Learning Disability Services Learning Disability Services – Capitation Share Capitation Share Briefing 15 th September 2016 15 th September 2016
Learning Disability Services Learning Disability Services ––
Capitation ShareCapitation Share
Briefing
15th September 201615th September 2016
OverviewOverview
l Context
l Next StepsNext Steps
2000/012000/01
l “� the inherently underfunded nature of the
Programme was first identified in 1996 as a
deficit of some £4.4 million.”
WHSSB Learning Disability Report (2000/1)
Context : Context : -- 2000 2000 -- 20052005
l A concentrated Resettlement Programme was implemented in the
Western area between 2000 – 2005. Given that other Trusts were not
at the same stage in their resettlement plans, investment that would
have been attributed to the above programme, was invested in
community services in other Trusts. This may have resulted in a
different funding position between Trusts
l During this period, parents/carers and Trust representatives met with l During this period, parents/carers and Trust representatives met with
the Western Board to highlight funding variances and the lack of
investment in the West.
l As a result of these meetings, the Western Board developed a 3 year
plan to further enhance the community infrastructure.
20042004
The fourth report of the Capitation Formula Review
Group revised significantly the percentage
attributable to Learning Disability with the West from
18.25% to 19.51% (there has been no change to the capitation formula since this report was issued, however, annual updates were made formula since this report was issued, however, annual updates were made
for population etc.)
It should be noted that the Capitation formula is a
statistical exercise which gives an estimate of the
share of funding to Trusts and across Programmes
of Care.
2007/08 2007/08
l 1 April 2007 the WHSCT was established. The
merger included the former Foyle and Sperrin
Lakeland Trusts which had provided LD services
across the West.
l From this time service planning changed to reflect l From this time service planning changed to reflect
the change in structures
2009 (April)2009 (April)
l The 4 local health and social services Boards
were dissolved and the new Regional Health and
Social Care Board was formed.
l Since the creation of the new Board, the Western
Trust has received its fair allocation of resources, Trust has received its fair allocation of resources,
year on year, for LD services based on capitation.
l Every pound of investment in LD has been spent
in Learning Disability services.
2013 (August)2013 (August)
RQIA carried out a review and produced a report
on findings in the document ‘A Baseline
Assessment and Review of Community Services
for Adults with a Learning Disability, August 2013’.
As part of the recommendations from the report,
the HSCB were requested to review the ‘equity of
investment in community staffing across the
Board area’.
In a workshop in May 2015 with Western Trust
Board, the Director of Finance of the Health
and Social Care Board gave a presentation on
equity which highlighted that the Trust had
more than its overall capitation share of
May 2015May 2015
more than its overall capitation share of
investment and there was a difference in
investment across Programmes of Care in the
Western LCG area.
The Trust makes a decision to allocate
£350k from its additional recurring allocation
as a step towards redressing the balance in
Learning Disability. This funding has been
invested in Phase 1 of a Community
Infrastructure Development Plan, employing
June 2015June 2015
Infrastructure Development Plan, employing
an additional 9 staff.
December 2015December 2015
As requested within the RQIA report, the HSC Board
shared a report with the Trust which identifies a gap
in funding for the West in comparison to other
Trusts. Trusts.
Given that this report is a ‘working document’ no
agreed deficit can be confirmed at this stage without
further investigation.
February 2016February 2016
Consultation is launched in December 2015 by the
HSC Board on the proposed changes to the NI
Weighted Capitation Formula. The Trust highlights
that there is a need to review the Learning Disability
component of the Capitation Formula as it was last component of the Capitation Formula as it was last
reviewed in 2004 using 2002/03 data.
April 2016April 2016
l Trust advised by HSC Board that it will receive
£2.1 million for Learning Disability services in
2016/17
l The Trust will divert additional funds for Phase 2 of l The Trust will divert additional funds for Phase 2 of
the Community Infrastructure Plan employing an
additional 11 staff.
l This will result in a welcome significant additional
investment in LD services in 2016/17.
May 2016May 2016
l On the 6th May a meeting was held with
parents/carers and advocates and
agreement to work in partnership.
Next Steps (May 2016)Next Steps (May 2016)
l Ongoing liaison with the HSCB.
l HSCB to update Learning Disability component of
Capitation Formula.
l Establish a working group with families.
Trust making decisions regarding its 2016/17 l Trust making decisions regarding its 2016/17
demography funding
l Long term plan to redress balance to be
developed.
