First Train to Liverpool

Ely Station with no a single other person about!

Ely Station 5:25am with not a single other person about!

A couple of Wednesdays ago I left home at an unnatural hour and caught the first train of the day from Ely Station at 5:30am to get to Liverpool in time for the annual TLAP Conference at Aintree Racecourse. I had intended to travel the day before but could not due to a Lakenheath Parish Council meeting I wanted to attend and I spoke about in my one of my last blogs.

Having got to Liverpool just in time to hear the conference opening words from Clenton Farquharson MBE who is Chairman of Healthwatch Birmingham and Co-Chairman of the National Co-Production Advisory Group and Sam Bennett who is the Chief Executive of the National TLAP programme, both of whom I sit on the National TLAP Board with, after which I settled down for the rest of the morning to hear the words of speakers at this important conference. TLAP stands for Think Local Act Personal, a nation programme board with many partner organisation promoting the personalisation of our Care Services and if you been kind enough to read this blog, you will know I sit on its Board representing the Local Government Association.

After lunch I co-chaired a workshop session called ‘Building strong inclusive communities. A Framework for Health and Wellbeing Boards’ where we talked about the new Framework for Building Community Capacity and how different Health and Wellbeing Boards are rising to the challenge it provides to put building the capacity of their communities at the heart of their thinking.

In the last Plenary of the day I took to the stage alongside. David Pearson, President of ADASS, Alex Fox of Shared Lives Plus, both of whom are fellow TLAP Board Members alongside Kathy Roberts from the Mental Health Providers Forum and Sherone Philips of the Nation Co-Production Advisory Group. The session was chaired by Richard Humphries of the Kings Fund who is one of this country’s leading thinkers on Health and Social Care. I was asked to speak briefly about the LGA First 100 days (of a new Government from May 2015) and what the LGA is asking for in respect of Adult Social Care and on behalf of Health and Wellbeing Boards across the Country. For the end of a long day it was heartening to see so many people remain for what was a very interesting Q&A session exploring the future of Social Care in a changing environment, relationships with Health and the cuts agenda that will be around for many years to come. Then it was back to the trains and the long day ended at 11:15 as I arrived home.

Policy to Reality

On Monday I blogged about my Mum’s passing and how ‘far too close to home’, I saw the system of health and social care, policy, commissioning and providers work, in our case, rather well. But as the various systems kicked in I thought to myself you know what, this is precisely why we must get the policies, funding and the way we set up the system, right. This stuff does actually matter for those vital moments in our lives when we need the system to take good care of us.

Last Wednesday I attended the Local Government Association’s Community Wellbeing Board meeting in London and in amongst a packed agenda was a discussion on Better Health and Social Care integration. One of those think tank pieces put together before the next parliament to give the Westminster politicians food for thought as the return after the general election, about the policies they need to enact to hopefully improve the system rather than hinder it.

Geoff Alltimes and Richard Humphries from the King’s fund were in attendance to discuss with us the Barker Report, as it will be known after Kate Barker who is heading it up, as they go about the evidence gathering stage. Here is a link to a short video explaining the commission and its remit http://www.kingsfund.org.uk/audio-video/kate-barker-commission-future-health-and-social-care-England

The report certainly pitches a wide variety of ideas about the future funding of the NHS and what is the role of social care in amongst its mix. Amongst them is such headline grabbers as charging to see your GP or attend A&E alongside the less sensational but more fundamental about the notion of a free NHS and how it sits so uncomfortably with the financial assessment and charging for Social Care. It was quite bizarre as the NHS element of Mums’ care was delivered and you could ‘watch before your very eyes’ the money being spent and yet when it came time for a small element of social care to be planned, out came the forms for this assessment and who is going to pay and the charging mechanism. This is not a criticism of those who very involved as they handled it very well but for such a small element of Mum’s care suddenly the system changed and it was jarring.

At the Board meeting we also discussed the governance and accountability of the NHS and I made the point hat there are so many, many structures in the NHS with vast armies of friends, governors and structures to delivery such things that in reality does it really work or it just a maze where no one, including those who designed it, quite knows who is responsible for what and when it goes wrong across an array of services, well!!. Because in my experience whenever you ask a question of any aspect of the NHS someone seems to point at someone else, just look at the Francis report on ‘Mid Staffs’ Hospital.

In an earlier blog I explored this with new Directors of Adult Social Services, how in local government, Councillors are the first point of call for residents because they elect them. The line to Directors to respond, is one email not a vast system of accountability. In making my point I was stressing to both Geoff Alltimes and Richard Humphries how I saw the future of an NHS delivering services but local government being far more involved with elected representatives being the key local way in which the NHS is provided with accountability and governance. It will be interesting to see their final report and I’ll blog it when it’s published in the autumn.

Health and Well Being Boards Tool Kit

One of the most interesting thinks I am involved in at the moment is the thinking behind the Health and Well Being Boards.

I am a part of the NHS National Learning Set work and sit in the Collaborative  Leadership work stream and we regularly come together to work on what in the NHS are called products which in the Local Government world are simply called papers and tools.

Whilst there is a great deal of controversy about the various aspects of the Health reforms; the one element that has not has a word of criticism is the Boards as I think everyone agrees they are going to be extremely important in the way in which the health and social care system improves.

As we roll out the work that will take us the better part of a year’s worth of meetings, virtual meetings and a number of workshop days I will post these on my blog for anyone interesting to go and have a read.

Yesterday I was invited to The King’s Fund, to take place in a slightly different day as the LGA and NHS do a body of co-creational round ‘Designing a Development tool for Health and Well Being Boards’.

The day was opened by John Wilderspin who effectively leads for the Department of Health on this important subject and during the course of the day we heard from a wide range of professional setting up Boards and from great thinkers such as Richard Humphries from The Kings Fund who speaks with great wisdom on how we move things forward. For my part I was one of only two Councillors there and it was a privilege to feed in some of the thinking on the Local Government side of things from a Councillor prospective.

At times this whole agenda seems a bit like the Hadron Collider in the two worlds are most definitely colliding and the learning about the other is quite fascinating. Essential I think it’s fair to say we all think that something amazing might just come of it but are not absolutely sure what yet.

 

There is no doubt that in social care we need to need to do things differently and that’s why I presented a new vision and strategy to the Cabinet in Suffolk in February and a big part of this is how we work better with Health colleagues and design a system for the journey the journey all of us will go on at some point in our lives as we need help for our Doctors, Consultants, Community Nurses and social care providers.

To be in at the very start of the journey is quite something and I hope my tiny contribution to the learning and shaping is of some benefit.

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