Incapacity Benefit reforms pilot

The Condition Management Programme The Role of Independent Providers Eric Sharp February 2006

Use of independent Providers

• Seven pilot areas • Models used are fully in-house, largely contracted out, and mixed • Reasons for choosing these models are related to local factors • Derbyshire and Essex have substantial contracted-out services • Mixed models seem to be preferred by the 14 ‘new’ sites

Contracted-out models

• One model is for assessment to be carried out in house, and provision to be contracted out – Essex use this • However, assessment can also be contracted out - Derbyshire do this • Modules of service can be contracted out – these can range from exercise tuition to elements of clinical service

Independent providers can bring:

• Specialist knowledge • Capacity and capability • Enthusiasm • Credibility with service users • An independent perspective

Challenges for independent providers

• It can be difficult to recruit and manage health care professionals in a non-health organisation • Long term funding may not be guaranteed • The services required may fall outside the direct experience of the organisation • There may be the need to share knowledge and materials with potential rivals

Challenges for commissioners

• Timescales are tight • Usually there is no right or wrong approach, but decisions are needed • Existing commissioning structures are not set up to initiate these sorts of service • There is no ready-made marketplace for services

Shared Challenges

• The commissioner will have an outline of the services needed, but providers will have perspectives to offer • Providers are competitors, but may have to work together • Services have to be delivered within a cost framework • Funding is time limited, and subject to review

Contracts

• The contract should reflect not only the type of service, but the approach to delivery – eg a groupwork contract will tend to inhibit individual interventions • Contracts can reduce but not eliminate the risks for both parties • Formal monitoring is not enough in itself – good dialogue and trust is essential • Volume-related or block contracts each have their advantages and disadvantages

More Challenges!

• The project is fast moving – providers should be able to follow the specification, but make creative suggestions for change • CMP needs to stay within boundaries, and not duplicate existing services • The requirements may change over time in the light of experience, or external pressures • But the rewards can be gratifying, in terms of customer feedback

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