ADASS / SCIE Seminar 02 July 2014 ‘Care Act 2014 & Commissioning for Better Outcomes’

Commissioning for Better Outcomes Jon Glasby and Catherine Mangan June 2014

Work so far  Literature review  Interviews with 21 key stakeholders from a range of perspectives – representatives of national organisations, commissioner, provider and social care users  Two workshops at the ADASS Spring seminar  Five stakeholder events: prevention, co- production, market development, outcomes based commissioning, workforce

Initial findings  Ambiguity of terms –Commissioning –Co-production –People using social care

Findings from literature review  Evidence base for the impact of commissioning is patchy and under-developed.  Wealth of guidance and good practice to drive quality and outcomes for health and wellbeing for people using social care services and their carers.  Often not clear on what basis examples of good practice are being cited.  Conclusions about how commissioning is working to achieve better outcomes is limited.

Wicked issues  Financial pressures, increased expectations and demographics  Lack of evidence of impact for commissioning  Challenge of meaningful co-production with social care users, family, carers and communities  Integrated commissioning and the need to adopt a whole life, whole system perspective  Potential tension between personalisation and population focused commissioning.  Intelligent use of information and data limited by capacity, accuracy of data held and information sharing issues

Wicked issues  Changing the relationship with providers  Prevention or diversion?  Tensions around cost and quality  Economy of scale or granularity of services?  Disproportionate attention given to the needs of particular groups  Challenge of equity  Outcomes based commissioning – how to do it and likely impact  Workforce - commissioner capacity and provider staffing quality

1. Is supported within local Councils 2. Is coproduced with people and their communities 3. Promotes health and wellbeing for all 4. Focuses on outcomes 5. Is person centred 6. Is integrated with other public services Draft principles – good commissioning……

7. Uses evidence about what works 8. Promotes equality 9. Delivers social value 10. Facilitates the diversity and quality of the market 11. Ensures sustainability 12. Provides value for money Draft principles – good commissioning……

Developing the standards  Two key areas:  Good commissioning is championed within local councils  Good commissioning is integrated with other public services

Example: Good commissioning is supported through the leadership, values and behaviour of elected members, senior leaders, and commissioners of services. It is underpinned by principles of co- production, personalisation and integration.

Example: Good commissioning coproduced with people and their communities. Co-production is a relationship with social care users; their family carers and communities that is underpinned by the principles of equality, diversity, accessibility and getting something back from putting something in.

Developing the standards  What standards would you want to see?  What might excellent/good/acceptable look like?  What evidence would you expect to draw on?  What format would be of most use?  How could you use the standards?

Next steps  Development of standards – by end August  Testing in areas in September – volunteers??  Development of peer challenge approach  Launch at NCAS conference – October

Contact #commissioning4outcomes Jon Glasby Catherine Mangan Twitter: mangancatherine

ADASS / SCIE Seminar 02 July 2014 ‘Care Act 2014 & Commissioning for Better Outcomes’