Notes from Hampshire County Council Provider Day 28 May 2013

Aim of Day: To involve Providers in the next stage of the commissioning plans, following the Supporting People Strategic Review of Long Term Services, and to introduce the concept of coproduction of contracts.

The commissioning aspirations following the Strategic Review, were outlined, in relation to:

1.National perspective – Care and Support White Paper

2.HampshireCounty Council Adult Services Vision: Prevention and Early Intervention; Reablement and Crisis support; Long Term Care

3.Personalisation and Co Production

4.Commissioning for Outcomes and potential for payment by results

Presentations:

Mike Ballard from SITRA, to look at Personalisation and Coproduction in more detail.

Ed Walton, Hampshire County Council, to present HCC aspiration to deliver and commission services in line with Think Local Act Personal (TLAP) objectives.

Kevin Ingram, Hampshire County Council Corporate Procurement team, providing information about possible solutions to working in partnership to deliver contracts; Consortia and sub contracting. Kevin also outline the Social Value Act 2013 and the potential this has for commissioning.

Discussion arising from presentations identified initial anxieties about HCC moving to larger contracts and away from small and unique providers; this is where we would like you to tell us about your concerns, and to think about how you can resolve this by working in partnership with larger and smaller organisations in the future. NB Formal consortia are not compulsory for tenders. This is one option available to larger and smaller providers to consider, when building a business case for delivery of a contract, which will require evidence of ability to delivery services to a range of support need and client groups.

Concerns were raised about some of the examples given in presentations, for example the use by some providers of zero hours staff contracts to deliver a more personalised services. This is one example of how one provider has chosen to do this. HCC is not planning to impose this or any other model of service delivery on any provider. In fact, we don’t want to impose any model. We would like to commission Providers to coproduce with us, and to develop their own model with service users and other stakeholders.

Questions were asked about Payment by Results, and the idea would not be popular if this were applied to the overarching strategic targets set in Service Specifications. Would you like to set your own target for delivering social value, that could be paid by results?

Coproduction: is a concept not a model, and this event is a first attempt by Supporting People to Coproduce services with Providers. The services that will be tendered, will be commissioned as developmental contracts, which will be coproduced with Provider, HCC, Service Users, carers, families, Care Managers and other stakeholders to develop and deliver Personalised, community based and community focussed services.

Work Shop

Tables were asked to consider questions and offer thoughts and ideas.

Future Provision

The numbers after the comment indicate the number of times this was raised by contributors.

•What outcomes would you like to see included/ what needs to be considered?

•Engaging in leisure training and employment.

•Recognise differences between providers – e.g. day services and housing. 1

•Having provider events to increase awareness of services to service users and carers – organised by Council. 1

•How would services users change service providers? 1

•Framework for Commissioning. 1

•Engage service users, carers and staff. 1

•Reduce procurement burden. 1

•Tenders should describe how it will be delivered over the full term of the contract. 1

•Customer satisfaction survey from SP – leading to individuals identifying their own outcomes – link to TLAP and outputs. 1

•Contract generic measurable outcomes that recognise “social values” and quality of delivery.1

•Customers wanting support and care from same provider.1

•Drop in centres and quick assessments for clients with autism or ADHD.1

•More flexibility with options to step up/step down level of care.1

•Control and choice of provider to move more to customers wants and desire.1

•Advocacy demand and supply. 1

•Clients feeling safe in the home.1

•SP could be part of Direct payments – give individuals money (still clear objectives).1

•Move away from seeing the client as a commodity. 1

•Better use of brokers in the commissioning/procurement process.1

•Individual budgets – Framework for individuals to be able to call off services across Adult social care and support. 1

•Launch pad model - providers need to work together. Al involved in working with individuals, monitoring, cover, increased communication, increase new project consortia. Share resources.

•Framework of overarching objectives/outcomes linked to TLAP ‘I’ statements 1

•Ringfence staffing costs to maintain good level of pay and conditions. 1

•How might you measure these?