Early Steps taken by the Trust for Early Steps taken by the Trust for
short term impact short term impact –– August 2016August 2016
l Having received the information at its Trust Board
in May 2015, in 2015/16 the Trust drafted a
phased investment plan for community
infrastructure, based on assessed areas of highest infrastructure, based on assessed areas of highest
need, and allocated an additional £383k to Adult
Learning Disability services to make a start on
reducing the differential.
Table 1: Phase 1 Investment Table 1: Phase 1 Investment
Community Teams £383k 2015/16Community Teams £383k 2015/16
Post Total Activity Status
2.0 WTE Band 6 Social Workers £80,000 80-90 caseload Completed
8.0 WTE Band 4 Family Support
Workers
£303,00 95-100 caseload 5 staff recruited
2nd recruitment round
commenced
2.0 WTE Band 5 Managers
Total WTE 12 Staff £383,000
High Cost Community Cases and Young High Cost Community Cases and Young
People Transitioning (2016/17) 1.8M People Transitioning (2016/17) 1.8M
16/17
Detail
FEITR /
GS1 Ref
No
FYE
£
TYE
£
Sources of Funding
Community LD Cost Pressure - Alloc 001 1,800,000 1,800,000
Sub-total Sources of Funding 1,800,000 1,800,000
Applications of Funding
High Cost Cases
High Cost Client 2015/16 (SS) 22,000 22,000
High Cost Client 2015/16 (SS) 23,000 23,000
High Cost Client 2015/16 (SS) 140,000 140,000
High Cost Client 2015/16 (SS) 79,597 79,597
High Cost Client 2015/16 (SS) 25,000 25,000
High Cost Client 2015/16 (NS) 60,000 60,000
Learning Disability - £1.8m Cost Pressures Funding 2016/17
Spending Plan
Trust Lead: Rosaleen Harkin
High Cost Client 2015/16 (NS) 60,000 60,000
High Cost Case 2016/17 (SS) 177,163 69,409
High Cost Case 2016/17 (SS) 98,464 98,464
High Cost Case 2016/17 (SS) 9,235 5,772
High Cost Case 2016/17 (SS) 228,000 142,500
High Cost Case 2016/17 (SS) 29,512 24,594
High Cost Case 2016/17 (SS) 0 10,772
High Cost Case 2016/17 (SS) 33,000 33,000
High Cost Case 2016/17 (NS) 11,993 7,268
High Cost Case 2016/17 (NS)
High Cost Case 2016/17 (NS)
Further Estimated Costs For Clients in 2016/17
High Cost Case 2016/17 (SS) 300,000 75,000
High Cost Case 2016/17 (SS) 104,000 104,000
High Cost Case 2016/17 (SS) 200,000 116,667
High Cost Case 2016/17 (SS) 27,000 11,250
High Cost Case 2016/17 (SS) 150,000 75,000
High Cost Case 2016/17 (NS) 350,000 175,000
High Cost Case 2016/17 (NS) 100,000 100,000
High Cost Case 2016/17 (NS) 100,000 100,000
High Cost Case 2016/17 (NS) 50,000 29,167
High Cost Case 2016/17 (NS) 188,000 78,333
High Cost Case 2016/17 (NS) 250,000 104,167
High Cost Case 2016/17 (NS) 170,000 70,833
High Cost Case 2016/17 (NS) 170,000 70,833
3,095,964 1,851,626
Young people transitioning from children’s Young people transitioning from children’s
to adult services (2016/17) 339K (TYE) to adult services (2016/17) 339K (TYE)
678(FYE)678(FYE)Facility Post Cost (TYE) Status
Benbradagh 1.2 WTE Band 3 to support 4 transitioning clients £17,100 Recruitment initiated; agency staff will be deployed in the interim
Maybrook 1.0 WTE Band 3 to support 1 transitioning client £9,500 Recruitment initiated; agency staff will be deployed in the interim
Glenside Reconfigured staffing structure to facilitate 4 transitioning clients £6,100 Recruitment initiated; agency staff will be deployed in the interim
Lisnaskea Enterprise Centre 1. WTE Band 3
to support 1 transitioning client
£13,200 Recruitment initiated; agency staff will be deployed in the interim
Berryburn 1.0 WTE Band 5 £20,300 Recruitment initiated; agency staff will be deployed in the interim
New Directions 1. WTE Band 6 £24,300 Recruitment initiated
Social Worker 1. WTE Band 6 £24,300 Recruitment initiated
Admin Support 1. WTE Band 3 £14,300 Recruitment initiated
18 Day Opportunities places £140,000 Work in progress
Whole Life model of day opportunities for existing service users to
