1. Investing in independence
Overview
Managing public resources to improve accessibility and quality of care will become an ever
greater challenge as the population in Barnet continues to expand and change. National
policy is geared to ensure individuals and communities can support their own care as
much as possible and stay free from illness for as long as possible. Local agencies are
required to use what we know about what keeps people well as a basis for future
investment, in particular to make a shift to a more collaborative model where people and
communities can become empowered to become active participants in their own well
being.
Barnet’s Policy Context
Barnet’s first JSNA is attempting to identify the current and future health, well-being and
care needs and preferences of our residents. As the delivery plan of our Health and Well-
Being Commissioning Framework it needs to be closely integrated with Barnet’s other key
strategies and plans to deliver improved outcomes for adults and children and young
people.
Health and
Well-Being
Commissioning
Framework
London Borough of Barnet
Corporate Plan
Relevant priorities:
Strong and Healthy
Supporting the Vulnerable
Barnet PCT Commissioning
Strategic Plan
Goals:
First things First: Getting the Basic Right
Improving Health
Local, accessible and excellent
Best Outcomes from the best centres
Building Resilience
Sustainable
Community
Strategy and
Local Area Agreement
Local Development
Framework
Theme 4: Healthier Barnet
Plans and policies to deliver the strategies e.g. Obesity Strategy, Mental Health Commissioning Strategy,
Physical and Sensory Impairment Commissioning Strategy, Older People’s Commissioning Strategy,
Learning Disabilities Commissioning Strategy, Alcohol Action Plan etc
Joint Strategic
Needs
Assessment
An integrated approach
to delivering improved
adult health and well-
being in Barnet

2. Set against a number of national of national policies that have been published over the last
few years which aim to improve the health and well-being of the population and deliver
more integrated and personalised services, these policy documents when taken together
emphasise:
• A need to work together to understand the current and future needs of the population
and individuals
• Empowering users and their families to understand what they can do to prevent ill
health and manage long term health conditions, putting them in control of their care
• A more proactive and preventative model of service with earlier intervention so that
users do not have to rely on hospital or institutional care
• Greater recognition of the role and contribution of the voluntary and independent sector
to ensure a richer mix of services
• Giving users more direct influence and choice in terms of services and providers
• Tackling inequalities and improving access to community services
• Integrated planning and service delivery across organisations to offer the best possible
quality of care and outcome for users whilst minimising waiting times
• Achieving the best value for money.
The challenge in Barnet is reflected nationally and led to the Government publishing a
paper to set out the future direction of social care for all adults of all age groups in
England in 2009 building on the concordat ‘Putting People First’ which has provided the
framework for the personalization of adult social services.
The Department of Health has now published its response to the evaluation of the first
individualised budgets pilots. This demonstrated that holding an individual budget was
associated with better overall social outcomes and higher perceived levels of controls for
those using them. However, the report identified there were significant barriers to take up
of the scheme amongst people with mental health problems and older people had less
positive findings than other groups. Amongst older people qualitative interviews suggested
that many did not want the additional burdens that they associated with planning and
managing their own support. Significantly the evaluation showed that the cost of service
packages under individual budgets was slightly lower than standard packages (£280 per
week versus £300 per week).
A the same time, personal budgets are being introduced into health services through
enabling legislation set out in the Health Bill published in January 2009. 37 pilots across
the country have been agreed and are exploring how direct payments for healthcare can
be made, especially to support people with long term conditions. By seeking to give people
greater control over how the resources are allocated to them, through ascribing a value to
need, the drive is to develop a more sustainable operating environment for health and
social care. This is set out in the diagram below taken from ‘All our Tomorrows’ and
underpins the model for this Barnet JSNA.

3. Barnet Council and Barnet PCT need to work with local communities to develop support
through easily accessible networks which will help promote health and well being and
prevent isolation and loss of independence. So far national and local evidence shows that
meeting the current and future challenges and delivering improvements rely on continued
developments in the following areas:
Empowering individuals and communities to maximize wellness, prevent ill-heath and to
make the best use of health and social care services through
• Community based health programmes which can target those in greatest need and
reach out to all sections of the community. This requires us to continue to develop
sophisticated use of social, demographic and housing data to pin point specific health
conditions, prevalence and risk in particular groups or areas to support interventions
which can address the lifestyles, interests and needs of different social groups.
• Continuing to improve universal access to advice and information by continuing to
modernise access points and using local intelligence to map the different ways people
approach services for help. This also means making the most effective use of existing
networks and contact points wherever possible and empowering front line staff to be
able to deliver key health messages in a targeted way. This approach needs to take
account of the growing use of the internet as a venue for an ever increasing segment of
the population as a means of obtaining information about conditions and for obtaining
support.
For those who need long term care or support due to age or disability:
• Implementing self care initiatives supporting people to manage their own conditions and
live independently. This requires integration of systems ensuring people have maximum
control over their lives and continuing development of the care market to ensure a wider
range of support options are available to support independent lifestyles.
• Continuing to increase the capacity of local housing stock to deliver suitable
accommodation for people with long term conditions to be able to live as normal and
independent life as possible.
• Changing models of investment by changing existing services to promote and
strengthen independent living.

4. Whilst the issues identified above equally apply to all care groups, these need to be
applied with understanding of the specific needs and issues relating to the different groups
of people with long term health and social needs. The following sections set this out in
more detail and should be read alongside the four integrated commissioning strategies.
These documents set out how health and social care will invest and disinvest in services to
meet the needs of the people of Barnet.