WinnerBirminghamEast andNorth PCT

No need to teach an old dog new tricks.

Arrangements made under the Health Act Flexibilities led to the then Eastern Birmingham PCT undertaking responsibility, in 2004, for an integrated provision with a pooled fund for Intermediate Care Services. The partnership arrangement with Birmingham City Council’s Adults and Communities directorate and incorporated a large community team providing rehabilitation at home and acute response functions and two bedded intermediate care facilities, providing for nurse led and social care rehabilitation.

The aims of the integration reflected the desire to deliver assessment and intensive rehabilitative care at home from intermediate care teams who were not hindered by distinctions between social and health workers. It also offered the advantage of quicker resource decisions made by a single service and more flexible responses to changes in demand. The service has a single and rapid point of access to a multidisciplinary team offering early intervention.

Figures for the first two years of the partnership show prevention of hospital admissions alone based on average cost would have saved over£2,500,000. The multi disciplinary nature of the teams and simplified recruitment attracts social work, nursing and allied health professional to the service, reducing agency costs and giving the workforce flexibility. Other new developments improving cost effectiveness include Intermediate Care Services within the re-provision of residential care through four special care centres and the incorporation of the falls service.

The subsequent joining of Eastern Birmingham PCT with North Birmingham PCT in 2006 sees the partners looking at opportunities to expand the joint service and exploring how other benefits might be gained. Learning from integrated provision and pooled budgets is identified in a report circulated acrossBirminghamand posted on the integrated care network website-

The winning factor identified by the judges in this submission was the sustainable model of partnership working, capable of withstanding organisational change and responsive to the needs of a highly diverse community.

Sally Plant - Birmingham East andNorth PCT-

Highly CommendedBlackpoolPCT,BlackpoolCouncil and Age ConcernBlackpool

Predict and Prevent

The causes ofBlackpool’s poor life expectancy - the second worst inEnglandandWalesand with little sign of improvement prior to 2004 – were analysed as part of the work of the Local Strategic Partnership.

Negotiated Agreements allowed for the development of responses to those conditions identified as priorities for action. One of these was deaths and hospital admissions for accidents – falls, fires and road traffic collisions - in the over 65s.

A number of collaborative interventions were put in place to reduce these numbers and some of the related health inequalities. Strategic environmental changes included aBlackpooldecent homes standard and new pedestrian crossings on well-used routes.

Joint training encouraged staff entering the homes of vulnerable people to assess for falls risks, accident prevention and home security while a service was established to make changes responding to a hazards assessment. Domiciliary medicine reviews and exercise are also available to the housebound.

Falls and other accidents are being prevented and ambulance call outs and emergency admissions reduced saving valuable public sector resources. Most importantly however the partnership approach is saving lives and the cost to the individual, family and friends.

Judges commended the intelligent use of data and the creativity that went in to service delivery.

Judith Mills, Public Health Specialist - Blackpool PCT (

Highly Commended EastSussexCounty Council, Adult Social Care andEast SussexDowns & Weald PCT

Whole Systems Improvement Programme

High levels of delayed transfer of care for older people in East Sussex during 2004/05 had a significant impact on care and capacity as well as financial costs to the system. A Whole Systems Improvement Programme was negotiated to resolve these problems and strengthen working relationships.

New integrated services promoting independence and cost-effectiveness – enhanced response teams, single access telephone number, older peoples mental health liaison - have since reduced delays. The keys to this improvement have been engagement of users and carers and collaboration on jointly commissioned services that have transformed care provision.

Juliet Mellish, Director of Whole Systems Improvement

Sandwell Primary Care Trust and Sandwell MBC

Joint Health and Social Care Policy Unit

The Joint Health and Social Care Policy Unit (JPU) was established in October 2004 as a structured partnership working in health, with the aim of delivering and managing joint strategic objectives, policy and commissioning in an integrated fashion.

The Unit covers broad areas of healthy public policy and enables a more unified response across cross cutting issues of strategy and service development.

Placing mental health strategy and commissioning within the JPU gives a more balanced, cost effective and linked approach to delivery against a broader agenda with improvements in quality.

Joanne Steventon

Tameside and Glossop PCT

Modernisation of Intermediate Care Services

Persistent data reports showing that intermediate care services failed to meet commissioner expectations prompted Tameside and Glossop PCT and Tameside MBC to work on a joint redesign initiative.

The operational management team of lead staff from the Primary Care Trust and Local Government developed three new teams. These worked across health and social care in both acute and community settings on admission avoidance, facilitation of early discharge and rehabilitation and maintenance.

Strategic and operational collaboration developed a strong vision and turned the reputation and performance of the service around.

Margaret Hyde, Communications Manager

Haringey Council and Haringey tPCT

Improving Well-being

Since 2005 Haringey Council and Haringey tPCT’s Well-being Partnership Board has worked to improve well-being for adults aged 18 and over.

A strategic framework based on the seven Our Health, Our Care, Our Say outcomes helps the shift from a focus on treating illness to the promotion of well-being. Other developments include a plan to reduce inequalities in life expectancy and the start of a joint commissioning approach for projects from the statutory and voluntary sector. Despite significant financial pressures this has resulted in a number of key indicators showing improvements.

Vicky Hobart: Public Health Consultant