North Wales Domiciliary care Collaboration The journey so far ………….

North Wales Landscape 6 x North Wales Local Authorities 1 x LHB footprint – BCUHB Counties have a mix of urban and rural areas with significant rural areas in the south of Denbighshire and Gwynedd Split of in-house and external provision differs considerably across North Wales – Anglesey and Gwynedd having the highest proportion of in-house provision and other LA’s predominantly undertaken reablement only via in-house teams.

Where it all started ……. North Wales Social Services Improvement Collaborative (NWSSIC) – established in 2006 - 6 Directors of Social Services plus the Heads of Services groupings (adults, children and business) North Wales Procurement Partnership – established in 2009 - regional procurement unit sponsored by the Chief Execs of the 6 North Wales Local Authorities with the aim of delivering collaborative procurement to gain cashable savings in areas of high cost spending …. including social care

NWPP’s year 1social care work programme This was developed by Corporate Procurement Managers by choosing areas of particularly high spend: - Care Homes - Domiciliary Care - Supported Living

Domiciliary Care Collaboration NWPP commissioned a market analysis of Domiciliary Care by PSL consulting in June 2009 Range of recommendations made: - develop regional procurement strategy Procurement options completed end of 2009

No desire by Directors and Lead Members to move to regionalised procurement due to a number of reasons - maturity of the market in some LA’s - one authority had already tendered - two authorities had the majority of dom care services being delivered by in-house provision though this is beginning to shift now - 3 LA’s set a rate with one LA setting a ceiling rate only - Other LA’s had a set fee rate

Where do we go from here …… Couldn’t be seen to be doing nothing – agreed to focus on two pieces of work which was common to the 6 Local Authorities: Development of a regional dom care contract with standard terms and conditions, service specification and outcomes Development of a regional quality approved provider process for approving domiciliary care providers across North Wales

Any Questions ………. 20 minute discussion about the development of the Regional APL process – please feel free to ask any questions 20 minute discussion about the development of the Regional Dom Car Contract – please feel free to ask any questions

What have we learnt ………… Right colleagues at the right level to make decisions need to be involved from the outset Important to have a good and dedicated project sponsor Collaborators need to learn to compromise – though this did happen over time Make sure that the governance and any agreements are recorded ….. someone will challenge these at some point! Collaboration is: Not easy Takes time Takes energy ………… BUT if you keep at it you will get there!!!!!!!!!........

What did we do well ……. After initial difficulties worked well as a group Learnt to agree and compromise Built up trust between colleagues Learnt from each other’s practices Sharing of information Worked with and supported providers particularly smaller providers Strengthened the network of Commissioning and contracting across North Wales within both Local Authorities and health

What could we have done better Have the engagement of the right people from the start Completed the project quicker Consistency of colleagues working on the project throughout its duration – though this cannot be avoided Completed the work quicker - this would have happened if there was full time project management capacity and if colleagues weren’t doing this on top of their day jobs!

Where are we going next ……. We are starting to look at developing a regional quality monitoring framework which can be applied consistently across North Wales to monitor the requirements of the regional contract ……….

Any questions ?????????