Agenda Item No
The Vale of Glamorgan Council
Cabinet Meeting: 14 July, 2014
Report of the Cabinet Member for Adult Services
Integrating Locality Social Care and Health Teams
Purpose of the Report
1. To inform Cabinet about the progress made towards ensuring that older and physically disabled people receive more integrated care services.
2. To seek Cabinet approval for providing the Director of Social Services with delegated authority, in consultation with the Cabinet Member for Adult Services, to complete the necessary organisational change processes required to facilitate the restructuring of locality based teams.
1. That Cabinet notes the success achieved in developing more integrated health and social care services and endorses the further levels of integration with Cardiff and Vale University Health Board described at Appendix A.
2. That Cabinet provides delegated authority to the Director of Social Services in consultation with the Cabinet Member for Adult Services, to complete the necessary organisational change processes required to facilitate the restructuring of the locality based teams.
Reasons for the Recommendations
1. To ensure that the plans for more integrated services receive appropriate oversight and endorsement.
2. To support implementation of the proposed structure, which will improve the provision of integrated health and social care services and help to meet the needs of older and physically disabled people more effectively.
3. In delivering care and support to adults, the Council and the Cardiff and Vale University Health Board have increasingly worked in partnership, through shared programmes of service redesign and the provision of integrated teams. As a result, many health and social care services are closely linked. Although relatively few formal integration arrangements are in place, our citizens experience better co-ordinated and more consistent service provision. The process of integration has proceeded more quickly in some areas, such as in the services for people with a learning disability or mental ill health. There is considerable evidence that Locality Health and Social Services are experiencing unprecedented pressures. More and more people are requesting help and, in some areas, referrals have doubled in a three year period. These growing pressures and costs make existing models of service unsustainable for both organisations.
4. Moreover, feedback from service users/ patients, referrers and wider stakeholders indicates that, while individual services are valued, the overall pattern of service requires many handovers between professionals and organisations and it is very confusing to navigate. Partly because of these barriers, the system does not always have capacity in the right place at the right time, which has an adverse impact upon the outcomes for service users.
Relevant Issues and Options
5. Welsh Government has made evident its intentions to ensure that social services and health services are delivered in a more integrated way, in order to improve the overall outcomes for service users and patients. The guidance document "Delivering Local Health Care - Accelerating the Pace of Change" provides clear direction for community services to be provided in partnership across health and social care. The Social Services and Wellbeing Act 2014 will also further reinforce the need to work closely in partnership.
6. In many respects, the Vale of Glamorgan and the UHB have been in the forefront of work to deliver more integrated arrangements in Wales. The joint Head of Adult Services/Locality Manager post both demonstrates this commitment and allows us to adopt a pioneering approach to shared management roles and more joined up services. However, the existing arrangements now need to be taken further in order to deliver a step change in the pace of delivery.
7. A staff and stakeholder engagement exercise on proposed changes to structural arrangements concluded in May 2014 and the feedback has been used to develop more detailed proposals.
8. These detailed proposals have been outlined in a consultation document for staff (appendix 1 - amended version following consultation). This consultation exercise ran between June 3rd and July 3rd.
9. The proposed structure removes many of the traditional barriers to providing co-ordinated and consistent health and social care services for the residents of the Vale of Glamorgan. Services will be more streamlined with improved access and response times for patients and service users.
10. Some additional resources have been made available by the Welsh Government for a limited period of time through the Intermediate Care Fund to assist with the work of joining up care and support, especially within older people services. It is essential that we make best use of this funding to remodel services and enable support to be provided to more people in the future without creating longer-term dependency. One of the agreed projects is to support development of the customer contact centre, which will provide triage and screening for locality based health and social care services. This work has already started and progress is being made in developing the systems which support better coordination of care.
11. While front line staff will experience some changes in working practices as a consequence of the proposed restructuring, it is intended that the required savings will be achieved through a change in the management structure which supports them rather than through any reduction in direct services.
Resource Implications (Financial and Employment)
12. The agreed savings plans for Adult Services include £50k savings in 2015/16 associated with this reconfiguration of the care management team. The proposed reductions in posts may result in up to two redundancies. There are also savings delivered for Cardiff & Vale UHB through these changes.
Sustainability and Climate Change Implications
13. There are no sustainability and climate change implications.
Legal Implications (to Include Human Rights Implications)
14. There are no legal implications as a direct result of this report and its recommendations.
Crime and Disorder Implications
15. There are no crime and disorder implications as a direct result of this report.
Equal Opportunities Implications (to include Welsh Language issues)
16. There are no direct equal opportunities implications as a result of this report. An Equality Impact Assessment has been completed with regard to the effect of the proposed changes and it is considered that there will be predominantly a positive impact for older people and disabled people.
17. This report contributes to the following corporate objective: "working with partners to meet the diverse needs of our residents in ways that will safeguard and support those who are most vulnerable and in greatest need; help people to keep fit and healthy; and increase social cohesion and equality of opportunity for all."
Policy Framework and Budget
18. This is a matter for executive decision.
Consultation (including Ward Member Consultation)
19. This is an issue for the whole of the Vale of Glamorgan and so there has not been any ward member consultation.
Relevant Scrutiny Committee
20. Social Care and Health.
Cabinet 25th February 2013: Final Revenue Proposals 2013/14 and Financial Strategy to 2016/17 Appendix D.
Social Care and Health Scrutiny Committee, 19th May 2014 - Collaborative Planning Older People's Services
Lance Carver, Head of Adult Services
Suzanne Clifton, Operational Manager
Philip Evans, Director of Social Services