An integrated approach Market Engagement: October 2016 HOMECARE IN SOMERSET An integrated approach Market Engagement: October 2016

Agenda Welcome Homecare in Somerset Our approach: Homecare Framework Workshop: Meeting demand Our approach Workshop: Zones Continuing Health Care Workshop: Fast-track EoLC Proactis Existing Business Timeline Next Steps

Our vision: Care Together Health and Social Care – not separate entities The workforce increasingly assess people and deliver services in joint teams Health and Social care have the same relationship with the same providers and wider communities Focus on working together to deliver significant improvements for people Design and deliver pathways for people that are responsive and as part of a whole system

Services In Scope Adult Social Care funded provision for people with longer term conditions living at home Continuing Health Care NHS Somerset CCG funded provision for end of life care ( Fast Track) and long term conditions Adult Social Care provision for people in Extra Care Housing

Approach Meets the needs of Service Users and Carers Promotes personal resilience and well being Responsive and flexible market - availability and capacity at the right time and in the right place across the county Outcomes focused service delivery for the future Skilled and committed workforce Efficiency and effectiveness Affordable – fair cost of care

Current picture Two commissioning models ASC and CCG delivering over 22,000 hours per week at a cost of £27.5m 8 strategic homecare providers covering 9 zones - agreed capacities payment by delivery Reablement block contract with strategic homecare providers ECH 5 providers delivering assessed care in 22 schemes Spot contracts with over 30 providers CCG any qualified provider (AQP) registration Annual contracts for CCG providers

SCCG - Continuing Health Care Patients requiring Double-up Visits Activity in Zones   SCC - Adult Social Care SCCG - Continuing Health Care Patients requiring Double-up Visits Zones Service Users Day Hours Night Hours Fast Track Patients Longer Term Condition Patients FT/LTC Day Hours ASC CHC Zone 1 126 1161.17  0 14 6 384.75 156.00 7 Zone 2 390 3504.20  5 15 17 895.75 177.50 52 13 Zone 3 312 2786.50  13 5 301.00 130.00 30 Zone 4 205 1402.00  12 8 582.75 310.00 10 3 Zone 5 225 1853.25  6 160.25 97.00 19 Zone 6 429 3682.83  11 670.50 273.00 48 Zone 7 197 1711.00  10 421.25 90.00 Zone 8 237 1996.45  1 4 191.75 9.00 12 2

Number of service users Number of hours delivered Average hours per week Number of service users Number of hours delivered Double-up Visits ASC CCG ASC + CCG Total 2121 132 18,097.40 4,850.50   192+53 Grand Total 22,947.90 245

What is a Framework? “a framework agreement is a general term for agreements with providers that set out terms and conditions under which specific purchases (call-offs) can be made throughout the term of the agreement” Once providers are registered and approved then we are able to ‘call-off’ the list of providers when we need to fulfil a customers needs and outcomes. Why is it different from a usual framework? – Suppliers can register throughout the duration rather than having set entry times.

Homecare Tiered Framework The framework agreement will take a Two Tiered approach and may or may nor be zoned. Tier 1: Providers in Tier 1 of their zone will receive all referrals in the first instance. Tier 2: Tier 2 providers will receive referrals when Tier 1 providers are unable to meet demand. All tiers will be awarded on the basis of the Quality Questions A set number of providers (per zone) will be selected for Tier 1 Providers who bid for Tier 1 but are unsuccessful will automatically be placed in Tier 2 Tier 1 providers will be monitored to ensure that they are able to meet demand Providers who continually fail to meet the demand criteria may be moved to Tier 2 and a Tier 2 provider could have the opportunity to move up to Tier 1

Key Features of Tiers Key Features of Tier 1 Providers will be able to secure the volume of business. Ability to see the packages of care first Key Features of Tier 2 Open Framework for Tier 2, therefore providers can join at anytime throughout the life of the framework Lighter touch process making the framework more accessible for small local organisations.

