Making It Personal How to Commission for Personalisation Claire Lazarus and Judith Smyth, OPM 9 th July 2012

Introductions

Content In this session:- An introduction to the draft publication Making It Personal – how to commission for personalisation How commissioning and commissioners can support the personalisation agenda How the guidance is being used

Making it Personal KIDS led project DfE SEN and Disability grant received April 2011 – 2 year project Partnership with In Control, OPM, National Association of Family Information Services (NAFIS), Disability rights UK (Radar)

Components

Progress to date Project Board Useful resources including case studies collected Young people and parents working groups Workshops organised for FISs - making_it_personal

Guidance for commissioners and others in children’s services 1 st draft produced October 2011 National workshop October 2011 Re-draft and 2 nd iteration produced Feb 12 2 nd national workshop March 2012 Workshop for South London LAs March 2012 Final national workshop 19/07/12 Bespoke support - making_it_personal

The guidance - how to commission for personalisation Iterative Practical Resource for commissioners and others Focus on personalisation and commissioning Interesting/challenging/alive Easy to use

What is commissioning

Understand, Plan, Do, Review – the familiar cycle The activities and processes that lead to decisions about how best to use public money and all the other resources available Good commissioning is needs led, outcome focussed and uses evidence of what works.

What is commissioning.2 It takes into account the views of stakeholders including service users; and Includes performance measurement and management, contestability (sometimes competition and outsourcing) in a well led and well governed system.

Why does commissioning work? A simple definition - Commissioning is the process for deciding how to use the total resource available; when done well it will improve outcomes in the most efficient, effective, equitable and sustainable way Its success lies in commissioners ability to be a powerful agent of change through a simple, clear and transferable commissioning approach. A simple process - that makes the most of all the resources/assets in a locality

Personalisation Describes the move away from people consuming services to an empowering, citizen-led approach to delivering outcomes Recognises that services do not produce outcomes – it is what people, along with their friends, families and neighbours do for themselves, supported by services which produce outcomes

Personalisation -Users are co- producers of the good(s) in question -Users are active participants in the process -Professionals deploy their knowledge to help users devise their own solutions – doing with not unto Passive consumer to active co- producer (Charles Leadbeater. Personalisation through participation. Demos 2004)

Policy and legislation since NHS and community care act Care management 1996Direct payment actLegalised direct payments 2001Valuing peopleGoal of citizenship 2003In controlSelf directed support 2005Improving the Life chances of disabled people and In work benefit calculation Individual budgets 2006White Paper 'Our health, our care, our say' DH funded individual budget pilots begin DCSF budget holding lead professional pilots begin Individual budgets for all adults Budget holding lead professionals (BHLP)

Policy and legislation since Putting people first Aiming high for disabled children In Control starts work with Local authorities to develop individual budgets for disabled children DCSF funded BHLP pilots for children in care begin Personal budgets for adults Individual budgets for children with disabilities 2008Darzi report 'High quality care for all: NHS next stage review. Personal health budgets 2009DCSF funded individual budgets pilots begin DH funded personal health budget pilots begin Think Family Family intervention project

Policy and legislation since Coalition government confirms its support for personalisation and individual budgets Supports and publishes evaluation of Ibs for disabled children 2011SEND green paper supports personalisation for disabled children SEND pathfinders begin SEND pathfinders to focus on single plan, personalisatiopn, greater involvement of the VCS and full engagement of children, young people and their families in decision making affecting their lives

SEN Green Paper By 2014 all parents in receipt of new Health, Social care and education plans (or statements) will be able to request a personal budget

SEN Green Paper cont. New plans 0-25 New local offer Transfer of power to professionals on the front line and local communities Key workers

How commissioning supports personalisation It’s objective and transparent It provides opportunities for new ways of thinking / challenging / resourcing Encourages diversity in provision Helps open up and develop the market – fostering competition and challenge It engages all levels, from leaders and politicians to service deliverers and users. Therefore getting greater buy in from the top to the bottom and bottom to the top

How commissioning supports personalisation. 2 It stands up to scrutiny It creates a virtuous circle in the services we review for improvement It is applicable whatever the service, agency, partner or authority It’s suitable for whole service system re-organisation or can be used for just one service It engages both procedures (processes and systems) and people (emotions and behaviours)

What is commissioning

Understand Personalisation & co-production Policy drivers Culture change Understanding needs Understanding the present system and what’s available/mapping Understanding cost & value/benchmarking

How the guidance is being used Shared with key strategic partners - health joint commissioning, parent forum chair & internal service managers Used to help develop knowledge and understanding of personalisation with other service areas Used to develop a clearer, consolidated and collective understanding of commissioning in children’s services

Plan Strategic commissioning – Integrated leadership and governance A strong commissioning policy/framework Must do standards for the whole system/commissioning principles Strategic commissioning team with clear delegation to operational level commissioners (if any) Annual budgets & plans

Do The hardest part of the commissioning cycle?

Do New systems & processes Changing cultures & behaviours Developing the market Workforce planning & development Information to support individual choice Different ways of commissioning Joint & collaborative commissioning

How the guidance is being used I found all aspects of the guidance useful but particularly the areas that give examples of good practice

DO Four prerequisites for successful leadership and management of change Pressure for change – without which the matter will remain at the bottom of the in tray Capacity for change – without which there will be anxiety and frustration A clear shared vision without which there will be a fast start that fizzles out First steps that lead to action without which there will be haphazard efforts and false starts

Leadership by credible and respected strategic commissioners Excellent executive and political leadership The HWBB and / or Children’s Trust well served by executive leaders from across the system - integrated reporting and decision making. Good communication with all stakeholders including workshops Strategy is translated readily into plans and action follows Annual budgets and operational/business plans follow from strategy and support implementation – in particular budgets provide for RAS and personal budgets It’s clear who will lead change in different parts of the system – with strong accountability

Barriers to change Include: Poor strategic and political leadership Too many pilots/projects, programmes, meetings and performance indicators – a distraction from whole system reform Lack of understanding about commissioning among people at all levels of the system - confusion about roles and functions Poor understanding of the cost and value of services especially those provided within the local authority

We therefore need to Gain public (and staff) support and understanding Know the cost and value of everything Stop doing what does not add enough value Work very closely with elected Members Lead change Work in the public interest rather than in the interest of particular services or professions or sectors Develop local agreement about the future of public services

Review Continuing learning together Search for better & less burdensome ways of measuring & managing performance Collect good performance information from service users and support users to work with service providers to improve their support/when needed to choose another service provider Continue work to explore the possibilities of using SROI?

Your experience of commissioning for personalisation What have you achieved? How have you done it? What particular barriers have you had to overcome and how?

Draft Guidance - questions Is there anything missing? Other exemplars? Any materials or tools that you’ve used that it would be useful to include? How intend to use locally?