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ITEM EX11 - ANNEX 6

EXECUTIVE – 1 OCTOBER 2002

INTEGRATING COMMUNITY EQUIPMENT SERVICES

Draft For Consultation

Oxfordshire Social Services and Oxfordshire Health Trusts Action Plan for Integrating Community Equipment Services

1. Introduction
   
   

1.1. Background, and further information

This plan contains proposals for meeting the National Health Service Plan targets to integrate local community equipment services by April 2004 and to contribute to the national 50% increase in the number of people benefiting from the provision of equipment. The general context is set out in HSC 2001/008:LAC (2001) 13 and the Guide to Integrating Community Equipment Services, both published by the Department of Health in March 2001.

Judith Argles – Service Manager Specialist Services, Oxfordshire Social Services Department, Shotover Centre, Craufurd Road, Oxford, OX4 2RA

Mary Applegate – Head of Therapy Services, Oxfordshire Health Trust, Montgomery House Surgery, Piggy Lane, Bicester, Oxon, OX26 7HT

1.2.Summary of key local milestones in our plan to achieve the integration of the community equipment services

Objective	By end of	Action	Cost of implementation	Responsibility of
1) Establish eligibility criteria for services	October 2003	Draft eligibility criteria Consult with stakeholders	Cost neutral	Judith Argles (JA) Mary Applegate (MA) and user representation
2) Identify models of service and structure for Integrating Community Equipment Services and identify the potential impact on Occupational Therapy Services	October 2002	Draft models Discussion with Primary Care Trusts, Acute sector, Social Services, voluntary organisations, user organisations and other stakeholders	Cost neutral	JA and MA
3) Identify a centre for information, demonstration and purchase of non specialist equipment	April 2003	Consultation with providers of information and advice (voluntary organisations, providers) Agree framework for service and provider organisations Identify present services and gaps Identify schedule for implementation	£££	JA MA and provider organisations
4) Single Point of Contact	April 2003	Consider potential providers of single point of contact taking into account the potential configuration of services Identify provider and establish costs Identify schedule for implementation	£££	Working Group of users, stakeholders
5) Identification of funding streams	April 2003	Discussions with Department of Health, Primary Care Trusts, Acute sector, Social Services Secure new Department of Health funding If no additional funding secured decide on priorities for services within existing funding	Hypothecated recurrent additional sum £698,120 Health and £698,120 Social Services by 2004	JA MA
6) Pooling Budgets	April 2004	Discussions with Department of Health, Primary Care Trusts, Acute sector, Social Services about what will be pooled Decision about integrating this budget with an existing pooled one or a stand alone pool Lead Pool manager appointed	££	JA MA Diana Roberts (DR) Jill Brooks (JB) Martin Bradshaw (MB) Jonathan Coombes (JC)
7) Evaluation of action plan in light of vision and local and national developments	Sept 2002 April 2003 April 2004	Reference group and statutory organisations to ensure direction of travel is achieving objectives	Cost neutral	JA MA
8) Ensure views of users inform future service development	Post April 2004	Establish group to monitor quality of service User surveys Reference group to inform future developments	£	JA MA
9) Resolve issues of co-terminosity	April 2004	Input into existing work on this		MA JA DR

1.3. What will happen next

Draft action plan agreed by all stakeholders and published in October 2002

Reference group will continue to meet and implement actions and ensure the direction of travel is achieving the objective of integrating community equipment services. (National Standard Framework for Older People Standard 2)

1.4. Overview of steps taken to produce the plan and partners involved in planning to date:

• Social Services and Health Integrating Community Equipment Services leads – Judith Argles and Mary Applegate
• Equipment service managers and staff – DMEED, Huntleigh National Care, British Red Cross, Contract Monitoring Officer
• Chief Executives from 5 Primary Care Trusts - Mary Applegate on behalf of 5 Primary Care Trusts and acute sector
• Voluntary sector organisations - British Red Cross, Dialability, Oxfordshire Association for the Blind
• User groups - My Life My Choice, Oxfordshire Council of Disabled People, Oxfordshire Parents with Disabilities,
• Housing Departments - Anchor Staying Put, 5 District Councils

2. Local implementation issues and what we are going to do

2.1. Service issues

• Services cover Oxfordshire geographical area for Social Services and for Health the geographical areas included in Oxfordshire Primary Care Trusts. Currently these two are different.
• Equipment in the main is supplied by Social Services and Health via a contract with an independent supplier, Huntleigh National Care or from the DMEED facilitation service who also use Huntleigh National Care for some equipment.
• Short-term loan of equipment is supplied from British Red Cross, Nuffield Orthopaedic Centre, Michael Sobell House and specialist societies.
• Information is supplied via a service level agreement that Social Services and Health have with Dialability.
• The main gaps in current service provision have been identified as communication aids for children and adults, telecare equipment and some equipment in nursing homes which is currently unfunded.

