(1) If we buy Planning4care, what support do you provide?

Support provided includes:

• Handover: Initial briefing session when the tool is delivered to local partners
• Knowledge Exchange: Regular briefings on relevant data and policy issues
• User support: Telephone and email support with the core development team

We are currently developing case studies highlighting use of Planning4care in developing JSNA and commissioning strategies. And the Planning4care user network is currently in development - so watch this space.

(2) What kind of data would we need to have access to in order to use the model, and how much of that would we need to plug in ourselves?

All of the data underlying the analysis has already been put into the Planning4care system; this includes population projections and socioeconomic data for your specific authority and, your own statistical returns on services and unit costs as published in Key Indicators Graphical System (KIGS).

The main area where local input will add value is on care packages. (See FAQs 5, 6, 7).

Other local input to think about includes:

• Inputting more recent local unit costs than those available from published statistical returns (see FAQ 7)
• Bespoke locality boundaries for mapping and analysis. (see FAQ 12)
• Using different population projections, such as the London projections developed by GLA/DMAG (see FAQ 17)

(3) What data is included in the current release of Planning4care?

The current release is 1.3. There is a full list of current data sources here.

(4) Does the classification of need (low, moderate, high, very high) correspond to the Fair Access to Care (FAC) criteria at all?

Yes, the pilot found these to be broadly comparable, so this would be a reasonable assumption to make.

(5) Does Planning4care assume "standard" care packages in response to particular levels of need? And how can I get reliable service and cost estimates if the representative care packages in the model do not reflect what is provided in our authority?

In the standard model, representative care packages reflect national average service inputs by needs group.

You can change these to more closely match the profile of care packages provided by your authority. Click on the tab 'care packages' in the horizontal navigation menu on the website, and follow the instructions. (Note: changes to underlying data can only be done by your group administrator )

(6) I would like to adjust the care packages to reflect what we provide, but not sure where I would get the data from.

This will depend on how you keep your client information at present, for example do you record assessment information about activities of daily living in such a way that it can be used to categorise clients by level of need?

In the pilot we used the 4 FACS categories as proxies for the 4 main needs groups, and analysed average home care and daycare input for each FACS group receiving community care (which turned out to be fairly close to national patterns).

(7) Unit costs published in KIGS can be a year out of date - can we update these?

The unit costs data provided on the system is the latest published local costs based on your statistical returns (PSSEX) and published in KIGS (see FAQ 3).

If you have more recent unit costs which you would prefer to use, you can put this in by going to the care package page (click on tab in horizontal menu) and entering them in the table provided. The model will then use the new unit costs for all calculations. (Note: changes to underlying data can only be done by your group administrator)

(8) What is the 'Wanless Core Outcomes scenario'? Is this the balance that we should be striving for - i.e. the gap between where we are now and the Wanless scenario is the one that we want to close?

The Wanless scenario is a thoroughly researched model for achieving more optimal outcomes for service users within a manageable financial framework and sets a useful benchmark for what you may strive for. However, it is not an 'agreed' or recommended national standard - it is up to local areas to decide the direction and scale of change. And with the advent of personal budgets, service users will also shape these changes.

(9) We want to explore different scenarios - how can we do this?

The Planning4care system makes available a number of different planning scenarios. We are currently (November 2008) developing a number of additional scenarios to go live shortly.

If you would like to explore different scenarios, please contact the Planning4care team.

(10) What do you provide with the optional mapping package?

The optional mapping package provides:

• Maps of the overall population size and prevalence rate % of social care need - provided for 'all with social care needs' and 'high or very high social care needs'.
• Background mapping of a number of key wider determinants of health, including the underlying needs factors used in the model, and the Indices of Multiple Deprivation 2007 and other important context
• If you provide us with postcoded client or service data, we will also overlay this point data onto the maps
• All maps are supplied in: a) printed; b) jpeg/tiff image format; c) standard mapping package format.

The optional mapping package costs £2,000.

If you would prefer to develop the maps in-house, we can provide the care needs estimates data at LSOA / MSOA level. There would be a charge to cover our costs for extracting this data, as this is not a standard output from the tool.

(11) Can Planning4care produce output maps of the underlying socioeconomic factors used in the model?

Yes.

However these are not delivered in the standard package, but are provided as part of the optional mapping package (see FAQ 10 above for details of the mapping).

(12) Can we put in local boundaries on the maps to fit for example our social services areas or PBC clusters and then map needs to these?

Yes. If you provide boundary definitions we can add these to the maps (see FAQ 10 above)

(13) Can we map service provision on top of and service users on top of needs estimates?

Yes, both service users and service provision can be mapped (see FAQ 10 above)

(14) Why aren't Confidence Intervals or other measures of precision provided on the outputs?

Error bars aren't necessarily appropriate to this sort of modelling. The Planning4care tool estimates prevalence of particular needs groups and then applies (and explores) different hypotheses to explore the implications for services and costs. The data provided is an estimate, rather than a precise science.

(15) How does Planning4care differ from the 'Projecting Older People Population Information System' (POPPI)?

