Will community services be subject to a procurement exercise?

The market testing strategy for community services is yet to be defined and will be dependent on the findings of engagement with stakeholders.  Further details of our approach will be made available in Winter 2015.

How will services continue to be delivered with less money available?

Working with restricted budgets is a challenge for the whole health and social care sector. The Council and the CCG have a good track record of delivering cost efficiencies and more effective working. If we maintain a focus on quality then cost benefits often come out of this. Your care, your way is a genuine opportunity for collaborative working which will help us to do more with less money available.

What is the role of the voluntary sector in community services?

The role of the voluntary sector is pivotal in community services. We are keen to build strong and resilient communities despite the current challenge of austerity. We will need to assess and understand the strengths and weaknesses that voluntary sector organisations can bring.

What do you mean by the term re-ablement?

Re-ablement services involve relatively short term intensive periods of support (e.g. therapy services) including a package of care in a person’s home (e.g. involving social work). Reablement refers to a range of services provided in an intensive way to people following a crisis such as ill health, to get back on their feet in their own home or to get them back home from hospital. Reablement services could be provided following problems with physical or mental health or following bereavement. It is about providing support to help people return to their life before a crisis. We are seeing good outcomes from reablement services at the moment and it can reduce the need for ongoing care.

When will we know what is happening about the future of community services?

We are only at the very beginning of a full review. It will take time to do this in a measured way but we expect the new service to be in operation from 1 April 2017.  A full break down of each phase of the process and estimated timescales are contained within our Overview Document.

What is the agenda for integrating community services?

Our early engagement suggests that people and professionals want seamless, integrated services.  This requires a review of the existing model of care in terms of data interoperability, points of access and integrated pathways.  We will be working closely with stakeholders over coming months to further shape our commissioning strategy in this area. 

We need parity in terms of offering the best possible services for people with learning disabilities

B&NES is one of very few areas in the country practicing joint commissioning between the Council and the CCG. The needs of people with learning disabilities is high on the agenda for both the CCG and the Council and we work closely together to deliver integrated services.

Does this review take into account neighbouring CCGs?

This review is about B&NES. Some of our neighbouring CCGs are working to different timescales but we recognise there are some shared boundary issues. We will not be directly impacted but will be alerted to any relevant changes. We will need to make sense of services with shared interests (e.g. RUH) and ensure these services meet our demands.

What about the quality of access for someone in the centre of Bath compared to someone living in Nempnett Thrubwell?

We are committed to delivering good health and wellbeing across the B&NES area but geography will play a part. Some rural locations make delivery more difficult but one of the reasons for the your care, your way review is to highlight issues and provide solutions and answers. Hearing from all local communities will be a key part of our engagement.

Are you ready to embrace a holistic resource model i.e. meeting needs of body, mind, spirit and environment?

There is some danger of getting stuck in thinking about medical models. We recognise that health and wellbeing can be attributed to lots of things and we still have a long way to go to understand this fully. However, commissioning decisions must be evidence based and use money wisely and effectively. We recognise the value of holistic care and that patients have multiple layers of issues. We have recently started social prescribing services locally which brings a wide range of opportunities but we need to be bold and explore this area further. We need imaginative and different solutions but they must be evidence based.

What are your views on addressing the parity of esteem agenda in community services?

Parity of esteem is integral to Your Care, Your Way. However, this is not straightforward and we must not stay in health silos. We need to look at care in the round. e.g. work in schools has looked at attainment in lower income pupils. The CCG's 5 Year Strategy focusses particularly on preventative services around lifestyle issues e.g. obesity, alcohol consumption and national focus is now on preventative measures too. We mustn't see community services in isolation and at this stage we don't want to commit to what is in or out of scope. Your Care, Your Way will also link to the broader role of the Health & Wellbeing Board whose remit covers areas such as planning locations of leisure services to encourage people to keep fit.

Will prevention be part of your care, your way?

Yes, this is very much at the front and centre of the review. We are already committed to prevention and this is demonstrated in the your care, your way Overview document. We have a strong history and emphasis on early intervention in B&NES which includes public health work in the community.

What role is there for pharmacists?

Pharmacists play a pivotal role in the community and are often the first point of contact for people including in terms of prevention. Technically, as they are part of primary care they are not part of the review process but we will take intelligence and feedback and make use of their services.

How do you see technology helping to deliver integrated services for both providers and service users and how much of this technology is in place to enable choice and control?

There are some areas where we have been using technology already e.g. to join up care data between providers but we agree there is a lot more to do. We will be looking carefully at technology options throughout the review.

You are asking us to be bold, ambitious and imaginative but to what extent will external providers be supported? For example, local providers with innovative ideas are often overlooked with contracts given to national providers offering cheaper option.

We want to ensure there is proper engagement with providers and to encourage them to be bold, ambitious and imaginative. If local providers are offering real innovation then why wouldn’t we want to use them? When encouraging views we will have to prioritise ideas and resources. Price isn’t necessarily the key driver but we do have to go through an appropriate procurement process. There is definitely scope for new ideas.

Have you thought about modelling and predicting need to evidence service design via joining up data?

The CCG and Council are currently scoping the detailed needs assessment work and part of this workstream supported by Bath University will be reviewing methods and available data sets in order to support demand and capacity modelling to support evidenced based commissioning.

Are we are a long way off talking about how tech can deliver this integrated health & social care service?

We will be looking carefully at technology options throughout the review and are planning to hold a focus group/workshop event soon with all the providers who have approached us about this and we will use this to identify next steps.  

What is the role of the arts in this process?

Commissioners in BaNES have well established links within the arts community particularly around areas such as mental health and fully understand how the process of creativity can enhance a person’s general wellbeing. We have recently started social prescribing services locally which brings a wide range of opportunities but we need to be bold and explore this area further.  We need imaginative and different solutions but they must be evidence based and cost effective.