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Sue Wilks, DAAT Manager

Sue Wilks, DAAT Manager. Drug System Change Pilot Commissioning for Substance Misuse in a Personalised Way. Personalisation & Self Directed Support - Background. The Concept personalised care in a self directed way using individual budgets via direct payments……….

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Sue Wilks, DAAT Manager

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  1. Sue Wilks, DAAT Manager Drug System Change Pilot Commissioning for Substance Misuse in a Personalised Way

  2. Personalisation & Self Directed Support - Background The Concept • personalised care in a • self directed way using • individual budgets via • direct payments………

  3. Personalisation & Self Directed Support Challenges • perceptions - giving drug users money • changing the way services are secured • changes needed by everyone – staff, service users, commissioners, providers • balancing choice, risk, clinical safety and flexibility • market and broker development

  4. Personalisation & Self Directed Support The Basics We are not offering choice and control : • in specialist prescribing • medical detox • drug of choice

  5. Personalisation & Self Directed Support We have: A set of very basic and simple tools developed, • Self Assessment Questionnaire (and Resource allocation) • Banding levels A – E, reflecting basic Tiers and services currently available • Personal support plan • Delay inputting of the resource until identified support to meet need from ALL resources

  6. Key points to cover • some notes to consider • current picture • desired picture • changing the approach • keeping a foundation • the reality

  7. Some notes to consider :- Where are we ? • We already provide some interventions in a semi personalised way .e.g. spot purchases, small flexible funding allocations • Treatment system is covered by several funding streams – PCT, LA, DAAT. Range of leaders needed to be involved • There are many steps and barriers to reaching our aspirations of social enterprises, buyer groups

  8. Consider :- Commissioning……. • how to change without destabilising the systems • joint commissioning outside of substance misuse

  9. Current Picture

  10. Desired Picture

  11. Changing the approach • Through new contracts and building in flexibility • Release funds from block contracts • Translate block contracts into individual budgets

  12. Changing the contracts 2 options suggested, through : • gradual reduction in contract value, releasing funding into new areas of service growth – commissioner to develop the flexibility • provider sub contracting and developing flexible markets within their contracts – provider to develop the flexibility

  13. Changing the contract Flexible markets and services Percentage sub contracted or distributed via self directed support Commission full service at outset ↑ ↑ ↑ Start of contract2.5 years 5 years Small amount of core commissioned services

  14. Changing the approach Release funds from block contracts • Structured day • Psychosocial services • Residential rehab Translate block contracts into individual budgets • Create unit price • Work with individuals to tailor their package linked to current provider

  15. Keeping a foundation • At the point of contact – few clients want to start taking control at this point, they want support, advice, and help to deal with presenting need • Not always able to take control and make choices at key points • Opportunities can be increased using anticipatory care planning.

  16. Keeping a foundation Core Commissioned service. . Flexible Markets – SDS options Wider reintegration & recovery community based services Limited SDS Choice and control Well being, recovery and reintegration Engagement developed

  17. The Reality To date the pilot has seen: • a few work through the full process / low allocations • a focus on structure - college and / or training – yet to translate into actual take up on courses • request to use resources for rent / accommodation – areas already known to be areas of unmet need in the sector. • a few disengage from the scheme. • low take up • concerns this is another tool in addition to others (CAT, ITEP, PSP) - need to streamline

  18. The Reality Next steps: • Now increasing practitioner engagement to enable more clients to engage with the pilot as numbers remain low. • Providers are considering how to respond and engage with the changes, but as yet little demand from client group. • Positive interest from service user groups – social enterprise and buyer groups

  19. Barriers & Constraints Need for hearts and minds to move – not just structural Using evidence based and registered services Commissioning boundaries – supporting people, criminal justice Maintaining and engaging small providers to retain the flexibilities they offer Existing commissioned services and contracts Transitional period for all areas of the system – clients, practitioners, providers, commissioners The Reality

  20. Thank you for your interest Sue Wilks sue.wilks@hants.gov.uk

  21. For further information : Please Contact : Jessica Berry Self Directed Support Project Manager jessicaberry@nhs.net Mob:  0776 0992311 Fax:  01256 818270

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