Continuing Healthcare

November 12, 2021

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Reflection on ‘Continuing Healthcare within Integrated Care Systems’

Seb Stewart, Commercial Director, CHS Healthcare

On 5 November, we held the second installation in our monthly CHC webinar series, ‘Continuing Healthcare within Integrated Care Systems’, I was pleased to be joined by both Stephen Chandler (Director for Adult Social Care, Oxfordshire County Council) and Paul Allerston (Partner and Solicitor Advocate, Hill Dickinson’s Manchester Health Advisory).

It was good to have over 170 people working in CHC across the NHS and local authorities join the interactive discussion.

Following are some of my observations and reflections on the discussion – you can watch the full webinar here:

And if you’d like to get in touch to discuss any of the issues and topics we covered please drop me a line:

What are the burning issues facing CHC teams?

Having a strong management and CHC delivery in place has always been a priority for organisations. But with plans to put ICSs onto statutory footing by April 2022, it’s critical that organisations are preparing for the shift now and feel comfortable by the time ICSs come into play.

Key findings from our pre-webinar survey showed:

  • 49% of registrants identified ‘workforce capacity’ as the most pressing challenge facing their organisation as it moves to ICS.
  • 76% said that ‘additional workforce capacity for reviews and assessments’ should be the main priority and would help them and their team in the shift to ICSs.

What does this look like in practical terms? ICSs provide an opportunity to look across social care and the NHS workforce. It was interesting to hear how Oxfordshire and Berkshire ICS are looking at importance of both nurse recruitment and retention. They see the move to ICSs as a means to ensuring that the expertise that exists within CHC teams are not lost but rather they are enhanced, and that the roles of those professionals and teams is recognised and valued.

Inter-agency collaboration a vehicle to reduce disputes

Another pressing issue is how inter-agency collaboration might work in the world of CHC as ICSs become fully functional.

  • 81% of people who answered our survey said that ‘advice and support on integrating systems and databases’ would support them and their team in the shift to the ICS
  • 41% saying that ‘compatibility of existing databases and systems’ would be the biggest challenge for CHC moving forward.

Beyond the practical issues of integration inter-agency collaboration should be strengthened by the ICS model which will provide systems, boards and committees with the opportunity to regularly review and address difficult issues together – the system wide approach giving additional clarity.

In practical terms complex cases where eligibility is considered over time, stand to be handled and improved through the collaboration between the ICS and placed based partners ultimately reducing disputes.

As the focus on ICSs intensifies there has been a lot of talk about leadership. We discussed the expectation on new ICS leaders to bring the NHS and local government together to create a permissive working relationship and how that has to be fueled by relentless collaboration and positivity.

Preparing for implementation

51% of people in our survey identified workforce skills as the second most pressing challenge for CHC in the shift towards ICSs.

The key take out from our panel was that continual workforce education is critical. This means policy reviews such as LPS, as well as strategic level policy and case-law guidance are embedded in ongoing work supporting consistency as well as building confidence in those people working in CHC. ICSs also provide an excellent platform for the centralised commissioning of training.

Budget setting

We know how important an issue CHC budgets are for many ICSs as they set up. The structure and scale of ICSs can provide opportunity for better budget setting and management. Detailed analysis of current level of need, current level of earned expenditure and ensuring an optimal usage of population health predicters will support robust budget setting.

Another key point about the move to ICSs is that CHC budgets can’t be considered in isolation and but must be seen in context of other budgets that support both older people and those with complex physical health needs. The scale of the ICS model can enable visibility of other initiatives and spending related to older people and care which – alongside CHC – improves the experience of patients and the people looking after them.

Next up in our series of webinars is a discussion about personal healthcare budgets – invites will be going out shortly and we look forward to you joining us.

CHS Healthcare has been supporting CCGs with Continuing Healthcare nationally since 2013 and are well-placed to support CCGs and local authorities to tackle their current and ongoing priorities. For more information, contact to discuss your needs.

You can access a recording of the webinar here:

As originally seen on LinkedIn

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