Actions

Outcomes/Results

Current Performance/ Progress

Priority

Lead

1(a)

Improve performance on Intensive Home Care through implementation of local C28 Service Plans.

· 03/04 C28 Value of 10<12;

· Achieve C28 targets.

· Home Care abstract data reviewed quarterly.

· £3.5m additional funding targeted at performance improvements.

· 03/04 C26 targets met.

· 02/03 C28 value = 6.5

· Locality Plans for C28 performance improvements in draft.

· Local domiciliary care prices established

· 02/03 C26 remaining within 5* band.

1

2

AW

1(b)

Participate in corporate Best Value Review of support to Older People in their own homes.

· Map of all Hampshire County Council services established and resources identified.

· Empowerment strategy in place across Hampshire County Council for Older People.

· 04/05 C32 value of 100 achieved.

· Older People Panel initial scoping of services across Hampshire County Council for Older People and resources committed OP Working Group now taking cabinet priority forward.

· BV Review postponed

2

CF

1(c)

Continue development of community based intermediate care schemes

(Cross Reference: 2(c))

· The service gaps will be identified and planned for across the whole system.

· Effective schemes will be accessible across County.

· 03/04 capacity targets (in DIS) will be met.

· Implications for future resource deployment through provision of non - chargeable services identified.

· A gap map of services is being prepared.

· Identified PDT type schemes operational in nearly all areas.

· Proposals for `Social Care' rapid response schemes prepared.

1

AW

1(d)

Identify and map need, resources and services for carers of Older People and Older Carers across the County.

· Plans implemented for improving support to carers.

· Scoping is underway.

1

CE

Priority Codes

1

Action in Hand

2

Action planned over the next year

3

Action planned in the medium term

1(e)

Accommodation:

· Identify resources and outcomes from supporting people applicable to Older People;

· Promote and evaluate pilot projects of the Millennium Homes concept.

· Establish priority needs of Older People with respect to housing provision in each locality especially extra care housing.

· Influence use of supporting people to achieve commissioning intentions.

· Confirm role of millennium homes in support of commissioning intentions

· Housing strategy in each locality identifies specific needs of Older People

· Further pilot in East Hants being developed re: Millennium Homes

· Extra care Housing bid options being explored

2

JE

CE

1(e)

PD and Sensory Action Plans

Users and Carers (03/04)

Direct Payments (03/04)

Technician Service (03/04)

Occupational Therapy Service (03/04)

Risks

- Stability of Additional C28 resources to 2006

- Achieving performance targets within a balanced budget and identified pressure of £2.3m in Domiciliary Care budget for 03/04 (based on 02/03 average activity)

- Income analysis and impact through increasing non - chargeable IC Services.

Actions

Outcomes/Results

Current Performance/ Progress

Priority

Lead

2(a)

Care Management:

· Make consistent progress towards the implementation of SAP across the County;

· Review implementation of NHS FNC

· Review implementation of FACS;

· Pilot Older People toolkit for use with new continuing care criteria and participate with evaluation and implement action;

· Revise and redefine the care management practice framework with reference to above and the needs of reimbursement processes.

· Increase the number of carers assessments and ensure that they are properly recorded on ACMS / SWIFT

· SAP defined and implemented across Strategic Health Authority area by April 2004;

· Recording and practice is in accordance with policy intentions.

· The Continuing Care Criteria is applied consistently and in accordance with legal precedence and OP access Continuing Care funding effectively.

· Care managers work within new frameworks consistently across the County

· Reviewing / Assessment / CP indicators.

· NHS FNC is secured consistently and integrated within CM framework

· Progress across PCT's variable. SAP network meeting (06/03) will establish priority work areas

· Project Manager in post to undertake review.

· Plan needs developing to achieve level of reviews.

· Guidance re-issued and Strategic Service Manager supporting 6 month CC pilot.

· Strategic Service Manager's for FACS and SAP working together to revise manual, link with reimbursement project and develop training.

· Implemented NHS FNC

1

1

2

TT

SG

2(b)

Delayed Transfers:

· Develop and submit business case to secure contingency resources;

· Continue to implement project plan for implementation of re-imbursement (01/01/04);

· Develop services that are effective in assisting with hospital discharge but are consistent with long-term commissioning intentions.