Planning4care extends the data provided in the POPPI system in a number of ways:

• The key difference is that Planning4care provides local level analysis, taking into account the impact of local risk factors (such as deprivation levels) on the level of social care need. POPPI simply applies national prevalence rates to local populations.
• Planning4care profiles the older population by different levels of social care need. POPPI primarily uses prevalence of different medical conditions.
• Planning4care links the overall level of social care need to indicative service requirements and costs (based on local care packages and unit costs), for both the whole population and those receiving LA funded/commissioned services
• As a strategic assessment tool, Planning4care can explore the impact of different scenarios (such as shifts from residential to community care, or changes in health-levels), on levels of need, service requirements and costs
• Planning4care can identify, and map, the areas of greatest need at sub-District level (based on the estimated impact of local risk factors). POPPI provides data to District only

(16) How does Planning4care differ from the 'Tool for Rapid Analysis of Care Services' (TRACS)?

Planning4care and Tool for Rapid Analysis of Care Services (TRACS) have different, but complementary, functions.

• Planning4care starts from a population needs assessment perspective, and predicts the overall care needs of the whole of the 65+ population, irrespective of how services are provided and funded at present. Planning4care also estimates how levels of need will change in the future, based on demographic projections as well as different scenarios such as changing patterns of care.
• TRACS allows a detailed analysis of purchasing patterns for the existing LA client base, and exploration of alternative patterns of costings and provision.

(17) Can we use different population projections, such as the London projections developed by GLA/DMAG?

Yes.

Release 1.3 of the Planning4care tool enabled users to provide their own population projections. We have loaded in the London projections developed by GLA/DMAG, and can load additional projections on request.

(18) Can everyone in the LA and PCT use the tool?

Yes. A single license covers all users in the PCT and LA

(19) Why do we need to know about "whole populations"?

Firstly, this is a "must do" and links to the new duty upon local authorities and PCTs to undertake Joint Strategic Needs Assessment (JSNA). JSNA identifies "the big picture" in terms of the health and well-being needs and inequalities of a local population, and is the starting point for setting local priorities through Local Area Agreements.

Secondly, commissioning strategies should take account of all people requiring social care, regardless of whether they are arranging their care through public agencies or not. CSCI has recently highlighted "a sharp divide" between those who do and do not qualify for publicly funded care, and Directors of Adult Social Services have an important role in ensuring that there is advice about options and sufficient quality supply of social care provision for all who need it, regardless of who is paying. This is underlined by the commitment in The Puttting People First concordat to achieve universal information, advice and advocacy.

Thirdly, the boundaries between "potential self-funders" and people getting services through local authorities will be increasing blurred in the future as the policy of individual budgets is implemented. The current review of funding arrangements for social care may also result in new funding arrangements that move away from the strict divide between potential self-funders and those publicly funded.

(20) What about 'Extra Care' - is this included?

Extra Care Housing is not included as a separate service category, but would be included under the broader term 'residential' services. A proportion of people whose needs are met by residential services at present, may in the future receive their care in "Extra Care Housing". This may have an impact on overall funding requirements if the unit costs for Extra Care Housing are different from that of Residential / Nursing Homes. This could be modelled by varying the unit cost in the Care Packages option.

(21) How do we use Planning4care in our JSNA and commissioning work?

See Using Planning4care to develop commissioning strategies for information.

(22) Are people needing intermediate or transitional care included in the model?

Currently Planning4care does not include people needing short term intermediate as a separately identified needs group. However, the estimates of numbers of people at different levels of needs will at any time include some people whose needs level is of a transitional rather than long term nature. We are looking at ways of separating out this group in future versions.

(23) Why have the estimated numbers of people with dementia changed in version 1.3 of the Planning4care tool?

Our analysis of dementia levels is now based on the Dementia UK 2007 study, as the currently most widely adopted set of prevalence rates by age and gender. We've also included estimates of the numbers with severe combined cognitive and functional impairment, from the prevalence rates given in recent PSSRU research. These are included as a subset of the "very high needs group" and replace the previous estimates of those with "critical interval" level of dementia.

In version 1.3 of the Planning4care tool, the prevalence rates by age-groups (5-year bands up to 84, 85+)¹ and gender are from the Dementia UK report², as being the currently most widely-used source of dementia prevalence. This provides the basis for estimates of the total numbers of people with dementia (all levels).

Estimates of the numbers of people within this group likely to have care needs at the "very high" level are based on the prevalence (by age group and gender) of people with combined cognitive and functional needs, taken from recent PSSRU research³. This group is expected to comprise primarily people whose level of cognitive impairment is sufficiently severe as to affect their day-to-day capacity to function - i.e. people for whom their functional disability is a direct result of their cognitive impairment. It will, however, also include some people who have both physical and cognitive impairment and for whom the requirement for day-to-day support is due primarily to their physical disability (i.e. whose level of cognitive impairment alone would not have put them in the very high needs group). 85% of this overall "combined" group are estimated to be in residential or nursing home care⁴.

¹ Source actually gives 5-year bands up to 95+, but population projections only have bandings up to 85+. We have therefore applied a national weighting to derive an equivalent 85+ prevalence.
² Dementia UK: The full report, Alzheimer’s Society, 2007
³ Comas-Herrara et al, International Journal of Geriatric Psychiatry, 2007, 22, 1037
⁴ Comas-Herrera et al, 2003, PSSRU Discussion Paper 1728