County council ‘riding the crest of the wave’ with proactive social care changes

Qualified social worker Gill Birch, who is an adult social care lead for proactive care in the north of the county including Horsham, explained how they were ‘riding the crest of the wave’, and were making an ‘enormous’ difference to people’s lives.

Speaking to the County Times she discussed the benefits to keeping clients out of hospital, creating contingency plans that help them manage crises, how she became a social worker, and the scale of changes facing the sector following Government legislation.

She said that proactive care meant putting plans in place to head off or help clients manage a crisis, and working closely with a range of professionals, including social workers, GPs, and occupational therapists for example.

The key driver was to allow people to live their lives as safely and independently as possible.

Gill explained: “Every time someone goes into A&E you are chipping away at their independence and that impacts on social care.

“It’s being much more efficient in health and social care when we work with the same clients.

“Some of the most positive outcomes are where you bring professionals together to share experiences and strategies and expertise to find the right way forward for that client.”

There are nine Multi Disciplinary Teams (MDTs) operating in the area, with two in Horsham, four in Mid Sussex, and three in Crawley, working with people with long-term conditions or social care needs who are at risk of unplanned hospital admission.

“Proactive care is about the bringing together of health and social care services and all our partners in the wider community to act in a preventative way.

“What we do is look to develop strategies between us to enable someone to be supported and sustained in the community.”

She continued: “What we want to do is to understand what takes you into crisis and manage that crisis into a more predictable way.”

Gill said they were already receiving very positive feedback from both clients and health and social care professionals.

For professionals it has been a welcome opportunity to develop their knowledge and skills, while for the people who use the service they are seen by a range of people all in one team.

She added: “Contingency plans are working. We are seeing a reduction in both calls to the ambulance service and conveyance to hospital.

“It’s working. We are getting that client thinking in a proactive way.”

Gill started her career at the former Department for Health and Social Security, before moving to an East London borough housing department offering advice and welfare, then managed the advice and welfare team.

She went to university, worked as an unqualified social worker, then went back to university.

She spent years running a social care team at an acute hospital in East London, and has worked all around the country, before joining West Sussex County Council in 2008.

Gill said: “I’m very keen to support and enable people who are vulnerable and I’m keen to ensure that the provision we have in place both locally and nationally meets the needs of these people.

“I like the challenge in this particular project, it feels like we are riding the crest of the wave.

“The change is the most dramatic since World War Two. It’s huge and I like being in the thick of it.”

The Health and Social Care Act, passed in 2012, made sweeping changes to the way the health service was run in the country, abolishing the Primary Care Trusts and handing over power to Clinical Commissioning Groups (CCGs) which are run by GPs in each area.

Meanwhile the Care Bill is currently going through Parliament, and aims to change the law relating to support for adults and for carers.

But Gill says that while Government legislation might mean a shift in working practices, within the industry they have been talking about more joined-up working between health and social care for years.

She said: “The key theme is integration, how do we work together? It’s not just about financial efficiency.”

At the moment her role sees her working in strategic planning, looking at how they are delivering services on the ground.

“Where we can we want to be able to reach those people who you can see in a slow pattern of deterioration and turn that around,” Gill added.

“We can make an enormous difference to people’s lives and help people find a way out of the problems in their lives.”

Riz Miarkowski, a Burgess Hill GP and clinical director for the Horsham and Mid Sussex CCG, explained that proactive care was allowing people with long-term health conditions to get the right support at the right time, from the right professional.

He explained: “Shifting health and social care closer to the patient’s home in a single package - rather than two different services - is the way forward and our early successes through proactive care proves that this is the right thing for patients.

“Proactive care puts the patient at the centre of their own care; they only need to tell their story once, and all members of the team work together to make sure the patient is getting the right care by the most appropriate member of the team.

“This clearly means the patient’s care is coordinated and joined-up, and it is also more efficient for the team – releasing more time to care. All agencies work together with the patients to help them stay safe and well, living independently in their own homes for as long as possible.”