LAUSR

Introduction: Third Party Delegation; The required governance framework, sets out guidance to support the delegation of a health task by NHS Health Professionals to non NHS support workers who may not have a contractual relationship with the NHS. The work draws on current guidance and best practice and provides guidance on the governance framework required to facilitate delegation across health and social care activities. As the nature of ‘twenty four hour care’ now required, is changing so there must be consideration of the workforce needed to ensure we have suitably skilled, confident and competent staff teams able to implement new models and ways of working which will be required under The Social Services & Well-being (Wales) Act 2014. It is important that there is a consistent approach to developing the social care workforce that do not detract from their core function but meets the needs of individual citizens and there is clarity with regards to the nature of the care and support that can be offered and the governance framework to support this. Policy context and objective: The Welsh Government is committed in facilitating a value-based approach to health and care, based on need and which incorporates the citizen’s voice in decisions about healthcare and services and to provide better integrated and more citizen focused services.  It can though however be difficult to manage because working across organisational boundaries is complex and can involve the need to overcome challenges and risks.  Complexity and ambiguity can lead to confusion and weak accountability and this in turn can lead to a reduction in responsiveness, quality and an increase in overall cost. The aim of this work is to put the citizen at the centre of their care and enable organisations to coproduce care with the individual in a coordinated integrated way based on the principles of Prudent Health and Care, to sustainably meet the needs of the individual. Target population: The framework is aimed at; Health Boards (Population based NHS commissioning and provider organisations in Wales) Local Authorities Joint Partnership Agreements Third Party Providers of care Highlights: The framework gives illustrative examples of where third party delegation has been successful in delivering sustainable bespoke packages of care for individuals.  These can be complex in nature requiring novel approaches to meet an individuals needs and to maintain them within their home environment. By supporting the care sector with this guidance it is envisaged that current barriers to integrated working will be demystified and a holistic approach to meeting an individuals needs can be promoted Transferability: Though this is based within the Welsh health and care sector the principles within this framework can be transferred to other health and social care economies where there are multiple providers meeting an individuals needs and where the plurality of providers may increase risks and reduce the quality of the individuals life experience. Conclusion: The framework was developed within Welsh Government and co-sponsored by the Chief Nursing Officer and the Director of Social Services and Integration.  It was published in April 2016 as a Welsh Health Circular and by joint letter to all Directors of Social Services in Wales.  It provides a resource to promote integrated care with real life and practical examples of health and social care working together.