Care Closer to Home Services for North East Essex Clinical Commissioning Group.

Descriptions

North East Essex CCG is responsible for commissioning the majority of health services for the people who live in the areas covered by Colchester Borough Council and Tendring District Council. This includes acute care, community care, mental health, and learning disability services. The CCG, together with Essex County Council, have a shared vision for the health and well-being of people in North East Essex ‘Embracing better health and well-being for all’. Even though the CCG will focus on priority and high risk groups within North East Essex, it is intended that everybody should be able to expect an improved level of health and well-being from the services we commission. This vision will be delivered by ‘Empowering people to stay fit and healthy, providing safe, responsive compassionate care when they need it’. This CCG's vision is underpinned by the following outcomes: — Putting people at the centre of their care; — Involving people in planning and developing services; — Ensuring that services are centred around the patient, are high quality, evidence-based, cost-effective, and sustainable; — Ensuring people receive seamless services across their health and care needs; — Ensuring carers receive the support they need Against this backdrop the CCG, in conjunction with its partner Essex County Council, is seeking to transform the way in which community based health and social care services are delivered across North East Essex over the next 7 years. This will lead to services which are more integrated, person centred, and are supported by appropriate care planning based on individual needs. Services will focus more on helping people to achieve the outcomes that are most important for them. This will help to ensure that they stay independent for as long as possible, enabling them to manage long term conditions and supporting them to recover quickly and regain independence following accidents or episodes of ill health. Care Closer to Home will form a key part of this strategy, and will support the CCG to deliver its long term vision ‘Empowering people to stay fit and healthy, and providing safe, responsive compassionate care when they need it’. In order to achieve the required step change in the way in which services are delivered, the CCG sought to procure a single ‘Lead Provider’ who will be accountable for the provision of all services within the scope of Care Closer to Home. This could either be achieved via a Prime Contractor or Integrator model, and the CCG was open to bids of both forms. In the case of a Prime Contractor, the Lead Provider would be expected to deliver a significant amount of the services directly, and sub-contract some element to others. In the case of an Integrator, the Lead Provider would manage the contract and associated back office functions, but subcontract the delivery of clinical services to other providers. In either instance, the CCG was explicit that the Lead Provider will remain accountable for the provision of all services within the bundle, including both direct provision of services and provision by partners and or sub-contractors. The CCG does not however envisage that a single organisation would be able to deliver all services within the scope of Care Closer to Home by itself, and expected bidders to demonstrate they have sufficient supply chains and partnership arrangements in place to deliver an integrated end to end service. In order to encourage innovation and transformational ways of working, bidders were asked throughout the procurement process to demonstrate how they will deliver services in a way which meets the CCG's desired outcomes for Care Closer to Home, rather than be provided with detailed service specifications. These outcomes are summarised below and set out in further detail in the Outcomes Framework: 1. People with long-term conditions, and their carers, are supported to be independent in their own homes and avoid hospital admissions; through effective, personalised and integrated community based services. This means that people can be confident that: ‘I know that my health needs won't mean I can't stay living in my own home for as long as I am able to.’ ‘I am confident that the support I need to be independent is there’;2. People make a good recovery from episodes of ill health or following injury. This means that people can be confident that: ‘I will recover quickly from my illness and can get back to doing all the things I enjoy’;3. People are enabled to live healthy lifestyles and are empowered to live independently and to take control of their health and social care needs during periods of ill health. This means that people can be confident that: ‘I know how to look after my health, and where to seek help locally if I need it’. The same outcomes framework will subsequently be used to incentivise the successful Provider to improve the outcomes of individual service users. Bidders were required to demonstrate how they will work within the CCG's Core Working Principles, which set out its minimum expectations around the provider's approach to service user care; empowerment; and ways of working within the wider health and social care system Scope of Services. The scope of Care Closer to Home encompasses a range of health and social care services which enable residents of NEE to receive treatment, care, and support in their community closer to their homes rather than in an acute setting where ever it is possible. Whilst its focus is on the older population, many of whom have multiple long term conditions, it will also provide services to those who have emerging needs in these areas. This may include Children and Young Adults in certain specialities. Who will access the service? Care Closer to Home will support people registered with NE Essex GPs who have care needs requiring support over and above that offered by primary care, but not needing emergency or complex acute care. The CCG has commissioned a risk stratification tool that allows pro-active identification of individuals at risk of hospitalisation within the next 2 years. It is expected that this approach will be used to pro-actively identify people who would benefit from integrated care assessments and care planning. Critical Success Factors (CSFs) the CCG requires the Provider to meet throughout the life of the Contract include: — An alignment to the CCG's strategic commissioning objectives; — Keeping patients well and preventing them from needing interventions in formal care settings; — Simplifying the care system for service users, cares and staff, and improving the experience by delivering seamless and integrated care; — Ensuring that all services users have a care or support plan in place; — Integrating Care Closer to Home services within the wider health and social care system; — Shifting planned care from acute hospitals to community settings where it is safe to do so, thus ensuring that people are treated in the right place, at the right time, and also reducing costly activity unnecessarily taking place in the acute sector; — Reducing unplanned hospital admissions/re-admissions and A&E Attendances; — Delivering social value across North East Essex, and therefore ensuring that scarce resources are allocated and used is a way which is most beneficial to the local community. This will include ensuing that local and voluntary sector organisations play a key role in delivering services in the future and the power of volunteers is harnessed; — Ensuring a smooth and well planned transition; service users will have concerns about care continuity that must be central to this process. The CCG and the successful Provider will work together effectively to identify and minimise risks associated with service transition and mobilisation.