S43 joint strategic commissiong fintry


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Joint Strategic Commissioning is at the heart of the Public Bodies (Joint Working) Bill. JIT has recently issued guidance on what Partnerships need to do in order to develop Strategic Plans that incorporate a Financial Plan, relating to all integrated resources, by April 2015. This session provides an opportunity to further explore the scale and scope of what partnerships are required to do to deliver on the opportunities and ambitions of integrated health and social care. Contributed by: Joint Improvement Team

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S43 joint strategic commissiong fintry

  1. 1. Joint Strategic Commissioning Raising the Bar Tony Homer, Joint Strategic Commissioning Lead, Joint Improvement Team 1 JIT is a strategic improvement partnership between the Scottish Government, NHS Scotland, CoSLA, the Third Sector, the Independent Sector and the Housing Sector
  2. 2. Content  About the JIT  Context –The Challenge, Key drivers, Legislation  Public Bodies (Joint Working) Scotland Bill 2014  Implications for Joint Strategic Commissioning (JSC)  Challenges for Partnerships
  3. 3. About the Joint Improvement Team (JIT)  JIT is a strategic improvement partnership between the Scottish Government, NHS Scotland, COSLA and the Third, Independent and Housing Sectors  We work with partnerships to create the conditions for improvement, to implement national strategies and to deliver better outcomes in health, social care and housing services, including through:  Building capacity and developing skills  Sharing knowledge  Improving outcomes through joint strategic commissioning processes which include effective analysis and needs assessment.  Constructive challenge  Strategic Planning (Joint Strategic Commissioning) Advice Note  Learning and Development Framework
  4. 4. Context The Challenge “public service providers must be required to work much more closely in partnership, to integrate service provision and thus improve the outcomes they achieve”. Statutory powers and duties focussed on improving outcomes. Embedding community participation in the design and delivery of services. Developing joined-up services, backed by funding arrangements requiring integrated provision. Applying commissioning and procurement standards consistently and transparently. Public Services (Christie) Commission (2011)
  5. 5. Why? Key Drivers for Change 5
  6. 6. Key Legislative Drivers Public Bodies (Joint Working) (Scotland ) Bill 2013 Social Care (Self-directed Support) Act 2013 & wider framework Community Empowerment (Scotland) Bill Human Rights (SNAP) Community Planning & SOAs Reshaping Care for Older People National Legislation & Strategies inc Criminal
  7. 7. The Public Bodies (Joint Working) (Scotland) Bill
  8. 8. Integration- The Vision People are supported to live well at home or in the community for as much time as they can They have a positive experience of health and
  9. 9. The Purpose of the Public Bodies (Joint Working) (Scotland) Bill •To improve the quality and consistency of services for patients, carers, service users and their families; •To provide seamless, joined up quality health and social care services in order to care for people in their homes or a homely setting where it safe to do so; •To ensure resources are used effectively and efficiently to deliver services that meet the increasing number of people with longer term and often complex needs, many of whom are older.”
  10. 10. Public Bodies (Joint Working) (Scotland) Bill (2014) Defines… Principles for integrated health and social care Nationally agreed outcomes for health and wellbeing Integrated governance arrangements for health and social care: delegation to a body corporate or lead agency
  11. 11. Joint Strategic Commissioning “Strategic commissioning is the term used for all the activities involved in assessing and forecasting needs, links investment to all agreed desired outcomes, considering options, planning the nature, range and quality of future services and working in partnership to put these in place.” “Joint commissioning is where these actions are undertaken by two or more agencies working together, typically health and local government, and often from a pooled or aligned budget.” Public Bodies ( Joint Working) (Scotland ) Bill 28.05.13 – Policy Memorandum para 117 Adopted from the National Steering Group definition
  12. 12. The Public Bodies (Joint Working) (Scotland) Bill - legislative requirements • Strategic Plans to be developed for all adult care groups, (Joint Strategic Commissioning Plans) to include specified functions and a Financial plan by April 2015 • Strategic Planning Group to be established by Partnerships for the purpose of preparing a Strategic Plan • Localities - Partnerships will establish at least 2 localities to undertake locality planning and inform the strategic plan
  13. 13. Good Strategic Plans (Joint Strategic Commissioning plans) should: • Identify the total resources available across health and social care for each client group and relate this information to the needs of local populations; • Agree desired outcomes and link investment to them; • Assure sound clinical and care governance is embedded; • Use a coherent approach to selecting and prioritising investment and disinvestment decisions; and • Reflect closely the needs and plans articulated at locality level. 13
  14. 14. Strategic Planning Group • Purpose is to prepare a Strategic Plan and to maintain an ongoing role in reviewing and improving the Strategic Plan • Membership will include: – People who use services and unpaid carers – Third and independent sector providers, representative organisations and advocacy groups – Local authority and Health Board nominees – Social work and social care professionals – GPs, clinicians, nurses, AHPs and other professional groups – Housing representatives – A representative from each locality planning group – Staff side and/or trade union representatives
