Date:
4.1 / Locality Steering Group:
4.1.1 / Locality Steering Groups comprising of older people who are local residents have been established within both Poole Town and Parkstone. These have been supported by older people who have not previously been engaged in any kind of user forums. All proposals for allocation of POPP funds are submitted to these groups and they have also been proactive giving suggestions for new local initiatives e.g. localised support for older people with mental health needs.
The success of these groups may be measured through the members taking a very proactive role in the delivery of a Health and Well-being Event on 3rd November 2005.
4.2 / Staffing:
4.2.1 / A requirement of all POPP bids was to demonstrate how partnership with Primary Care Trusts would be progressed. The staff team of Poole’s project illustrates well how this has been progressed. Currently the staff team comprises of: -
Title / Appointed / Role / Employed by
Project Manager (1fte) / March 2006 / To oversee project / BoP
Resource Centre Administrator (1 fte) / July 2006 / To provide full administrative , helpline support and establish Resource functions / BoP
Locality Coordinators (2 fte) / July 2006 / To coordinate interventions in each locality / BoP
Community Matron (1fte) / August 2006 / To provide proactive health interventions / Poole and B’mth PCT
Health and Social Care Assistants (4fte) / Sept 2006 / To provide health and social care support / BoP
Data Input Officer / Sept 2006 / To maintain databases / BoP
Community Matron (0.6 fte) / October 2006 / To provide proactive health interventions / Poole and B’mth PCT
Pharmacy Technician (0.27 fte) / January 2007 / To facilitate medicines management / Poole and B’mth PCT
Occupational Therapist (1 fte) / January 2007 / To facilitate admission prevention / BoP
4.3 / New ways of working:
4.3.1 / Within the national POPP programme there is an explicit agenda to introduce and test new ways of working and to consider ‘radical system change’. Within the Poole project this has been evident in several ways: -
  • Multi-disciplinary teams under single line management.
  • Creation of new posts of Health and Social Care Assistants which combine the roles of home care assistants and nursing auxillaries.
  • Operating a new case finding model within Poole hospital i.e. proactively identifying at risk situations rather than reacting to a referral.
  • Team working from a Community base i.e. a local church.
  • All requests for residential care by ‘POPP service users’ being monitored by the POPP team.
  • Developing information sharing agreements with South West Ambulance Trust (only the second locality in the South West region to have done so).

4.3.2 / A particular and unique feature of the Poole project relative to the other projects in England is that we have avoided the traditional approach of committing all the funding in advance. Rather as the project progresses and new challenges or opportunities arrive funding is available to develop new initiatives. For example, the Health and Well-being Event older people within the two localities reinforced the need to develop specific interventions on chiropody, sight and hearing loss and mental health.
4.3.3 / Target Attainment:
i) The Department of Health prescribed key targets for the POPP programme to address. These are:
  • Reductions beyond local PCT/SHA targets in Emergency Occupied Bed Days (EOBD)
  • PSA Intensive Home Care (C28) to achieve 34% by 2008
  • Increase in Older People Helped to Live At Home (C32)
ii) The Borough of Poole is already a high performing authority on C32, indeed the best authority in the South West region and already exceeds the national PSA target. The POPP team has therefore in its initial phase sought to focus on reducing the number of emergency occupied bed days incurred by older residents of Poole Town and Parkstone i.e. length of stay following an emergency admission. Whilst a caution has to be exercised until such time as a robust pattern emerges, fully verified information from the PCT suggests a real reduction in Emergency Occupied Bed Days as a consequence of the case finding approach adopted by the team in Poole Hospital.
Geography / % change 05/06 – 06/07 (as at Sept 07)
Borough of Poole / -6.13% / No POPP intervention
Poole Town / -18.09% / POPP locality
Parkstone / -13.34% / POPP locality
iii) At this early stage the project in Poole is on course to meet the targets submitted to the Department of Health i.e. the reduction of 3589 reduced bed days by March 2008 from the 04/05 baseline. These – if met and translated into cash terms will more than equate to the investment made by the POPP programme.
4.4 / Funding:
4.4.1 / As indicated above the project in Poole has taken on the opportunity to avoid committing all funds in advance but rather to invest in initiatives as new opportunities/challenges present. Within the programme rules the full permitted 25% is being carried forward to 2007/08, and a sum of £35,000 is still available in this financial year to invest.
4.5 / Sustainability:
4.5.1 / The particular challenge to all projects within the programme is to find sustainable interventions which can contribute to achieve the shift from acute hospital to community interventions. This requirement has already become embedded within the Poole project. As a consequence of the success in reducing Emergency Occupied Bed Days/length of stay following an emergency admission the case finding model is now being rolled out to core Adult Social Services teams and Poole Hospital staff. This has the advantage of embedding good practice at an early stage and freeing up the POPP team to undertake proactive work in other critical areas – notably reducing emergency admissions.
5. / Next Steps:
5.1 / To date the focus of interventions by the POPP’s team has been at the acute end through the reduction in Emergency Occupied Bed Days by facilitating rapid discharge. The multi-disciplinary team will in a second phase be concentrating on further reducing bed days by reducing the number of emergency admissions – given that previous local studies have found that up to 14% of such admissions are avoidable.
5.2 / Running alongside the above initiatives a focus in 2007 will also be had on promoting well-being. This will represent lower levels of preventative support such as better information and better access to existing statutory and community facilities. Together with new services in the POPP localities of chiropody, sight and hearing and mental health these collectively should provide a stronger sense of well-being which research suggests provides a more sustainable pathway to maintaining good health and independence.
5.3 / Consistent with the roll out the case finding model, as other proactive changes are introduced and tested, the benefits will similarly be rolled out to core Adult Social Services and PCT teams.
6. / Summary:
This report highlights the progress that has been made in promoting the health and independence of older people in Poole Town and Parkstone. The project is still at an early stage but early evidence suggests success in key areas.
7. / Recommendations:
7.1 / Members are asked to note the contents of this report.

1