Integrated Personal Commissioning
What is Integrated Personal Commissioning (IPC)?
The NHS Five Year Forward View introduces IPC as “a new voluntary approach to blending health and social care funding for individuals with complex needs. As well as care plans and voluntary sector advocacy and support, IPC will provide an integrated, “year of care” budget that will be managed by people themselves or on their behalf by councils, the NHS or a voluntary organisation.”
The goals of the programme are:
- People with complex needs and their carers have better quality of life and can achieve the outcomes that are important to them.
- Prevention of crises in people’s lives that lead to unplanned hospital and institutional care.
- Better integration and quality of care.
There are nine national demonstrator sites for IPC. Tower Hamlets is the only London borough participating in the three year programme. IPC is part of the new models of care. The learning from the demonstrator sites will inform the wider roll out of IPC cross the country.
Who will this benefit?
The programme is aimed at individuals who have high levels of need, have both health and social care needs, where a personalised approach would address acknowledged problems in current care provision and help prevent further deterioration of their health and enable them to retain their independence. Tower Hamlets is focusing on the following four groups:
- Children and young people with complex needs, including those eligible for education, health and care plans.
- Adults with multiple long-term conditions including COPD.
- Adults with learning disabilities with high support needs, including those who are in or at risk of being placed in institutional settings
- Adults with significant mental health needs, including those eligible for the Care Programme Approach
What does this mean for people?
People participating in IPC will receive the following:
- Person-centred care and care planning. Care planning will be based on the strengths and preferences of individuals and the outcomes they want to achieve, instead of a service offer driven by the care system.
- An optional integrated personal budget for health and social care. This could be managed by the council, the NHS, or by a third party provider (e.g. a voluntary sector partner); or by the person themselves through a direct payment.
- A clear offer with tailored information, advocacy and support to help people through this process
- Access to “more than medicine” services in the community.
Financial Model for IPC
Current financial models do not encourage a proactive approach to care, they tend to reward NHS and social care activity and crisis services. The IPC financial model attempts to shift incentives towards proactive care, prevention and coordination of care, by testing an integrated capitated payment approach. This will align financial accountability and the outcomes that matter to people. With capitation, providers are incentivised to understand who is at risk take early action to prevent deterioration and coordinate services, which, to be effective involves working in partnership with the people and their carers.
Integrated personal budgets will give people greater flexibility over how they achieve their agreed outcomes. Providers will need to have a better understanding of what people want, respond to gaps in service provision (need for new services and/or for quality improvements to existing services) in order to become a provider of people’s choose. Whist for commissioners, understanding how people are using their budgets and potential gaps in provision will inform commissioning decisions and new commissioning approaches.
How does IPC link with existing initiatives?
- The new IPC programme does not seek to duplicate or replace existing initiatives. Instead, it aims to build and strengthen what is happening locally e.g.
- Expansion of personal health budgets beyond people with Continuing Health Care
- Development of the Better Care Fund
- Implementation of the Care Act 2015
- Local delivery of the Care Programme Approach (CPA) for people with severe mental illness
- Special Educational Needs and Disability (SEND) reform as part of the Children and Families Act 2014.
Who is eligible for IPC in Tower Hamlets?
Tower Hamlets IPC will be open to adults who are residents in the borough and meet the following criteria:
- registered with a GP in the borough and
- in receipt of a social care package
- with multiple long term conditions; and/ or sever mental illness; and/ or learning disabilities.
For the children’s cohort, the broad eligibility criteria will be as follows. This will be refined following discussion with the SEN and children social care teams in November 2015.
- Resident of Tower Hamlets and registered with a GP in the borough
- Have an existing Statement of Educational Need and Disability
- Have a social care package in place
- With a health need
For more information please email TowerHamletsIPC@towerhamletsccg.nhs.uk