create capacity in day care for young people transitioning
Between 7 and 10 places £70,000 Clients currently being identified
Total £339,100 (TYE)/ £678,000 (FYE)
Table 4: Phase 2 Community Teams Table 4: Phase 2 Community Teams
£466K£466KPost Total £ Activity Status
6.0 WTE Band 6 Social Worker £266,868 250-270 Caseload Recruitment initiated
2.0 WTE Band 7 Social Work
Practitioner
£105,610 Practice Development across SW
workforce
Recruitment initiated
1.0 WTE Band 6 Nurse £44,478 800 contacts per annum Recruitment initiated1.0 WTE Band 6 Nurse £44,478 800 contacts per annum Recruitment initiated
2.0 WTE Band 3 Admin Support £49,738 To support increased workload
generated by additional Social
Work Staff
Recruitment initiated
Total 11 WTEstaff £466,694
Summary of early investment Summary of early investment
decisionsdecisions
£m Status
Investment Plan to date
June 2015 - Community Infrastructure
Development Plan (Investment Phase 1) 0.4 In progress
2016/17 HSCB Allocation £2.1m WHSCT 2016/17 HSCB Allocation £2.1m WHSCT
Iinvestment Phases 2 & 3)2.1 In progress
2016/17 WHSCT Demographic Allocation -
Community Infrastructure Plan (Investment Phase
4) 0.5 In progress
Total Investment Draft Plan 3.0
Medium term Investments planned Medium term Investments planned
(2016/2019)(2016/2019)Description Investment £k Status
Transport Vehicles 160 Approved
Short breaks 267 Work in progress
Refurbishment of Community Facilities
Glenside
Other day centre requirementsLakeview Hospital
491
To be determined24
Work in progress
Work in progress
Infrastructure, Equipment and Vehicles
Equipment
Other
Total 942+
Future Medium/Long term Investment Future Medium/Long term Investment
PlanningPlanningTotal Investment Planned to date (see short
term actions) 3.0
New Investment Plan (suggested areas)
Allied Health Professionals (AHPS) 0.3
Under development (for
comment by carer groups
Domiciliary Care 1.0
Community Medical/Dental 0.4
comment by carer groups
and subject to
equity/capitation review)
Grants, Goods and Services/ Daycare/Day Opps 0.8
Nursing/Residential/Supported Living/Respite
Short Breaks 2.0
Social Work 0.2
Other 0.3
Total New Investment Plan 5.0
Total Draft Plan 8.0
Meeting with WLDAG July 16 Meeting with WLDAG July 16 -- Actions Actions
ArisingArisingAction Timeframe Lead
WHSCT internal working group established (T
Millar, Paul Quigley and Rosaleen Harkin) It may be
necessary to co-opt staff onto LD working group as
and when required.
July 2016
Completed
Trust Director
AMHD
Extend working group to include communications
plan including HSCB, WLDAG, DOH
July 2016
Ongoing
Trust Director
AMHD
Share indicative investment plans areas with
WLDAG for comment
July 2016
Completed
Asst Director
Finance/ Asst
Director LD
Implement 2016-17 Investment Plan - £3m July/August
2016
Ongoing
Trust Asst
Director LD
Develop business case(s) for approval at CMT July-Sept 2016
Spending Plans
for initial
investment
Trust Asst
Director LD
l WLDAG
l 4th March 2016
l 6th May 2016
l 16th June 2016
l 7th July 2016
l MLA BRIEFINGS
l 20th May 2016investment
developed.
Attend HSCB LD Capitation Scoping Workshop
Receipt of HSCB Report - LD
September
2016
Summer 2016 –
actual date
TBC
Trust Director
AMHD Asst
Director LD,
Asst Director
Finance
HSCB
Share WHSCT final LD investment paper with Trust
Board, HSCB
Autumn 2016 Trust Director
AMHD
Undertake high level LD productivity assessment by
LCG
Autumn 2016 Trust Asst
Director
Finance
Develop an Infrastructure, Vehicle and Equipment
Plan
September
2016
Trust Asst
Director LD
Developing an information, training and education
plan for LD families
September
2016
Trust Asst
Director LD
l 24th May 2016
l 3rd June 2016
l TRADE UNIONS
l 8th June 2016
l 31st August 2016
l Fermanagh & Omagh Council
l 24th May 2016
Any Questions?
Thank YouThank You
Any Questions?