Alliance partners develop a programme to improve care pathways by integrating health and social care systems, providing the best quality care to people and improving their health outcomes

Challenges

 In August 2014, after years of pressure on services locally, we launched our ESBT programme to galvanise the transformation of health and social care services. ESBT is a partnership between two local CCGs, the acute trust and county council. Our aim is to integrate our whole system – primary prevention, primary and community care, social care, mental health, acute and specialist care to ensure we use our combined £850m annual budget to achieve the best possible services for local people. Our plans are founded on international learning from examples including The Alzira Model, La Ribera Salud; and Canterbury Health Board, NZ.

Actions

 Managing such a complex and far-reaching transformation programme is a tough task so a collective voice is extremely important, and our fundamental guiding principle is that ESBT is 100% of everything we do and everything we say. That’s why we established the ESBT Programme Board, which includes representatives from all the ESBT partners, as well as public health, GPs and Healthwatch East Sussex. With an increasing and ageing population, and pockets of health inequality and deprivation in our CCG areas, we are investing in care delivered earlier and closer to home, which underpins significant improvements in the experience of care for patients, improves the quality of services and health and wellbeing of our population, and helps to keep services affordable for years to come.

 The ESBT partners are committed to breaking down organisational barriers to deliver the right services, in the right places, at the right time for local people. By enabling and encouraging previously separate organisations to work together, ESBT has already begun to implement significant improvements in care pathways. ESBT represents the vast majority of the local health and social care workforce, serving nearly half a million local people. By working really closely with the public we serve, patients, carers, service users, staff and local politicians, we’re ensuring our focus is on spending wisely rather than cutting badly. ESBT’s significant investment in primary prevention, primary care and community-based services is designed to improve services for local people, in terms of the quality and outcomes of the care they receive.

  As more treatment, care and support is delivered in the community we can alleviate pressure on our hospitals and free them up to concentrate on providing the hospital-based services which they are best placed to do.We know that service redesign in itself is not enough so work is underway to develop a fully integrated accountable care model across the ESBT footprint, setting out a business case by July 2017 for future organisational arrangements to implement a full accountable care model in 2018/19. Gaining acceptance and commitment for radical ideas in complex political environments is difficult and another of ESBT’s important steps forward was that the ESCC cabinet gave ESBT the ‘green light’ to move towards a new way of working, enabling us to fully realise our ambition to create a new model of PACS-type accountable care – the ESBT alliance.

Results

ESBT’s many achievements so far include:

•Health and social care connect puts local people in touch with the right service at the right time, receives c. 11,000 contacts a month/120,000 per annum.

•Since June 2016, the award-winning i-Rock youth mental health service has had more than 350 contacts with young people.

•Our crisis response service helps to prevent unnecessary hospital admissions. To date 72% of people seen by the team had not been re-admitted to hospital within a month.

•Our Welfare Benefits project has supported over 7,000 people, 79% of respondents said their mental wellbeing improved after getting in touch.

Spread

 From the start we have had a comprehensive public and stakeholder engagement programme – including local people, patients, councillors, MPs, healthwatch, the voluntary sector, charitable organisations, and health and care staff. Local people play an active role in determining and shaping the health and care services that will support and serve generations to come, and our staff are being empowered to begin true health and social care integration in a way that is unprecedented in its scope and ambition.