Care Market Strategy: Provider Workshop 28 June 2017 Peter Fairley Andrew Spice Simon Willson Monica Gandy
Objectives for the Sessions To explore what the future shape of the health and care market in Essex might look like from the provider perspective; To describe what providers think this might require them to do differently; To set out what providers think the county council and its partners need to do differently; Explore and understand how we can work together to shape the market in Essex and what we might need from each other to make this happen.
Setting the Scene
Our legal duties under the Care Act 2014 Duty on local authorities to promote a sustainable, diverse and vibrant market for care and support that delivers high quality services for all local people. Focusing on outcomes and promoting wellbeing Promoting choice to drive quality Supporting sustainability Working with partners and people who use care/carers Approaches to market intelligence and facilitation Importance of workforce development and pay Securing quality and outcomes through contracting
Aim of the Care Market Project Purpose of the Project Scope Methodology – collaborative, inclusive, evidence based and informed choices Key Timelines and Activities Key risks: Input and engagement from stakeholders – managing expectation Creating a shared understanding Something that is too vague and undeliverable
Market Strategy - Overview The Strategy Delivery Plan Diagnosis/Problem Future Direction Coherent Action (joined up) Detailed Actions More outcome focused – personalisation (choice and wellbeing) Low cost/no cost solutions ‘Asset’ based approach (individual & community) Sufficiency (supply, quality and workforce) Integrated & more innovative Flexible and adaptable Vision and Principles (description of the future) Commissioner Statements ‘Big ticket’ action items /cross cutting e.g. Prevention, increased DPs and ISFs, greater focus on independent living, more support for unpaid carers etc., etc., To follow publication of the strategy & determined in collaboration with providers and SUs May June July August Onward
The Care Market Now (1) Cost pressures Vacancies Good quality but on average 25 providers at serious risk at any given time Barriers to entry for new providers or existing providers to adapt or change offer Pricing variations because of multiple buying mechanisms A lack of a clear commissioning strategy There is little mix in the composition of the current mainstream care offer – almost all private sector providers Evidence that many, in particular SME providers, are operating at stress levels – operating at minimum margin or lower, leading to lack of resilience and quality issues
The Care Market Now (2) Innovation is almost exclusively with third sector and other none for profit organisations. There are some examples of system redesign. There is little evidence of a system wide culture which supports the development of new models of working Current analysis of overall space to demographic demand suggests that there is sufficient supply in the short to medium term. However, this hides supply issues in particular geographical areas and for particular service types (e.g. nursing), and supply issues because of available staffing In terms of choice and variety, the offer, particularly within the older people’s market, is limited – essentially residential care or time and task home support Some core ‘business processes’ need improving and more reliability e.g. payments, discharge, placements
What does the care market look like for you in the future?
Exercise 1: Exercise in THREE parts Parts one and two are to be completed in SILENCE
Part 1: Individually – describe in as few words as possible what the care market of the future looks like for you Focus on strategic/generic issues not current operational issues e.g. working more directly with SUs; focusing more on personal outcomes and less on time and task; using new technology etc., ONE idea per card (Big, neat writing please!) Write as many cards as you want You can put your name and organisation on the card if you wish 30 mins
Part 2: Place your completed cards (writing face up) on the floor in the inner circle Review all the cards on the floor If you DISAGREE with any statement, place it in the outer ring 15 mins
Part 3: Officers will group the cards into thematic areas where possible Group observation & discussion 15 mins
BREAK – 20 minutes
What will providers be doing differently?
Exercise 2 In groups, supported by officers Based on the future you have described, how do you think you would be working differently? E.g. What would that look like for them; what would it mean for their staff, for SUs; what skills might they need; what might it mean for hospital discharge and/or other specific activities e.g. reablement, assessments and reviews; working with other providers and services (integration and collaboration) ; how might quality be measured; assessing quality, managing risk; how would SUs be kept safe etc., Ideas on a flip chart and summarised. Report back Top 3. 20 +10 mins
Quality & Safeguarding Risk management Workforce Processes and Systems Communication Leadership & Management Structures (including relationships to other organisations, integration) Quality & Safeguarding Risk management
What do providers think the council and its partners would need to be differently?
Exercise 3 In 3s, 1 officer to sit with each trio Using the PROFORMA What do providers think the county council and its partners would need to be doing differently? 3 changes per trio to be fed back to the group 20 +10 mins
Do Differently (Including more of , less of as well differently) Partner Do Differently (Including more of , less of as well differently) Suggestion 1 Suggestion 2 Suggestion 3 County Council Borough/District Council CCG Hospital Voluntary/Community Group(s) Family/Carer
How can we work together to complete this strategy?
Exercise 4 WHOLE group discussion 20 mins
Next Steps and Evaluation