Transcript Powerpoint Template

Emma Meekin
Access to Resources Team Manager,
Cheshire West and Chester Council
A little bit of context
• Commissioning on a small scale (in terms of numbers),
with a defined role within social care, but high cost...
• ... Therefore high risk area in terms of finance, and high
profile with senior managers and councillors
• This area includes the whole commissioning cycle –
needs analysis, procurement, market management,
contracting, review
• Can be very complex, with needs identified and care
plans determined by social workers
• With all the similar features of commissioning on a
larger scale, including challenges... And opportunities
The problem we had...
• A duty team to manage emergency referrals
• 1 contracting officer for agency contracts (residential
and foster care)
• Negotiation with agencies done by social workers
• No consistent approach to using providers
• Costs agreed by a range of people and paid by others
• No management of data or finances
• No way of knowing whether we were improving
outcomes for children or getting value for money
ART’s objectives
• To ensure that we receive quality, value for money
services that improve outcomes
• Researching options, developing preferred provider
lists to drive up quality and using commissioning
frameworks
• Negotiating with providers regarding cost and quality
• Tracking placements and costs
• To reduce the pressure on social workers to
commission services
• To oversee the use of all external resources and
reduce ‘drift’ in placements
The role of the ART
•
Using a model from other places: Ealing, Westminster, Tower Hamlets,
Croydon, Bournemouth, Essex, Lambeth, Buckinghamshire, Sheffield, Merton, Kent, Peterborough, Hackney...
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ART offers a ‘one stop approach’ to accessing services that will
investigate all available resources both in-house and external with a
key aim of commissioning high quality, value for money services that
improve outcomes for children and young people.
ART will aim to provide a single point of referral for:
– advice on placements
– resource finding
– contracting, review and monitoring
– centralised purchasing/brokerage of services
– payment and invoice management of all services purchased
DCSF Commissioning Model
What makes good commissioning of
placements? (1)
• Understanding the needs of children &
young people requiring placements;
identifying priorities
– Social worker needs assessment
– Triangulating the views of education,
health and any other professional who
knows the child/young person
– Views of children and young people
What makes good commissioning of
placements? (2)
• Looking at available resources & planning
service provision
– Looking at in-house provision: fostering,
residential, therapy, short breaks...
– If these are ruled out, considering options in
a graduated response, unless needs dictate
otherwise; using provider frameworks
– Opportunities for creativity
What makes good commissioning of
placements? (3)
• Outcomes for children and young people
– What do we want placements to achieve
for our children/young people?
– Challenge for providers
– Evidence, including the views of the
child/young person
– Multi-agency input
– Regular review and tracking of progress
What makes good commissioning of
placements? (4)
• Commissioning services efficiently,
commissioning (with pooled budgets)
– Working with education and health colleagues
inc. payments
– Negotiating with providers over cost
– Contracting, where off contract
– Involving all parties in outcome agreements
– Reducing placement cost as outcomes
improve
What makes good commissioning of
placements? (5)
• Monitor and review services and process
– Contract monitoring meetings
– Compliance visits
– Information required from providers
– Feedback from providers, social workers,
other relevant professionals,
children/young people
– What difference has it made?
What makes good commissioning of
placements? (6)
• Plan for workforce & market development
– In house vs. agency provision: what could be
provided in house more cost effectively?
– Commissioning frameworks: tendering for
services not part of PNW/Adult’s LD framework
e.g. therapy
– What can be provided before a child is in care or
to divert large packages of care?
– Sufficiency: Working with providers to develop
provision closer to home
Focus on prevention?
• Long term prevention: to avoid placement
moves and improve outcomes for some of the
most complex children/young people
• How do we use data to inform future
commissioning and market management?
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need
statistics
spend
trends
efficiencies
Case studies (1)
• Young man W, 10 years
– W was placed in foster care since the age of 5 with very
experienced and highly regarded carers
– Complex young man with considerable emotional difficulties
often displayed through aggressive and destructive
behaviour. There were considerable issues with behaviour in
school leading to non attendance
– Involvement of police, externally commissioned therapy,
CAMHS, education, social care
– Multi-agency work done to support placement stability
– Now accommodated in a specialist residential school with
care, therapy and education included
– He says he really quite likes it
Case studies (2)
• Young woman Y, 13 years
– 3 placement moves in 3 months
– Complex behavioural and emotional difficulties, with a
number of missing episodes and high risk of sexual
exploitation. Secure provision considered in order to
keep her safe
– Risks taken by previous care providers unable to
manage behaviour
– Current placement managing incidents... At £6150 per
week
– She says “she is happy at placement but really misses
her family and wishes to be at home”
Key learning points
• Relationships with providers
• Working together: across teams, directorates,
agencies, local authorities...
• Focus on outcomes and aspiring for better for our
children and young people
• What are the systems and processes that can
help us?
• Embracing the opportunities to be innovative and
not being afraid of change... or challenge!
"If you always do what you've always done,
you'll always get what you've always got."
Henry Ford (1863-1947), American founder of
the Ford Motor Company
“Change is inevitable, progress is optional”
Tony Robbins, US Life Coach