LOCAL DEMOGRAPHIC INFORMATION
In terms of population and demographic data, our residents are relatively healthy compared to the rest of England. In addition, socio-economic risks to wellbeing are significantly lower in the Harrogate District than elsewhere in England. Like most health and care systems in England, Harrogate and Rural District is struggling to match demand and affordable supply. There is a combination of an ageing population, an increase in the number of people with long-term conditions and the changing expectations of the local population. An ageing population presents several risks including:
- Isolation, and its mental health challenges;
- Access to public transportation;
- Capacity to meet the demand for health and social care services that increase with age such as dementia, frailty, sensory deprivations such as eyesight and hearing, falls and fractures, joint replacement, continence, chronic wounds, and multiple long term conditions.
ADULT SOCIAL CARE
This document gives an overview of adult social care in North Yorkshire, as at Summer 2018. More detailed local information for Harrogate and rural district will be posted as this website is developed.
Adult Social Care is organised as follows:
- Referrals are made through the Customer Resolution Centre at County Hall. Monday-Friday, in hours, this Centre includes a team of Social Workers, Occupational Therapists and other social care staff, who provide specialist advice and information, triage contacts and referrals, resolve issues at first point of contact where appropriate and put straightforward interventions in place
- The Living Well Team, linked to a number of GP Practices, looks to prevent, reduce and delay the need for long-term care, through up to 12 weeks of support to individuals to help them increase their confidence and be more connected to the community. Wherever possible, the aim is to keep people independent and well, at home
- In the locality, there are teams for Independence and Reablement (crisis support, prevention of hospital admission, most hospital discharges, rehabilitation at home), comprising Social Care Assessors, Occupational Therapists, Independence Co-ordinators, Reablement Workers and for Planned Care (long-term support), comprising a similar mix of social care professionals. These teams serve the local areas within Harrogate and rural district. These teams work with all adults aged 18+, with the exception of people with mental health needs. These services include assessment and support for Carers
- Where people require a care package, this will usually be provided by a home care provider (for people living in their own home) or a residential or nursing home (for people requiring 24 hour care). An increasing number of people are living in extra care housing, with current schemes in Harrogate, Knaresborough and Ripon and plans being developed for new schemes in Starbeck and Boroughbridge. Just under half of people who live in residential or nursing care are funded by the County Council – the remainder either fund their own care or funded by the NHS
- The County Council directly provides residential and short-breaks services at Station View, Springfield Garth and 80 High Street
- More people are choosing to use a Direct Payment to access their care services at home and they are supported by the Direct Payments Service to do so
- People accessing social care are supported to have a benefits check via the Income Maximisation Team
- Social Care Mental Health Services work closely with Tees, Esk and Wear Valleys NHS mental health services to provide support for adults aged 18-65, focusing increasingly on prevention, recovery and crisis support
- The vast majority of social care provided in the area (and funded by the County Council) is commissioned from the independent sector and from the voluntary sector
NEW CARE MODELS ‘VANGUARD PROGRAMME’ (2015-2018)
The 3 year New Care Models ‘Vanguard’ Programme took place in the Harrogate locality between 2015 and 2018. This programme brought together the Harrogate and Rural District Clinical Commissioning Group (HaRD CCG), GP practices, primary and community care partners, social care partners, local people and communities to work in partnership to pilot the transformation of primary and community care.
Following the closure of the New Care Models ‘Vanguard’ programme, a number of lessons have been learned and there are several key recommendations to take forward (see the link above for the ‘Sharing the Biscuits’ report for more information). A workshop following the ‘Vanguard’ developed an action plan – the ‘Keep Change Transition Plan’ – to maintain momentum in the short term and pave the way for longer-term transformation.
PRIMARY CARE HOME MODEL
Primary care home is an innovative approach to strengthening and redesigning primary care. Developed by the NAPC, the model brings together a range of health and social care professionals to work together to provide enhanced personalised and preventative care for their local community. Staff come together as a complete care community – drawn from GP surgeries, community, mental health and acute trusts, social care and the voluntary sector – to focus on local population needs and provide care closer to patients’ homes. Primary care home shares some of the features of the multispecialty community provider (MCP) – its focus is on a smaller population enabling primary care transformation to happen at a fast pace, either on its own or as a foundation for larger models.
Four key characteristics
There are four key characteristics that make up a primary care home:
- an integrated workforce, with a strong focus on partnerships spanning primary, secondary and social care;
- a combined focus on personalisation of care with improvements in population health outcomes;
- aligned clinical and financial drivers and
- provision of care to a defined, registered population of between 30,000 and 50,000.
YOUR COMMUNITY YOUR CARE – GREEN PAPER
Action is happening! The HaRD CCG has also laid out its vision and commissioning intentions for the next phase of the ambition to deliver a fully commissioned integrated model of primary and community services in the locality in the ‘Your Community Your Care’ Green Paper’ (February 2018). The case for change is outlined in this paper –
“The health and social care needs of our local population are changing. We have a combination of an ageing population, an increase in the number of people with long-term conditions and the changing expectations of our population. Together these increase demand and create pressures on our health and social care system”.