The Commissioning Academy: Greater Manchester Outcome Based Commissioning in Practice: Cheshire West and Chester Jamaila Tausif Senior Manager: People Commissioning Programme Director Integrated Personal Commissioning

Content: This presentation will cover: The Cheshire West approach to outcome based commissioning (OBC) through one dedicated example.... “putting theory into practice.” The process of setting outcomes and key drivers Implementation a new form of commissioning with providers Co-production with residents A case study of outcome based commissioning – looking at: Housing Related Support. Monitoring the outcomes from contracts and their performance in line with outcomes rather than on activity. Key lessons learnt.

West Cheshire: Geography: Unitary Authority in the North West. Includes the City of Chester. The towns of Ellesmere Port / Northwich and Winsford. Neighbours North Wales, Cheshire East and Wirral. Population: 330,00 residents. 50% rise in those over 65 by % rise in those over by year gap in life expectancy between our most and least deprived wards.

Setting Priorities: Let’s Talk Consultation: Priority Issues: Consultation on the strategic direction of the Council, our ten priorities, and our budget proposals for the next four years. Multi-method approach: Questionnaire, budget simulator, focus groups, web-chat, engagement events with partner organisations and businesses, links to community organisations, targeted engagement with harder to hear groups Full 12 weeks: October- early January. To provide a maximum opportunity to engage. Respondents: 1,873 in total

Acting on Outcomes: All documents cover : New Council Plan: Setting the overall strategy and direction of the Council (What our priorities are, how they have been established, what we’ll do to make a difference). Four Year Budget: A fully financed four year budget that accounts for required savings, and the priority outcomes. Individual Outcomes: For each of the ten outcomes, a more detailed ‘Outcome Plan’. This includes timelines, changes in practice, and targets for services. Commissioning Intentions: A summary of the information and documents above for a provider audience.

Theory into Practice: Engage the public earlier in the process to identify desired outcomes. More time on strategic planning. A much broader approach to market development and oversight. Design payment approaches that create appropriate incentives. Work across organisations and systems to take a broader approach to outcomes.

Commissioning Intentions: Aimed at Providers. Provides further information on our operating context (Policy, financial, and legislative). Outlines the key outcomes we are hoping to achieve. Set’s out the changes in practice and service that will accompany these services. Includes important performance information and targets across the system.

A Case Study on Floating Support – A Preventative Housing Related Support Service

Strategic Planning Commissioning moving to a early intervention and prevention approach Consultation with resident's as well as customers revealed a gaps in provision. Now approach to support rather than wider borough coverage. Duplication of support 27 services delivered by 14 different providers. £2.2 Spend across the service Dependency model of care rather than empowerment Focus on activity rather than outcomes for individuals

The Process we went through: A needs assessment was completed for the full Programme of Housing Related Support Services This provided insight to demand and supply available Customers needs and service requirements were cap tured

Procuring Services Redesign looked at various options Commissioners explored options of delivering using both UK and international best practice Number of workshops to bring in New potential providers Decision taken to go with 1 service for all Floating Support across Cheshire West

HRS: What did the old set of services look like? – discussion on the threats and challenges. Contract AreaUnits Neston and Ellesmere Port54 Chester and Rural135 Northwich and Winsford 184 Total for Cheshire West & Chester 373 Distribution of Units?

OPI1 Service Provision £22, OPI2 DA Customers contacted within 24hr £10, OPI3 Rest of SU's contacted within 48hrs £10, OPI4 FS allocated before release from prison £4, OPI5 Assessment Completed 10 working days £3, OPI6 Decisions made in 5 days £3, OPI7 Sustainable independence 6 months post service £30, OPI8 Service user satisfaction £5, OPI9 Questionnaires complete £5, Payment by Outcomes

Clear from the design of the contract specification what commissioners expected. Clear from the outset the Outcomes the provider needed to meet. Clarity on the evaluation process linked to outcome based payments Monitoring and evaluation:

HRS: Contract Management. 4 annual formal reviews, important to know your provider and they know your expectations. Monthly electronic Outcome Indicator returns Concentrating on the things that make a difference to individuals

Outcome Indicators established early. To reflect the purpose of the service To reflect the things that are important to customers. Keep them simple Outcome Indicators:

The Outcomes we achieved New service under a single provider leading to better management of delivery previously Focussed on Outcomes for customers Move to an independence model Coverage around the borough to include young people and families Added value - 5 Hubs, not specified and no additional cost to contract. Increase community capacity by use of volunteers Better value for money, contract reduced from £2.2m to £940K, Previous contract supported 342 individuals per year. New contract has supported 1780 in the last 18months.

Lessons Learnt BE BOLD. Move from reporting numbers to reporting outcomes. Recognise the need for strong leadership. Understand your implications on the existing market. Make sure that residents, partners and Members understand the outcome you are working towards.

Thank you. Any Questions? Jamaila Tausif Senior Manager, People Commissioning, Contracts and Quality Assurance Programme Director for Integrated Personal Commissioning Floor 4 Nicholas House Chester CHI 2NP Telephone: