Reablement – Contract Monitoring QIPP
The Journey –
The Somerset Clinical Commissioning Group (SCCG) led the review and redesign of reablement services over the last two years to help improve outcomes for patients. We worked with local authority colleagues to lead a joint programme to review existing services and implement a redesigned service model based on systems thinking methodology. We also worked with a range of stakeholders from the NHS, adult social care providers, and independent and voluntary sector organisations. The programme has been discussed and supported by the Somerset Health and Wellbeing Board.
Compass Disability was commissioned to bring together focus groups and develop a questionnaire giving people the opportunity to feedback their experiences of reablement services. We held extensive stakeholder events with representatives from NHS, adult social care providers, independent and voluntary sector organisations and undertook a ‘deep dive’ exercise to understand what was happening in existing systems.
A pilot integrating health and social care teams at one GP surgery has been in place for 18 months. It has been rolled out to 15 practices in the Taunton and Area GP Federation with plans to phase in the service across the whole of Somerset.
A clear message from the service users was: “I want to maintain my independence: help me to find the solutions to do the things that matter to me”. The key difference with this model is that we are asking patients what they feel is important to them and what goals they want to achieve. The teams have flexibility to find solutions centred on these goals. This is a fundamental shift from the ‘one size fits all’ approach often seen in existing services.
Outcomes
Improved patient experience and quality of life as care delivered in a more appropriate setting; 1{79f878acaa41f375dcd804cc8c058b5459a5482f20a3b9f87269b26c8734749b} reduction in emergency admissions 7{79f878acaa41f375dcd804cc8c058b5459a5482f20a3b9f87269b26c8734749b} reduction in readmissions
Annual value of savings made
2012/13 £311,000 (Gross) Recurrent
2013/14 £1,659,000 (Gross) Recurrent
Patient setting
| In-patient X | Out-patient | Community base X |
| Mental health | Chronic illness | Cross-systems X |
Clinical area
| Staying healthy | Maternity/Newborn | Children and young people | Acute care X |
| Planned care | Mental health | Long-term conditions X | End of life |
Information, tools and techniques used
Project Management Board jointly with Local Authority with Project Manager
Geography
County wide Somerset
Project being rolled out Somerset wide. Population 550,000
Timescale
2008 and ongoing
April 2012 to March 2013
Contact details and further information
Ann Anderson
Director for Clinical Commissioning Development
Ann.anderson@somersetccg.nhs.uk
01935 384190