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CCG Series: Pioneer CCG on the future of joint commissioning


7 January 2014

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South Worcestershire CCG is one of the government's 14 integrated care pioneers. The CCG's chief clinical officer, Dr Carl Ellson, explains the progress his organisation has made
We’re seeing more and more patients with complex health care needs and all too often, patients experience health and social care services that are fragmented, difficult to access and not based around their and their carers' needs. This is just as much of a problem between different NHS services as it is between NHS and social care services.

South Worcestershire CCG is one of the government's 14 integrated care pioneers. The CCG's chief clinical officer, Dr Carl Ellson, explains the progress his organisation has made
We’re seeing more and more patients with complex health care needs and all too often, patients experience health and social care services that are fragmented, difficult to access and not based around their and their carers' needs. This is just as much of a problem between different NHS services as it is between NHS and social care services.
Since the publication of the ‘NHS Future Forum Report’, the government has put integrated care at the heart of its vision for England’s health system. It sets out this vision and the need to deliver more specialised care in ‘Integrated Care: Our Shared Commitment’, a national report published in May 2013. 
To facilitate this, £3.8 billion of government funding has been transferred from health to a locally pooled budget for health and social care to work together in improving the lives of our most vulnerable patients. It’s important to remember that the Better Care Fund (BCF – previously known as the Integration Transformation Fund) is not new money – the £ 3.8 billion pool merely brings together NHS and local authority resources that are already committed to existing core activity. 
The BCF does offer a major opportunity to drive forward integrated care.  At a time when the NHS is facing growing demands from an ageing population, it is self-evident that clinicians and organisations should work together to meet the needs of service users and ensure that the right care is provided in the right place at the right time.
In Worcestershire, where we already have a good track record of joint commissioning, work to integrate services has already started. We’ve been working together with neighbouring CCGs and the local authority through our Health and Wellbeing Board, to develop a shared approach to delivering more integrated services. The Well Connected programme brings together a variety of projects within one organisational structure and has recently been selected by the Department of Health as one of the 14 sites across England to be ‘pioneers’ for integrated care. Early successes include, by the end of this financial year, all Worcestershire primary care practices sharing the same IT platform. One of our current challenges is to decide which client group we wish the Well Connected programme to focus on and how much to invest via the BCF. Our early thoughts are that we should target the over 65’s and those living with long term health conditions as research tells us that a significant number of these  group could avoid admission to hospital and could be better cared for in the community if we work together. 
We need to identify all those who are involved in commissioning services to those groups, thinking beyond just health and the local authority, by including other agencies such as the housing and voluntary sector organisations.  The ramifications for providers could be very significant – which means their engagement in the process is essential. All providers of services to these groups need to be identified and again encouraged to work differently, in a more integrated way. 
The BCF for me is the foundation of a genuinely integrated system and something I feel is such an obvious way forward as many other clinicians have also been saying for a long time. Being a pioneer site we have the opportunity to deliver our ambitious plans to improve, integrate and personalise both health and social care. We can now take the current rules and where they appear to get in the way of progress, influence policy makers to help ensure that every resident in Worcestershire is living longer and living well.

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