1. West London Market Position Statement Welcome to a provider forum October 14 th 2013

2. Objectives To tell you about the West London market position statement To give you a chance to meet some commissioners To let you know about some opportunities To discuss with you your views on how we can work together to develop the market 2

3. Why we have one All local authorities are producing an MPS by Jan 2014 We want to provide providers with a regional message We think it will help to work with providers to develop care services 3

4. What it says Offers an analysis of current provision and future demand Shows the range of services councils will want to commission in future and the types of changes in the care market we need to see Suggests some opportunities to work together We can not continue to buy the same type and range of service, it will not meet the communities needs and there will not be enough money. 4

5. The opportunities Shared planning with providers expected demand for nursing places and planned reductions in residential places. Partnerships with providers to develop new models for targeted care covering high quality end of life care; positive / active rehabilitation or very specialised services for complex needs Extra care or Supported housing development Extra care and supported housing becomes the default option with providers actively encouraged to build quality extra care and supported housing instead of residential care homes. Alternatives to residential care Working with providers to produce services which are a good alternative to residential care. 5

6. Strategic Intentions Social Care Bill NHS Integration MTFS & QUIPP WLA Priorities & Market Position Statement Social Care Market Management Clarifying Commissioning Intentions

7. The vision for transforming care and support will have profound implications for LA systems, processes and people Key requirementsTiming Duties on prevention and wellbeingFrom April 2015 Duties on information and advice (including advice on paying for care) Duty on market shaping National minimum threshold for eligibility Assessments (including carers’ assessments) Personal budgets and care and support plans Safeguarding Universal deferred payment agreements Extended means testFrom April 2016 Capped charging system Care accounts

8. Scope – Funding Reform

9. NHS agenda and Integration CHILDREN’S & ADULTS’ SERVICES

10. CCG Priorities Improving access to Primary care (out of hours) Reducing pressure on LAS Out of hospital strategy

11. Integration Agenda Based around improving patient experience, outcomes & PIs Driving new efficiencies, or vehicle for delivering savings, or protecting funding Local Out of Hospital Strategy GP network ICP principles Risk stratification Community Nursing Pilot Frequent Attenders study Local Co-design – flexibility in approach Personal health budgets ITG Funding from Govt – transferring NHS money and pooling funds via jointly agreed plans and performance targets

12. Emergent Strategic Themes Community Budgets Employment and skills Integrated care Demand management Market management Local Elections Local Council & European elections 22 nd May 2014 Impact on local priorities and MTFS

13. WLA CHILDREN’S & ADULTS’ SERVICES

14. ActivityActivity Description APC Scheme Design/implementation of market management system for care home placements incl: processes for accreditation, price harmonisation, preferred rates for placements, void management, placement void matching and quality controls. Home Care (KT) Procurement of a framework agreement for the provision of personal homecare and housing related support services Value circa £51m pa. Housing Related Support Procurement of a framework contract for housing related support for older people. High Cost Placements Price reductions / equalisation across WLA WL Councils Supporting People To reduce spend by 25% and reconfigure the SP market. To pursue collaborative purchasing across the WL WL Councils, through framework agreement for all services. Care Place To procure a MIS for the ASC Efficiencies Programme that will deliver management and performance information for residential & home care accreditation, purchasing, supply & monitoring. Annual Inflation Avoidance Resisting cost increase by managing market demands for inflation rises on care fees. Future Care Programme Working with BCMs to create a sub-regional market management (strategic procurement) strategy based upon re- shaping the care offer Programme Management High quality programme management for the ASC EP ensuring projects / activities delivered to time, quality and budget. Results: Live for older persons. 70 homes on list. Being used on average for 55% of spot placements. Management of volume nets Boroughs an additional £150k per quarter rebate from the market. Also 4 yrs no inflation. Procurement of a replacement for the existing framework which expires 2014. Aim is to hold low prices for another 4 years whilst looking at London Living Wage. Looking at a select list of providers to work with WLA on future provision and reducing costs but increasing quality of existing provision across LD/PF/MH Negotiations saved £7m and Framework now live from September 2012 lowered prices between 10-15%. Built a MIS that delivers real time cost and management information for residential providers. Looking to sell the system to DH and London. £1.6m cashable saved last year. This year aim to hold inflationary uplifts at zero percent. Same aim next year (2013-14) Working with BCMs to shopping list of future need. A plan to manage providers in the future. New models of care based upon emerging work on integrated health and care pathways. High quality programme management for the ASC EP ensuring projects / activities delivered to time, quality and budget. Reports to x3 levels of governance plus Pan London board, ADASS, JIP, capital ambition, LSPB, Benefits realisation board.

15. WLA BCM Future Care Programme The ASC programme needs to move from tactical procurement to strategic procurement ( market shaping) and innovate to help crate new offers of care Collection of west London and market data to help create a gap analysis ( current & future need vs current and future supply) Compliments Borough commissioning intentions by looking across boundaries at ways of enabling that local plan Will produce a sub-regional commissioning strategy to compliment or help local commissioning intentions A strategic market management plan ( using the IPC work) Work with large health organisations to ensure WL ASC provisions is integrated where appropriate Shaping future procurement projects that deliver sufficient local supply of care – but the right type, location, quality and price Provides valuable information to the market about our intentions to help them commit capital and revenue investment for our residents

16. WLA Market Position Statement Preventative Health and Wellbeing Services Information & advice More for carers Financial planning Social, employment, leisure, education Community Services for FACS eligible clients Wider promotion of telecare Less day centres More support planners Integration Care homes Extra care, demand management, supported housing

17. WLA emerging priorities (20 th Sept BCMs) Investment in reconfiguration of Supported Living for people with complex needs Extra Care /Sheltered Housing + development Community based rehab models Community Services model (prevention/telecare/information and advice/admission avoidance) Residential Care Quality and demand for bed categories Homecare capacity and quality Working with other commissioners/purchasers (NHS & Public Health)

18. Taking it forward Discussions How can you change residential care services to support people in their own homes, extra care housing or supported housing What support do you need from councils to help you do this 18

19. Further contact or comment For further information or comment contact Matthew Jones or Hari Pillai at WLA West London MPS is at http://www.westlondonalliance.org/wla/wla. nsf/Pages/WLA-114 or you can go to the WLA website at WWW.westlondonalliance.org http://www.westlondonalliance.org/wla/wla. nsf/Pages/WLA-114WWW.westlondonalliance.org 19