· Evidence associated activity throughput in DIS etc.

(cross reference : (1C))

· 1/1/04 implementation target of (tbc)

· £3.5m available in 03/04 to support performance;

· Successful implementation of processes 1/1/04;

· Services across the whole system are developed which support return to home at the earliest opportunity and avoid reliance on bed-based care.

· DOH/SSI informed about whole approach and data collection definition

· Delayed Discharge Performance Indicator.

· Contingent resources identified;

· Project Plan on schedule.

· Service development underway to prevent admission and support discharge. To continue and be steered by gap map analysis.

· Regular reporting across a variety of activities associated with delayed transfers.

· Social Care Waits halved from 04/03 to 10/03

1

1

2

1

LW

Priority Codes

1

Action in Hand

2

Action planned over the next year

3

Action planned in the medium term

2(c)

· Evaluate effectiveness of the different models of intermediate care developing across Hampshire County Council.

(cross reference : (1C))

· Intermediate care targets (NSF)

· Service developments for 04/05 informed by evaluation and cost effectiveness understood.

· PMU leading evaluation Minimum data set being implemented.

1

AW

2(d)

EMH Services

· Determine County Policy on preferred model of service provision.

· Engage specialist advisers to review and propose community developments.

· Review and develop role of ASWs in OP Sector

· EMH services are consistently provided across the County and most appropriately to meet needs:

· Community provision is developed to improve outcomes for Older People with Mental Health needs.

· EMH practice improves and effective work is undertaken for OPMH

· Conference to discuss outcomes from residential consultation exercise has highlighted and signposted future actions.

· Initial work begun on determining breadth of ASW role within County.

· Joint Project with WHT to review integrated models.

2(e)

PD and Sensory Action Plans:

· Technician services 03/04

· Sensory Services 03/04

· ICES Project 03/04

· Care Management 03/04

Risks

- Sustainability of additional delayed transfer resources to 2006 - especially if recruitment of additional Care Management posts to support reimbursement is permanent;

- Balancing delayed discharge performance and cost of funding with potential stacked up costs if delays transferred to interim bed - based care.

- Securing acceptable and adequate management information from which to measure performance on delays.

Actions

Outcomes/Results

Current Performance/ Progress

Priority

Lead

3(a)

Develop strategy for the options to deliver Long Term residential and nursing home care for OPMH

· Continuum of care across residential and nursing homes identified.

· Capacity defined and procurement solutions determined with response implications.

· Service specifications developed.

· Practice model developed for in - house residential care and implementation begun;

· Unit cost analysis underway for Nursing Home Strategy.

· OPMH Strategy drafted.

2

CP

3(b)

Develop costed models to meet identified gaps with associated pricing strategy.

· 04/05 pricing negotiations informed by this work;

· Resource redeployment identified across service headings.

· PAF Unit Cost (Residential / Nursing Care) indicators.

· Analysis of cost and effectiveness of EMH rate introduction underway.

· Liaison with PCT over nursing home price initiated as joint commissioners.

2

CP

AE

3(c)

Determine market mix and role of in-house units in relation to the above including new nursing home beds.

· Market gaps identified and addressed to 2006;

· NCIS Service mix confirmed and implemented.

· Resources secured for these developments.

· NCIS initial service mix schedule prepared.

· Provision of IC beds beginning to the analysed.

· Nursing Home Project Plan meeting milestones.

2

CF / AE

CT / VO

Risks

- Increasing pressure for in-house units to increase staffing levels to meet NCSC inspection requirements and securing resources.

- Developing a joint approach to market developments in NH care with PCTS

- Identifying and securing ongoing revenue funding for new nursing homes.

Actions

Outcomes/Results

Current Performance/ Progress

Priority

Lead

4(a)

Work with PMU and IS Section to improve the availability of management information and quarterly reporting PAF indicators.

· Effective management information reports available on a monthly basis.

· PAF indicators will be reviewed at locality meetings quarterly through the availability of area - specific values.

· New PM information officer for Older People supporting these developments.

· SWIFT implementation will meet MI data capture needs.

· Some activity / performance information available.

· Area annual values available on request as are ad hoc requests for information.

· PAG (Older People) implementing work plan to improve PI Quality.

