Voluntary Sector Partnership Joint Commissioning and Procurement Presentation 20th October 2016 Ian Mello, Borough SRO Locality Plan Susan Crutchley, Programme Manager
Agenda 1) What is joint commissioning? 2) Why RMBC & CCG are doing it? 3) How it is being done (i.e. staff working as teams around theme such as dementia, older people, children, joint commissioning boards etc.)? 4) Will there be the opportunity for co-design of services with the sector and the communities they serve as part of joint commissioning? 5) Will there be a commissioning strategy developed, if so, will this be shared with the sector? 6) How will this affect current funding/contracting arrangements between the sector and CCG or between the sector and RMBC? 7) STAR Procurement – short presentation about the process – Development of Tender Specifications, Advertising the opportunity, Pre- Qualification Questionnaire, Invitation to Tender, Timeframes for submission of documents, decision making 8) Locality Plan update
1) What is joint commissioning? Joint Commissioning is a strategic approach to planning and delivering services in a holistic, integrated joined-up way. It is a means for the different partners commissioning public health and health services and social care provision, to deliver positive outcomes for local populations. We also jointly commission with other north east sector localities such as Bury and Oldham. 2) Why RMBC & CCG are doing it? The NHS Five Year Forward View set policy clearly that CCG’s and Councils must deliver integrated services and work towards new models of health and social care in one single joint commissioning context. The Greater Manchester Health and Social Care Partnership is also taking this policy forward more locally. 3) How it is being done (i.e. staff working as teams around theme such as dementia, older people, children, joint commissioning boards etc.)? To date we have created an Integrated Commissioning Board and throughout this financial year we are in a shadow or learning year for adult services commissioning. We have also worked together on major projects such as the Oasis Unit at Rochdale Infirmary.
4) Will there be the opportunity for co-design of services with the sector and the communities they serve as part of joint commissioning? Both the CCG and Council are fully committed to this principle and want to take this forward locally. Last year we held over 40 engagement events for the Locality Plan and we will be establishing another programme of them very soon. 5) Will there be a commissioning strategy developed, if so, will this be shared with the sector? The Locality Plan will soon have an Operational Plan and this effectively will be our five year commissioning strategy. This has to be completed by third week of February 2017 for submission to GMHSCP: we want to engage and consult with you and the public and our stakeholders about this.
6) How will this affect current funding/contracting arrangements between the sector and CCG or between the sector and RMBC? We are currently working with CVS and partners on the Health and Well-Being Alliance model and see this as a formal part of our Locality Plan. We are also working towards one single procurement and contracting approach across the CCG and Council: we are happy to develop this with the sector going forward. 7) STAR Procurement See following slides
STAR Procurement – The Process. • All clients must complete a Procurement Initiation Document before starting their process. This includes budget available, current arrangement and service outcomes. This is then signed off by Finance and Operational Leads. Any contracts above £250,000 total value are sent for Cabinet approval at Rochdale. • Needs Assessments, Market Engagement Sessions, Service User Feedback are all collected as part of developing the Tender Specifications. • All Procurements over £50,000 are advertised via the Procurement Portal The Chest. This is a clear audit trail of the process from start to finish. https://www.the-chest.org.uk/ Procurements over EU Thresholds are advertised for Minimum 30 days
STAR Procurement – The Documentation . • Suitability Assessment Questionnaire - Pass/Fail Document which checks Organisations Policies E.g Health and Safety, Safeguarding, Financial Standing and Economic Capability. • Invitation to Tender – Document which instructs all bidders on timescales and evaluation criteria for each project. Organisational proposals are also detailed in this document. These are evaluated using a strict Quality Guidance document briefed with Evaluation Panel. • Decision Making – All bids are evaluated in conjuntion with the Council’s Contract Procedure Rules and Best Practice. Moderation meetings to determine an agreed score and bidder feedback is undertaken. Common place to try and get Service User representation on the panel providing no conflict of interests occur
Locality Plan Update • LCO development • Transformation Fund Bid • Locality Plan Service Model: (over 50 engagement and co-production sessions held to develop service model, biggest process in any GM Locality Plan: will be repeated throughout Winter 2016 until February 2017)
As you are no doubt aware the locality has to establish an LCO under the Greater Manchester Strategic Plan and guidance on this is clear : “ Fully integrated Locality Care Organisations (LCOs) will be established in each part of Greater Manchester. These Organisations, including all health and social care providers in a locality will be working together collaboratively to provide care to a defined population within a defined budget with primary care at the centre, predicated on the GP registered list. Each area will develop and design their delivery models. However, there will be core features of these new organisations to be defined and agreed locally.”
What are LCOs? • Multiple organisations working together to deliver health and care services within a defined budget; • Have the ability to manage and co-ordinate the care of individuals along full length of clinical and social care pathways; • Demonstrate a standardised approach to quality improvement activity, including patient safety; • They treat and support patients in different more appropriate settings as a result of improved co-ordination; • Importantly they demonstrate increased involvement and engagement of patients and service users in design, delivery and improvement of services; • They are proactive in the management of population groups to inform early intervention and prevention; • They have integrated IT solutions to support the collaboration .
Developing Accountable Care Local Care Organisation What difference will we make? 1 Impact aspiration What are needs of population by population, activity, spend, needs Population needs 2 What are the highest priorities to address? 3 Changes in Care What are the key changes in how care is delivered to key segments of population? What changes are required in who does what from where? Delivery 4 (core processes, workforce, delivery in person vs electronic, setting)? requirements How will flow of information will change to enable these changes? Changes in (Information governance, patient level data set, core functions of delivery, engaging 5 information patients, performance and payment) What changes in payment need to be made to: a) directly reimburse costs, b) Changes in 6 incentivise behaviour, c) transfer accountability/risk will be made? payment How will this operate and how will it be phased in? What are key functions the need changes (e.g, function of teams, operational control, Governance 7 managing financial risk, accessing capabilities)? Identify changes in governance and delivery model (e.g., accountable care, group, etc) Support the transformational changes needed in behaviour and interactions in the 8 Development system 31
Example of LCO operating model 13 Review of performance and processwithin thecareteam 5 12 Multi-disciplinarycare team Case conference to working discusscomplex ü cases/issues ü 7 Navigation to access support Specialist 1 Patient resources 3 1 2 Identification 8 Identification Patient ofpatient ofhigh risk enrollment GPP 2 Allied health goals Discharge planning patients In CC programme health and coordination 11 professional Regular reviewand update ofcare plan with patient/family 9 Care coordinator Social Accessto specialist opinion worker 10 4 Pharmacist Integrated health Development Behavioral and social care ofcare plan health team in home with patient 37 1 Specialists in both inpatient or outpatient settings 2 Includes primary care physicians, advanced practice nurses, physicians assistants SOURCE: North West London Integrated Care Pilot; Dorling, & Richardson - Evidenced interventions for integrated care (2014)
GM Devolution Plan: Transformation Fund • The Plan enabled GM to secure a £450 million Transformation Fund. • The Fund was designed to enable places to develop new models of care which began to change the nature of demand and to keep existing services safe and sustainable while the radical change was happening. • The agreed £450m is to be used to drive the transformation required by the 5 Year Forward View and as such the funding from NHSE is to be phased through a 5 year period, as outlined below. 16/17 17/18 18/19 19/20 20/21 Total TF (£m) 60 120 150 70 50 450
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