  15. 15. The Role of Localities  To feed into the strategic commissioning process a collective view on what needs to be made available in respect of their locality  On an on-going basis decide on proposals from local professionals, users and communities on ways to improve the delivery of services for the locality.  In time, greater responsibility over financial & service planning, changes and decision making.
  16. 16. Localities – securing real added value  Not just a talking shop....  From care groups to assets, multi morbidities and real lives  Community empowerment and understanding people’s priorities  Making space for ‘individual commissioners’ to be heard and to share their thinking  Empowering clinicians, users and carers all to play their part  Where service changes can have a real and quick impact on outcomes
  17. 17. Critical success factors...
  18. 18. Group Discussion
  19. 19. • Do the key themes and legislative drivers reflect your experience of the current landscape? • Pace of change – what’s the reality? • How easy is it to put together and ‘good’ strategic plan- what helps/hinders? • What is your expectation of the future commissioning role in a world where ‘Individuals become commissioners’? • Outcomes- is commissioning sufficiently linked to outcomes? • Is ‘co-production’ achievable with ALL players at Strategic Planning Group and locality level?
  20. 20. • Joint Improvement Team http://www.jitscotland.org.uk/ • Scottish Government and COSLA (November 2010) Self-directed Support: A National Strategy for Scotland – section 5 “The Shift” http:// www.scotland.gov.uk/Publications/2010/11/05120810/0 • Public Bodies(Joint Working) (Scotland) Bill, Delegated Powers, and Policy Memoranda and Explanatory notes, 28.05.13 http://www.scottish.parliament.uk/help/63845.aspx • SWIA Commissioning Guide for self evaluation www.swia.gov.uk • Procurement Scotland www.scotland.gov.uk/Topics/Governement/Procurement • Age, Home and Community 2012; A Strategy For Housing For Scotland's Older People: 2012 - 2021 http:// www.scotland.gov.uk/Publications/2011/12/16091323/0 • Scottish National Action Plan for Human Rights http://www.scottishhumanrights.com/application/resources/documents/SNAP/ SNAPpdfWeb.pdf 20
  21. 21. Additional Slides for reference
  22. 22. Social Care (Self-directed Support) Act 2013
  23. 23. Social Care (Self-directed Support) Act 2013 • Comes into force in 2014. Replaces the previous legislation on Direct Payments & Self-Directed Support (SDS). • Requires a step change in how we view individuals – as commissioners of their own support regardless of their chosen option 23 “Individuals will have greater choice and control over the services they use through self-directed support for social care and person-centred healthcare.”
  24. 24. Potential Implications for future commissioning Points for consideration • Shift in Culture – using the SPG and locality planning as a means for the voice of the ‘individual commissioner’ to be heard; making a reality of ‘prevention’ and ‘upstream options’ in the Strategic Plan • Financial flexibility – ensuring that good quality, value for money services are available for people who decline self-directed support, or for users who choose not to become employers • Clear individual pricing mechanisms required in house and externally • Workforce – workforce planning essential to ensure sufficient numbers of Personal Assistants to address potential demand. • Commissioners as facilitators- Strategic Planning includes facilitating markets and building community infrastructure links, between existing assets.
  25. 25. • Provider diversification- Providers may find the transition to self- directed support challenging. Market facilitation and re-visiting the in-house / external position will be key • Independent advisors/advocacy- enabling individuals to make choices- change existing support • Care Management System - greater emphasis on providing information about choices and facilitating decision making • Add in shifting procurement parameters..
  26. 26. Procurement
  27. 27. Procurement Changes • ‘Person centred services’ will be subject to a lighter- regime for the procurement of certain social, health and education services with a higher threshold of €750,000 applying • Public bodies may take into account the need to ensure quality, continuity, accessibility, affordability, availability and comprehensiveness of the services, the specific needs of different categories of users, including disadvantaged and vulnerable groups, the involvement and empowerment of users and innovation • The Procurement Reform (Scotland) Bill, 2013 focuses on sustainable public procurement that supports economic growth by delivering social and environmental benefits including community benefits, supporting innovation and promoting public procurement processes and systems which are transparent, streamlined, standardised, proportionate, fair and business-friendly • http://www.scottish.parliament.uk/parliamentarybusiness/Bills/68170.as px
  28. 28. Human Rights
  29. 29. Approach for Change • Human rights – PANEL Approach – Participation – Accountability – Non discrimination – Empowerment – Legality
  30. 30. Joint Strategic Commissioning Cycle
  31. 31. The Commissioning Cycle 31 Developed by the Institute of Public Care, Oxford Brookes University
  32. 32. 32 • All four elements of the cycle are sequential and equally important. • The commissioning and purchasing/procurement cycles are linked. • The commissioning process must be equitable and transparent, and open to influence – a co-productive approach. • Have a written joined up commissioning plan, focusing on how to meet needs, improve outcomes and standards, to be met by all public service providers, with a clear financial plan Key principles of the model
  33. 33. A Tool for….  Understanding long term demand giving a common perception of the world.  Understanding the best approaches and methods for meeting that demand.  Improving and modernising supports and services to achieve better outcomes.  Encouraging innovative solutions by ALL providers.  Achieving best value by better configuration of delivery and greater efficiencies.  Managing and facilitating the market in a climate of changing independent and third sector providers.  Working across boundaries
  34. 34. Levels of commissioning; National Regional Sub-regional Area or strategic Locality Individual 34