In 2016, partners in St Helens realised they had to do something radically different to tackle growing costs and demand and make the best use of available resources. They undertook development sessions with the LGA and others, and decided to implement an ambitious and rapid programme of transformation. This case study forms part of our integrated care system (ICS) resource.
St Helens People’s Board was formally constituted in January 2017 and carries out the statutory functions of the health and wellbeing board (HWB) and the community safety partnership. The board provides ‘democratic stewardship’ and has a wide membership across public services and the voluntary and community sector. It oversees the development of a locally-driven, whole-community model called ‘St Helens Cares’.
In June 2018, the council’s people’s services department and the clinical commissioning group (CCG) came together to form St Helens Integrated People’s Services (SHIPS). The accountable officer of the CCG is also strategic director of people’s services in the council and is employed by the council. SHIPS covers CCG responsibilities, including devolved commissioning for general practice, adult social care, children’s social care, educational improvement and public health. Budgets are combined through a Section 75 agreement and there is close oversight of performance and finance.
St Helens has developed a lead provider model in which key health and social care commissioners and providers work together under a memorandum of understanding. Initial priorities are frailty pathways, respiratory pathways (adults and children), children’s mental health and adult mental health.
“St Helens leaders all share a vision and a commitment to work in a collaborative way to make a difference, and to maximise the ‘St Helens pound’ on behalf of all our residents. We are still on that journey and already we have seen tangible results and have been recognised both nationally and regionally for what we are doing. There is still more to do but we are all committed to delivering the vision.”
Geoffrey Appleton, Vice Chair, St Helens People’s Board and Lay Chair, St Helens Clinical Commissioning Group
Some key areas are already starting to show an impact. For example, ‘St Helens Contact Cares’ is a single front door staffed by a multi-disciplinary team based in the main acute hospital, with a single phone number for referrals. Early outcomes include:
- a reduction in secondary care activity, including A&E presentations and a reduction in the rise of non-elective admissions
- an increase in people accessing intermediate care
- best-performing area in the North West for delayed transfers of care.
A key priority of St Helens Cares is to improve outcomes for people who are frequent users of health and care services but without a major underlying health problem. A social prescribing model in primary care is showing early signs of positive impact. St Helens is engaging with primary care networks to ensure that new social prescribing arrangements enhance this model.
St Helens works across the wider footprint of Cheshire and Merseyside Health and Care Partnership on topics that are better developed at the system-wide level.
The People’s Board has developed a framework to identify future areas of work which contribute to community safety and the wider determinants of health, one of which will be domestic violence.
Sue Forster, Director of Public Health