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Agenda item

Joint Commissioning for Health and Care - Care Outside of Hospital

Report of the Director of Commissioning Inclusion and Learning (SCC) and the Executive Director of Delivery, Care Outside of Hospital (CCG)




Sarah Burt, Deputy Director of Delivery, Care Outside of Hospital, Sheffield CCG, and Nicola Shearstone, Head of Commissioning Early Support, Sheffield City Council, presented the report which outlined the potential whole system changes required to support an improvement in the health and wellbeing of people in Sheffield and reduce health inequalities.  Two key elements were outlined – the prevention of multi morbidity and the development of a robust out of hospital health and care system.



The CQC Local Area Review Report 2018 had indicated that many people had a fragmented experience of care and there had been insufficient focus on prevention.  Inequalities and multi morbidity were seen more frequently in deprived areas and there was a need to invest in neighbourhoods to achieve fairer healthcare.



Good practice was developing across the city, but it had not always been effectively evaluated or given sufficient oversight to develop across the system.  There needed to be more focus on prevention and embedding the person centred approach.  There was a need to develop an outcomes focused approach, working with key stakeholders, developing ideas and initiatives through co-production.



A number of aims had been identified which included:

o   To develop a prevention focused health and care system.

o   To identify people who are at risk of developing long term conditions and multi morbidity and maximise independence and resilience within their own home and community.

o   To provide optimal support to people (and their families) who are multi morbid/complex or at the end of life.

o   To build on an integrated approach across health and social care to ensure best use of shared resources.



To achieve the aims, there was a need to shift to preventative and proactive evidence informed care which was delivered closer to home and away from hospital.  This would require a change in the culture of the way people’s health and social care needs were managed.



Councillor Olivia Blake, Cabinet Member for Finance, Resources and Governance suggested that more mention needed to be made of Mental Health and it was accepted that whilst Mental Health was implicit within the report, more needed to be done to ensure that it was explicit.



Councillor Jackie Drayton, Cabinet Member for Children and Families expressed concern that people were working in silo’s and the work of the voluntary, community and faith (VCF) organisations should be included.  It wasn’t always about doing something new, but ensuring accessibility to what was taking place and creative commissioning.



A workshop of all the Accountable Care Boards was being arranged to look at all the different projects etc. that were taking place.  There was a need to make the most of what was already being done and help people navigate existing services.



A cultural shift was required and a systemwide approach did not mean that one size fits all.  Equitable funding was not always right and there was a need to build in flexibility.  Officers needed to be empowered and providers were ready for a change in how they were commissioned.  This would require a long term commitment to change.



There had not previously been a mechanism to differentially invest at community level.  The new plan would look at different approaches in different parts of the city.



RESOLVED: That a further report be provided to the Joint Commissioning Committee to provide input into prioritisation.



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