  • Who would monitor services? 1
  • How would we measure maintenance packages.1
  • Want individual outcomes for each service user. 1
  • Happy with QAF. 1
  • St Andrews too compartmentalised. 1

•Keep measurements fluid and as open as possible – what has to be measured, keep simple and then can focus on clients. 1

•Measuring quality of life, personal perceptions – can these be measured bottom up rather than top down?1

•Payment by results. 1

•Need to agree shared outcomes at the start with individuals 1.

•Why are we all using different tools?1

What do you think about payment by results?

  • Process can be tricky. 1
  • Targets and timescales need to be realistic. 2
  • Have lead in time for teething problems. 1
  • Needs to be joint ownership. 1
  • Must not compromise on quality. 1
  • Carrot approach. 1
  • Dire idea!1
  • See prison services – PBR – difficult. 1
  • Worry about payments being withheld. 2
  • High need/High vulnerability/unpredictable clients. 2
  • SP Services – Small companies will struggle. 4
  • Worry about reputation being affected by sub-contractors. 2
  • Flexibility in contracts – listen to providers. 1
  • Safeguarding – how do you safeguard individuals effectively? 1
  • Effect on workers behaviours and the quality of staff. 2
  • Tailoring services to those outcome areas/cherry picking gateway control of who’s on service? 1
  • Provide an incentive to do what the commissioners want not necessarily the individuals.1

Who might your potential partners be?

•How do we partnership work with competitors – including in-house services? 1

•How does this tie in with CCG’s? 1

•CCG’s, JSNA and Health and Wellbeing board.2

•Volunteer networks, third sector and housing. 2

•Peer support networks.2

•Locally committed organisations 1

Co-production

•How can we all increase co-production?

•Individual personalised goals with actions/measures when goals are not achieved. 1

•Co-Production is reliant on partnership working with the local authority. 2

•Clear understanding and time given by HCC. 1

•Involve service users and carers in procurement. 1

•Different way of contracting. 1

•Work with locally committed organisations. 2

•Listening to and involving and acting upon suggestions from individuals, their families, friends, advocates and employers.3

•Networking.1

•Links with preferred care providers. 1

Social Value

•How could your service measure this?

  • Peer support is positive but has it’s own risks – how best to support people to support each other? 2
  • Right people with the right support? 1
  • Equal values for service users and staff. 1
  • Ring fence pay and conditions. 1
  • Issues for staff – zero hours contracts. 2
  • Social value for staff/employment/support – stability of organisations, travel time and costs for staff. 1
  • Personally identified outcomes.1
  • Capture the “added value” components – the creative, flexible ways of offering support that leads to greater independence and improved circles of support.1
  • Customer opportunities, retention, apprenticeship, volunteering, sharing your resources and developing customers skills and confidence.1
  • Customers quality assessment.1
  • How can you evidence its success?
  • Avoid tokenism….1
  • Wider information of who else is doing similar things. 1
  • Outputs are valid measurements (maintenance of house etc) as well as outcomes. 1

Consortium

•Who else is about (providers) and what could they offer to a consortium?

  • Maybe an “introductions” meeting where organisations could “present” would be good. 3
  • How can we provide adequate references 5
  • Apparent pressure upon providers to absorb the lead and costs involved in this process. 1
  • Use consortia – an organisation to lead on meeting/working with an individual.1

Concerns/Suggestions

  • What about the people we currently support not meeting the Adult services eligibility criteria? 1
  • Clearer information and guidance linked to the above.1
  • List of attendees from today to be shared.1
  • Speed dating for providers.2
  • Gardening Projects.1
  • Why are we all using different tools for assessment?1
  • Services need to be seamless for the person 1
  • ‘only tell my story once’ system to reduce the need for service users to repeat key information to different agencies. 1
  • Potential impact on smaller organisations needs to be considered.1
  • Zero hours contracts – potential issue for staff. 1

Next Steps

Providers would like support to develop ideas of working together in the future, a ‘speed dating’ event was suggested, and will be arranged by HCC, for later in the Summer 2013.

Future Provider Day will be arranged to further develop the idea of Coproduction with Providers who may wish to tender for services later in the year. It will not be compulsory to attend any of these events.

The abovediscussions, ideas and concerns for future commissioning will be further developed at future meetings with Providers, Service Users, and other Stakeholders will have opportunities to be involved with the development of commissioning plans.