1. Outcome Based Commissioning The Chester-le-Street Experience: The First Year Anne Lowery Pauline Temple

2. Durham County • Durham County • Rural county – 12 major centres, > 300 small towns / villages • Population 499,800 • age profile changing - v young people - ^ older people • 2001 census BME population 1% - Irish, Indian and Chinese people • Ranges of affluence and deprivation across the county • Recently merged from 5 PCTs to 1 PCT • Durham County Council – Management Restructure • Currently 8 principle authorities set to become a Unitary Authority • Chester le Street • Largely rural smaller major centre • Population 53,694 – 8,300 older people 65 years of age and over • Newly Integrated Team

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4. The Early Months • Support for the Pilot • Doing the leg work! • The reading • Visiting Hartlepool • Looking at what has gone before • Identifying a willing Team! • Chester-le-Street Integrated Team

5. In Spring • Setting up the System to get going • Steering Group: Social Workers, Manager, Service Users, Finance, IT • Clarified the aims of the pilot • Consultation • Internal: Executive Management Team, User Carer Forum, Good Practice Forums, Older People’s Modernisation Board, Intermediate Care • External: Domiciliary Providers, Age Concern • Chester le Street Preferred Providers • Invited to: • a half day event • make an expression of interest • Submit method statements • Preferred Providers appointed via a formal evaluation

6. The Summer • Pilot Design Group • Social Workers, Service Users, Providers, Manager, Domiciliary Providers • Model agreed and dates set for training and pilot • Leaflet Design • Evaluation subgroup • Research Governance Approval • Survey questionnaires, Staff, Service Users, Providers • Team Preparation • Meeting with the Team • Shadowing Team • Finance subgroup • Flexibility for Providers • Pilot structures around hours not money • Weekdays and weekend differentiated on care plan • Social activities to be funded by service user • How to record payments

7. Into the Autumn • Developing the Training • Training Pack • Presentation based on SPRU and White Paper Our Care Our Health Our Say • Article ‘Our Flexile Friend’ Charles Patmore • Role Play and Case Studies • Practice writing outcomes – current care plans - new Action Plans • Delivering the Training……. • The Pilot Commenced……… • Communication Forums • Joined up forum to discuss progress, problem solve and improve working relationships

8. The Picture So Far…… • Reduced number of referrals into the Team • Long Term Conditions management • Intermediate Care • Redirected to other agencies, Age Concern, Home Independence • FACs Critical and Substantial • Slow start • Time to support change • Review of Target Group • 20 Service Users in the Pilot • Mainly maintenance outcomes

9. Next Steps • Evaluation Process • Full report • Has OCBC provided a better service? • What do Service Users and Carers feel about it? • What do Staff and Providers think about working this way? • June 2007 feedback to Management Teams and Older People Modernisation Board • Direction on way forward across the county • Training Plan – Roll out September / October