Developing diversity in the marketplace

Andrew Jepps, Assistant Director, Adults and Children’s Commissioning

The Challenge of Choice

The changes in commissioning

•Moving from “traditional” social care commissioning•Moving towards:

• providing market data• signalling the market, • identifying where we procure, structure and capacity

build, where we intervene• developing market position statements

Analysis

• Joint Strategic Needs Assessment– Population data; comparative information; benchmarking;

demography; performance data– Customer and patient information; formal consultations,

ongoing feedback, focus groups, etc

• Other resources– Supply data, market intelligence– Where possible, detailed information on PBs

choices

Research

• Research into Self Directed Support – Your Money or Your Life?

• Lack of research capacity• Challenges in consumer research

Policy

• The multiple meanings of “choice”• Consumerist and/or empowering?• What do people really want?

Practicality

• Redesigning Resource Allocation System• Affordability• Ability to plan for the long term

Existing commitments

• Four PFI specialist care centres• Transferred residential care homes (PPP)• In-house direct services (residential,

reablement, specialist dom care, day centres)

Local Authority Teckal Company

• Ambition for April 2012• Challenge in releasing back office costs• VAT issues• Different spread of risk• Potential for ability to reposition services• May address some shortfalls in affordable

supply

Care homes

• Expected to pay rate challenges• The balance of self funding• The risks of failure in quality• The risks of failure in sustainability

– -Urgent closure protocol at SCIE site

Voluntary sector

• Diversity in range of VCS organisations• Challenges in aligning compact with procurement

advice• What is the balance of risk?• Reductions in prevention funding and reshaping

of services• Capacity varies organisation by organisation

Campus reprovision

• Complex and time consuming process• ISFs used• CHC issues• More limited “set menu” of providers ultimately

used• Challenges in the ability of threatened providers

to enable change

Capacity building

• VCS training on commissioning and procurement• National Provider Development project – Think

Local Act Personal (SCIE) (e.g. Acquired Brain Injury)

• Market place events – dream cards etc• Getting a Life Project

Mixed position

• PBs 45.5%• Nearly 40% of these have direct payments• About 4,000 PBs• Personal Health Budgets• PBs in children’s services• Increase in care home places within the county