Framework call-off criteria Tier 1 providers will receive all referrals in the first instance. The referral will include an anonymised Understanding You D: Assessment and E: My Care and Support Plan Providers will need to respond within a specified timeframe if they can meet the individuals needs Providers will be evaluated on the following criteria: Start Date Price (against set range) Competency e.g. Dementia, End of Life, Nurse Led, Medicine Policy Level If Tier 1 providers are unable to meet the requirements, referrals will be sent to Tier 2, who will go through the same process

Zones in Somerset: 10 minutes group work… How Many zones in Tier 1? 0 zones – just a tiered framework 2 Zones - East and West or North and South 4 Zones - Taunton Deane / Mendip / Sedgemoor / South Somerset 8 Zones – close fit with the current contract How many providers in Tier 1? (in relation to your conclusion on the zone size

Somerset Currently 9 zones – moving to 8

Cost of Care Tier 1 and 2 Price range will be in place for day time and night CHC fast track E of L rates will be set in the first instance

Rural / Urban travel Collection of client contributions There will be no set rural / urban rate . Rurality will be reflected in the range through individual bids The Service Provider is responsible for designing and implementing a system for collection of Service User contributions in line with guidance Robust management and accounting systems and procedures must be in place to monitor the visits and monies collected by the Service Provider

Contract Management The Local Authority will oversee the framework ASC care coordinators will manage sourcing via the framework EoLCC will continue to coordinate supply EoLC once a provider has been sourced via the framework All contracted providers will need to be registered for SAF (Self- Assessment Form) Online which is managed through Proactis.There may be separate arrangements on top of this for CHC. EoL will continue under same arrangements

Meeting demand: 10 minutes group work How will the system ensure capacity is maintained? Think about what this means across the two tiers Think about the geography of Somerset

End of life Care: Fast track Framework will include EOL fast track domiciliary care CCG functions But will begin as a separate Lot to the Homecare Framework EoL fast track to be managed via the CCG EOL care Co ordination Centre Review and development of the pathway over the next year to phase within Homecare framework ( CHC long term conditions included in the Home care Framework)

10 minutes talking: End of life Care, Fast track What are the key elements that are important to you to ensure a smooth move from a separate lot to integrate to the tiered approach?

Process for the Homecare Framework Providers will be required to register an account on Proactis (If you already have an account because you are on LDOF or SAF Online you do not need a separate account) All providers will need to complete the Selection Questionnaire (previously Pre-Qualification Questionnaire) Each Tier will have a set of Quality Questions to respond to All Quality Questions will then be evaluated by a panel

Registration and Tier Selection Outcome Quality Questions – Tier 1 CALL-OFF PROCESS Selection Questionnaire – ALL PROVIDERS Quality Questions – Tier 2

Proactis

Sign Up

Registration Providers are required to register EACH service team/location rather than registering the company as a whole Must be able to provide services within Somerset. If applying for a CQC registered service, must have the correct registration category

Home Page Clear and simple navigation Touch Screen and Desktop compatible Auctions WILL NOT be used for the framework

Current/New Care Packages Existing care packages will not be affected by the new framework SCC will issue new spot contracts to their providers with updated Terms and Conditions to cover existing care packages. From 27 March 2017 all new care packages will be commissioned through the Homecare Framework. If you would like to be considered for any new care provision then you must be registered and approved on the framework.

PQQ & QUALITY QUESTIONS Proposed Timescale FRAMEWORK ADVERTISED DECEMBER 2016 PQQ & QUALITY QUESTIONS JANUARY 2017 EVALUATION & TIERING FEBRUARY 2017 GO LIVE – 27 March 2017 ALL NEW CARE PACKAGES

Next Steps Please ensure you have signed in on the sheets provided Look out for the advertisement of the Homecare Framework on ProContract – you will then be directed to Proactis If any providers would like to volunteer to test the framework, then please sign up and speak to one of the team We will hold another event after the Framework has launched