Transcript Competitive Tendering

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COMMISSIONING SERVICES
TO MEET THE NEEDS OF
PEOPLE WITH LEARNING
DISABILITIES IN SCOTLAND
View of those who use services
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Learning Disability Alliance Scotland
• Our job is to make sure that
• the Scottish Parliament,
• the Westminster Parliament
• and local statutory organisations like councils
• listen to the views of people with learning disabilities and
their families and carers
• and reflect these in all major policies, laws and changes
which may affect them.
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Commissioning up to 2005
• Early commissioning is characterised by
• No Central Strategy from Government
• Shared values at all levels
• Haphazard growth based on local and personal connections
• The Same As You (2000) was a ten year plan to
modernise learning disability services
• Established 3 yearly “Planning in Practice” agreements
as a planning and commissioning tool.
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What changed
• PIPs were never fully embraced nor did they link to
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procurement.
Continuing local variations in how services were planned.
Local councils became responsible to 75% of spending on
learning disability support
Commissioners worked with voluntary sector to deliver
broadly what was in these plans and what fitted with the
ethos of particular groups.
No agreed basis of quality but large investments in
services.
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Commissioning & Procurement
Challenges 2006 on
• Rise of public sector efficiency agenda - McLelland Report
• Almost all external services had to be justified by “Best
Value” and competitive tendering became the
procurement tool of choice.
• Local authorities seeking to reorganise “high” spending
and rationalise “numerous” services
• From 2006 – 2008 4 high profile Learning Disability were
subject to competitive tendering.
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Emergence of Competitive Tendering
• Poor consultation.
• Service Users information and consultation managed by
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Advocacy agency – a conflicted dual role
Limited involvement in procurement process in some
cases.
Most Services Users were not told until one month before
change – to avoid worry - and of course were unhappy
worried and angry
Lots of anxiety during transition with some short term
problems but managed okay.
In the long term – staff and management continuity has
helped and service users have adjusted but still some
resentment.
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Competitive Tendering in Edinburgh
• Whole service competitive tendering
• 700 in Edinburgh
• Aim of process was choice, quality, cost reduction and to
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meet the needs of those without a service.
Limited consultation
People very angry
Better organised in users & carers groups
Major campaign in Edinburgh
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Why the concern?
• Lack of choice of what happened to them
• Had a different view of what was quality.
• Many been involved in planning and consultation
processes but not these plans were not used.
• Contrast with public statements about user involvement
and participation.
• People had “hidden” relationships with support
organisations.
• People felt there were alternatives such as Direct
Payments.
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Candlelight Vigil
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Demonstration at Council
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Letter writing
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Outcome
• Competitive Tendering abandoned in Edinburgh.
• Services users very happy.
• Still talking about it.
• Providers agreed 10% cut in costs.
• New commissioning and consultation process drawn up.
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National Award for Campaigning
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A new Commissioning Strategy
• Growing concern led to new strategy
• Positive link between Commissioning and Procurement as
part of overall process
• Continuity between all stages of Analyse - Plan – Do –
Review.
• People who use services should be involved at different
stages.
• Different ways to involve people.
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A debate on quality
• 3 schools of thought
• User Defined Quality - Talking Points
• Proxy Indicators of Quality – policies, previous experience
• Inspected Standards – eg medicine
• No single agreed method
• Only 2% found poor – given time to improve – not
necessarily decommissioned.
• National Involvement Network
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Choice
• Most people choose to stay where they are
• Choice enters when services are bad or people have a
bad experience.
• Some reasons
• Assessing, planning and delivering complex packages of care
involve a lot of work.
• Individuals are involved in “unseen” ways with organisations
• However for many people there is no need to move
house to exercise choice.
• Eg service users involved in recruitment but also can
refuse particular staff.
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Self Directed Support
• Personalisation seen as service change mechanism.
• More control for individuals – can be linked to cost
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reductions but not necessarily.
Pilot project examples are good quality, slow and well
received.
Only 963 people with learning disabilities or their families
have such payments.
Most who voluntarily choose this have had bad previous
experiences.
A number of local authorities including Glasgow are
imposing a form of Individual Budgets.
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Preventative Services
• More Scottish Government investment this budget
• Reablement for Older People
• For people with learning disabilities
• Clear Intended Outcomes
• Local Service Coordination • Accessible Information & Advice.
• Emergency Planning • Short Breaks • Social And Friendship Support Flexible Support Budgets
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Procurement in Scotland
• PIPs have stopped and no major new plans or
commissioning work recently.
• No competitive tendering for existing learning disability
services since Jan 2010.
• Framework agreements more common.
• Quality is a condition of contract renewal and service user
views are a component of quality.
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Future Developments
• Self Directed Support will becomes default
• Individual choice of support type and provider
• Regulation continues through Care Inspectorate, Scottish
Social Services Commission, OSCR
• Local authority commission may limit degree of choice
• More investment in preventative services