2

CF + Team

(PMU + IS Section)

4(b)

Develop quality monitoring mechanisms for residential / nursing care particularly for clients with dementia.

· Standards are set and monitored across residential / nursing home care.

· Specifications for EMH care defined, monitored and improvements plans designed.

· Initial work beginning on specifications for EMH care.

3

CP

4(c)

Roll out model contract guidance and service specification for day care services.

· Consistent standards of service across day care provision.

· Day Care strategy and stakeholder event support these developments.

· Workshop planned for December 03.

2

CE

Risks

- Improvements in data integrity keeping pace with MI provision.

- Achievement of ownership of data by operational groups while data quality issues emerge through increased availability

Actions

Outcomes/Results

Current Performance/ Progress

Priority

Lead

5(a)

Re-cast local budgets to an agreed needs - based formula for implementation from 04/05

· Review and re-cast of historic models of allocation to produce more current and equitable allocations

· FSS formula under consideration for possible use, along with impact of local pricing strategies.

2

CF / FSU

5(b)

Produce financial modelling information to predict resource requirements to meet demands

· Financial strategy developed for commissioning plan time frame.

· Year on year activity projections being developed.

2

CF + Team

5(c)

Produce activity and budget level baselines and projections against which investment and disinvestments can be tracked as well as impact analysis on performance

· Modelling of resources, activity and performance supports service planning

· Activity and budget baselines established.

· Initial disinvestment proposals included in 03/04 budget schedules

2

Team

Risks

- Implications of re-cast model will need long lead in time if significant shifts across areas are needed;

- Ability to determine longer term (3 year) financial strategy (Commensurate with PCT LDP planning)

Actions

Outcomes/Results

Current Performance/ Progress

Priority

Lead

6(a)

Identify necessary training to assure effective skill levels.

· Specific and specialist skilled staff will be in post to provide services

· Gap identified in meeting training needs for staff working with OPMH.

· Shift in funding sources and meeting grant requirements being analysed - particularly responsibilities to independent sector.

2

Team

6(b)

Ensure effective recruitment and retention policies are in place.

· Vacancy levels / Sickness levels / turnover levels across areas/ different roles tracked and analysed.

· Workgroup established to address problems in North of County

1

CT / CF

6(c)

Review approach to workforce development across care sector and review elements of WDC strategy to meet needs for nurses in NHS for transferability

· Plan is developed for meeting future needs for care staff across County

· Involvement with WDC for NCIS and ongoing learning from their approach

3

CF

6(d)

Workforce Plan 03/04

6(f)

Training Plan 03/04

Risks

- Competing for Care Staff cohort across similar service.

2002 / 2003 Budgets are based on Period 13.

2003 /2004 Budgets are based on the budgets as at period 4.

Activity Information has been extracted from the Community Care Statistics.

Average Costs are based on the annual gross cost.

Base Activity for 2003/2004 has been calculated by analysing the Community Care

Statistics for April - June 2003 in order to calculate an average for the year.

Additional Activity

In addition to these allocations, there is £3.5m available to meet the costs of achieving

delayed discharges targets. The allocations are still to be made subject to the business

plan being approved.

Average Activity

Gross Budget

Gross Expenditure

Average Cost

Variance Against budget

£'000

£'000

£

£'000

Residential

2,622

45,043

43,571

16,615

(1,472)

Nursing

1,474

31,506

32,109

21,779

603

Day

1,846

2,644

2,684

1,454

40

Domiciliary

5,727

24,570

25,581

4,467

1,011

Fieldwork

-

5,462

5,368

-

(94)

Other

-

1,522

1,677

-

155

Total

11,670

110,747

110,990

-

243

Base Activity

Base Budget

Budgeted Average Spend

Additional Funding

Additional Planned Activity

£'000

£

£'000

Residential

2,540

41,756

16,439

500

(2) 243

Nursing

1,616

32,454

20,083

0

-

Day

1,838

3,266

1,777

0

-

Domiciliary

5,603

27,257

4,865

3,255

(1) 958

Fieldwork

-

5,401

-

745

(3) 24 (Staff)

Other

-

1,352

-

0

-

Delayed Discharges

-

-

-

(4) 3,000

-

Total

11,597

111,486

-

7,500

-