2.2. Integration objectives

• To identify funding streams, new local investment and eventually pooling budgets
• To enable 50% more individuals of all ages and types of disability to benefit from equipment that helps them to be cared for or maintain their independence at home
• To resolve boundary issues (geographical and service-related)
• To have management arrangements in place by 2004
• To resolve assessment for equipment issues and agree common criteria across services
• To identify shortcomings in provision systems, including, for example, equipment tracking, adverse incident reporting, and staffing levels to enable timely and appropriate assessments
• To identify referral routes and choices for provision
• To involve users in planning, and ongoing service monitoring
• To aim for continuous service improvement mechanisms.
• To develop a Centre for Independent Living or equivalent facility

2

	Area of need identified	How identified	Objectives to meet this need	To achieve by end of	Who is responsible
1	Equipment display area – several options without a clear route through the system (including private purchase)	Baseline audit	Clear route through system with single point of contact for equipment	April 2003	JA/MA
2	Inadequate provision for people to choose equipment for themselves	Baseline audit	Voucher scheme and private purchase	April 2004	JA/MA
3	Repeat assessments carried out by professionals with different organisations	Baseline audit and staff information	Pooled budget and staff training	April 2004	JA/MA
4	Inadequate access to equipment at the time of need	Baseline audit	Single point of contact and clearer route through the system	April 2003	JA/MA
5	Inadequate review of major items of equipment once provided	Baseline audit	Establish review system with equipment provider	September 2003	JA/MA
6	Inadequate display area for children’s equipment	Baseline audit	Establishment of single point of contact and demonstration area	September 2003	JA/MA with reference group
7	Inadequate access to communication equipment at the time of need	Baseline audit	Identification of additional funding for this area	April 2004	MA/JA
8	Delay in fitting or adapting communication equipment once provided	Baseline audit	Fitting and adaptation of equipment to be carried out within one week of delivery	April 2004	JA/MA with Liz Shaw
9	Inadequate provision for specialist assessment and then provision of equipment	Baseline audit	Identification of specialist referral route and identification of funding (see 1)	April 2003	Liz Shaw
10	Waiting list for assessments	Baseline audit	Clear and easily available eligibility criteria and provision of information in a variety of formats	April 2004	JA/MA

2.3. Summary of the implications of potential constraints

• If insufficient new funding is identified in the first few years: The plans will need to be reviewed and revised. with an emphasis on elements that can be achieved by remodelling services using existing resources and establishing priorities for the service
• If insufficient numbers of therapists are recruited and if inadequate resources are available to fund them, to increase substantially the rate of assessments: We will work closely with local disability and independent sector organisations to increase opportunities for people to self-select equipment, and to capture this information on our information systems. We will also reconsider skill-mix issues regarding who can be trained to assess for which types of equipment. Doing so may delay the timescale for achieving a substantial increase in the number of new people able to receive community equipment.
• Primary Health Trusts, Acute sector, Housing, Social Services not working in partnership to integrate community equipment services

 3. Key milestones in our plan to achieve integration of the services

By end of	Task	Responsibility of	Additional resource implications
October 2002	Draft eligibility criteria	Judith Argles Mary Applegate and user representation	Cost neutral
April 2003	Consult with stakeholders

By end of	Task	Responsibility of	Additional resource implications
April 2003	Consultation with providers of information and advice (voluntary organisations, providers)	Judith Argles Mary Applegate and provider organisations	£££
October 2003	Agree framework for service and provider organisations
April 2004	Service Operational

By end of	Task	Responsibility of	Additional resource implications
October 2002	Consider potential providers of single point of contact taking into account the potential configuration of services	Working Group of users, Stakeholders	£££
April 2003	Identify provider and establish costs
October 2003	Commence Implementation

By end of	Task	Responsibility of	Additional resource implications
December 2002	Discussions with Department of Health, Primary Care Trusts, Acute Sector, Social Services	Judith Argles Mary Applegate	Hypothecated recurrent additional sum £698,120 Health and £698,120 Social Services by 2004
April 2003	Secure new Department of Health funding

By end of	Task	Responsibility of	Additional resource implications
March 2003	Discussions with Department of Health, Primary Care Trusts, Acute sector, Social Services	Judith Argles, Mary Applegate, Diana Roberts, Jill Brooks, Martin Bradshaw	££
March 2003	Decision about integrating this budget with an existing pooled one or stand alone pool
April 2004	Lead Pool manager appointed

By end of	Task	Responsibility of	Additional resource implications
April 2003	Reference group and statutory organisations to ensure direction of travel is achieving objectives	Judith Argles Mary Applegate	Cost neutral

By end of	Task	Responsibility of	Additional resource implications
April 2003	Establish group to monitor quality of service	Judith Argles Mary Applegate	£
April 2004	User surveys
April 2004	Reference group to inform future developments

By end of	Task	Responsibility of	Additional resource implications
April 2004	Input into existing work on this	Judith Argles Mary Applegate Diana Roberts

By end of	Task	Responsibility of	Additional resource implications
October 2002	Draft Models	Judith Argles Mary Applegate	Cost neutral
April 2003	Discussion with Primary Care Trusts, Acute sector, Social Services, voluntary organisations, user organisations and other stakeholders

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