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Place Based Engagement and Integrated Leadership in Oldham

Background

The MioCare Group has achieved good engagement within the Greater Manchester ICS at place based level, covering the Oldham area where it has become a key stakeholder and taken the system lead for hospital discharge and enablement.

Greater Manchester is a very large ICS with a population of 2.8 million, making it difficult for providers to influence at ICS level.

The system level covers the full geography and those organisations that are partners within the ICS are represented by their most senior officers. The place based partnerships operate like 10 mini systems. One of these is Oldham with a population of 235,000.

The experience of MioCare offers some keys to good engagement and useful insights:

The services provided by the MioCare Group were largely provided in house by Oldham Council up until 2013 when the group was created, and it remains a Council owned company. It has an established history of partnership working and having a seat around key tables, to which it brings its independent voice.

Building on established and influential relationships and membership of existing partnership forums can provide routes into engagement with ICSs.

There is a history of integrated working in Oldham, joint management structures and integrated pathways. This includes the Community Health and Social Care alliance between the local authority Adult Social Care, the community health service provided by an NHS trust and MioCare. The Local Authority DASS provided the leadership for the community health service and provides a strong voice on behalf of commissioned services and to a lesser degree, non-commissioned services.

Use existing allies and partners and enhance their understanding of the social care provider contribution. Understand how statutory services are managed and how best to align the social care provider contribution to this. Understand if social care alliances are in place and consider affiliating to these.

During the pandemic MioCare provided the system leadership for transforming integrated discharge planning across key organisations and continues to make a significant contribution to enablement and intermediate care. This saw the MioCare Group’s Managing Director – Karl Dean – lead an integrated workforce which included staff from NHS trusts, independent providers and the local authority. This greatly contributed to the organisation’s credibility and leverage.

Seek out opportunities to develop and lead integrated care pathways which bring the unique contributions of person-centred, preventative, agile services which are rooted in an understanding of communities and local population wellbeing and health determinants. Larger organisations tend to be bureaucratic and can’t move as quickly as some social care providers.

In Oldham working in a truly integrated way has led to good system performance and improved outcomes for those leaving hospital on a discharge to assess pathway. Funding of £2.5m has been secured over 2.5 years to sustain this integrated model.

Partners doing real work together with successful outcomes can fast track relationships.

For MioCare, this has enhanced its reputation and secured additional resources

At a place based level, an informal integration agreement has been agreed between the CCG, Local Authority and 2 Health Trusts. There are affiliated members to this agreement which includes primary care and MioCare.

Understand if integration agreements are in place and if social care providers are party to these.

Local Joint Strategic Needs Assessment have been useful at place level to ensure local needs are key to the assessment.

Know your local JSNA. Are your current services and potential contribution recognised in the assessment? How can you influence the Health and Wellbeing Board to make sure they are included going forward?

Coordination of social care provider input to the ICS is largely via the Local Authority. Communication is considered to be good. The Local Authority provides regular updates to the wider social care sector and holds weekly Care Home Provider forums.

Know how your local ICS communicates with wider partners and negotiate access to these communication routes.

The average weekly time commitment for MioCare to maintain this system engagement is 2.5 days of the managing director’s time. Typically one of these will be for operational responsibilities related to the integrated pathways and the remaining for engagement with place based governance. There are both opportunities and losses associated with this time commitment.

Consider other social care provider organisations with which to share representation and engagement activity.

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