Devon’s plans to change care management

Care management is changing. It’s buzzing. It’s exciting. Why?

People are more aware of their needs and want a say in how they are met. Successful support plans which combine individual, community and public sector resources help people maintain independence even in complex circumstances. Care management should be a partnership with service users, not a hurdle.

cost effective

This short series of articles describes how we are transforming care management by making it simpler, user-led, more effective and less costly. There are three stages:

● Initial contact when we aim to resolve the needs of 70% of those who contact us.

● Stage two supports people with long-term and chronic health conditions. This is provided through fully integrated teams of health and social care staff.

● Stage three is a brokerage service which arranges all provision, from the simplest to the most complex. This frees up care managers from finding services and negotiating costs in complex cases.

Our contact point Care Direct Plus (CD+) uses telephone assessment and resolves 75% of requests within two days. Calls take between 20-30 minutes during which a user-led assessment is completed. Most people will then have their needs identified and resolved through the provision of disability equipment, domiciliary care, arranging respite care, and so on.

We were initially surprised by the high volume of contacts about disability equipment and minor adaptations. Some of this was due to individuals trying to find out where they were on our waiting lists. The other calls were from people determined to keep their independence. Often simple and inexpensive equipment was all they needed. This reinforced our plans to introduce a simple and speedier process to provide equipment and minor adaptations.

The next article will describe the rapid equipment service which resolves 85% of user requests for minor equipment within five days. Before this we had an average 16-week wait with almost 500 on the waiting list.

Telephone assessments

Care Direct Plus is a success with our public. Telephone-based assessments work because the people who ring us know what their needs are and, with the guidance of well-trained staff, can shape their own care plan. If the CD+ worker identifies risks or uncertainty, they refer to the complex care team. There is the capacity to refer back if we see unmet need when delivering equipment.

Staff are enthusiastic about being able to see things through from start to finish, often within hours. It is highly efficient. Our assessment and care planning performance indicators are up from occasionally flashing on red to a comfortable dark green. As a result of transforming our care management and business processes, we can provide a speedier and better quality service, with at least 10% fewer staff. In doing so, we have freed up staff in the integrated complex care teams from the high volume, less complex work in order to concentrate on quality preventative work. More on that in a future article.

David Johnstone is director of adult and community services, Devon Council

➔ Report describing the assessment project at www.devon.gov.uk/modernisation

➔ Analysis of Devon’s transformation and Torbay’s excellence model