Framework for integration

National policy over the last 10 years has emphasised the need for collaborative working between the statutory and voluntary agencies to improve services for older people and people with long term conditions.  Following the Change Agent Review in 2001, the Cumbria Partnership Executive was formed consisting of the most senior managers of health and social care services in Cumbria.  The Cumbria Partnership Executive was tasked with focussing on older people’s services in particular.

The Cumbria Partnership Executive created what are now 2 Framework Agreements, and a reimbursement protocol, which represent ‘high-level’ agreements between health and social care partners “to do together what we are not capable of doing separately.  It represents a sharing of risk and development opportunities.”

The focus of each of the Framework Agreements is to deliver on a core agenda with 4 primary objectives (to be achieved by 2008):

1. Priority is given to addressing the needs of older people with complex care needs.
2. A reduction in Delayed Transfers of Care and reduction in emergency bed days.
3. The modernisation of services so that they meet the expectations of older people.
4. New co-ordinated arrangements to meet the needs of older people with long-term health conditions in the community.

These objectives are to be achieved through the establishment of aligned/integrated local joint care management teams that are multi-disciplinary in nature and that incorporate:

• single assessment,
• access to shared resources,
• devolved budgets,
• use of agreed pathways and
• new methods of working regarding long term conditions.