Market Shaping and Market Position Statements Why now and what for? November 2014

This session will cover…. What is market shaping, and why is everyone talking about it now? New requirements for LA’s and CQC around Market oversight How can we establish a different relationship with Providers? Our approach to developing Market Position Statements in Hertfordshire – You tell us how the MIPS's we develop can help you Some general information about the Care and Support Act and where you can find out more

Firstly a bit of history – how social care markets have changed over the last 50 years

Why do we need market shaping and MPS’s? From April 2015 statutory requirement for all LA’s to have Market Position Statements (In Herts we are producing our MPS’s with health input too) To ensure sufficient provision – current and future Ensuring the local care market is sustainable – Providers know what the LA needs to purchase Fostering continuous improvement We cannot achieve any of this without the active co- operation of providers and without clarity over our strategic approach

What the MPS should do… Present a picture of current demand and supply, and what this will look like in the future- clarifying our purchasing intentions Explore what strategic commissioners can do to support and intervene in the local ( and possibly regional) market Explain to Providers why we are doing what we are doing – and show the evidence Support market analysis by bringing together intelligence from the JSNA, contract monitoring, reviews and consultations, and national policy drivers ( i.e. self funders) It should cover all potential actual users in the local area ( i.e. not just those that receive social care funding) Its just the start of market facilitation- market shaping is a continuous process

What the MPS will include in terms of likely future levels of resourcing... Which areas of supply the LA sees as high priority Where we wish to see services develop – and where we would be less likely to purchase in the future Indications of future public resourcing ( i.e. more integrated commissioning with health, Public Health, increase in pooled budgets across agencies)

What the MPS will include in terms of likely future levels of resourcing... If less funding is to be made available – where will these areas be? Analysis of likely areas where services may be de-commissioned Opportunities for the market to be involved in ideas for service redesign – re designing existing provision, using land and buildings differently

Current numbers – our base line information... Older people in residential care – 3,169 People with Learning Disabilities in residential care – 753 People with physical disabilities in residential care – 168 Older people with a homecare package approx 6, Older people in Flexicare

Identifying models of practice the LA and partners will want to encourage An explanation of desired models of care – what would represent good practice More integrated and flexible provision, - e.g. the Flexi bed An analysis of what needs to change – i.e. move to 7 day working, assessments at weekend to support discharge etc Timescales for getting there

What needs to be in the MPS ( tell us what you think about this ) Summary of key care and wellbeing outcomes to be achieved across a care group Briefly describes elements of policy, legislation and regulation that will impact on the market Predictions of future demand, outlining key pressure points – for next 5-10 years Highlights particular aspects of demand – i.e. dementia An analysis of what we anticipate the impact of more service users purchasing their own care Local intelligence and trend data

Local intelligence… what impacts on the market in your area? Proximity to London – impacts on recruitment and retention Location of other large employers offering similar types of work patterns i.e. shift work, Amazon and Tesco Robustness of the voluntary sector Hospital activity and behaviors – discharge processes and links with social care Closure of hospital wards or down sizing – i.e. fewer beds in the new Lister will impact on need for community based services

Market Oversight – what is this? The Market Oversight regime fits within the Care and Support Act 2014 requirements Drive to ensure there is a diverse market of high quality care and support Link between quality of care and financial sustainability is crucial – as a providers financial position deteriorates so does the quality of care Robust plans in place in Hertfordshire to ensure the wider market intelligence activity functions well – for example aligning monitoring resources across HCC, CCGs and the CQC Ambition to prevent market failure through effective market shaping and sharing of intelligence across commissioning bodies – early intervention to support providers LARGE SCALE PROVIDER FAILURE IS RARE

Market Position Statements in Hertfordshire Currently looking to develop the following: Older People Learning Disabilities Physical Disability and or Sensory Impairment Mental health Carers Aspergers Provider engagement “Market Development days” in November

Care Act Context Sets out to reform the social care support system from April 2015 ( consolidating legislation from over 60 years ) Introduces a Care Cap on costs for assessed eligible needs from April 2016 Requires a whole system approach to be underpinned by promoting wellbeing

Key Partnership Requirements A joint up information, advice and advocacy ( IAA ) offer so partnerships facilitate provision of consistent and proportionate IAA or know where to signpost to Universal approach for the wider population to prevent, reduce and delay needs deteriorating Carers New Rights – carers support including assessments and reviews and carer ‘friendly’ principles embedded Market oversight and provider failure – partnership approach with CQC to co operate,prevent and sustain and HCS duty to provide continuity of care when a provider fails

Additional Care Act Requirements National eligibility criteria – to also facilitate ease of transition for people moving areas Service user and separate carer entitlements to Personal Budgets and Direct Payments to meet their eligible needs HCS duty to carry out safeguarding enquiries or ensure others do Provision of appropriate services for eligible people in prisons Transition arrangements for moves from Child into Adulthood

Want to know More ? Click on the video below for a Care Act overview produced by SCIE kskeXdAA