1. Y O U R C O U N C I L Dynamic Provider Framework Home Care Presented by: Preeya Madhoo – Head of Category Management Jane Love – Interim Head of Commissioning - Adult social care

2. Y O U R C O U N C I L Why did we do this? The Council’s current provider framework was ending. The Council needed to make significant savings, whilst maintaining frontline services and wanted to provide opportunity for local providers on a level playing field. Promote more and better choice and control & provide greater flexibility and person-centred care to the service user. Adopt an approach to using quality thresholds and KPIs that continually incentivises providers to demonstrate high performance. Mainstream enablement services to enable a wider access to the service and in doing so continuity of care Consider how use of technology could help meet key objectives

3. Y O U R C O U N C I L Baseline position Population of Medway is c.260,000. Over the next 10 years, there is expected to be an increase of 16,300 people over the age of 65 living in Medway. The Joint Commissioning Strategy for Older People estimates that there are 2,367 people with dementia in Medway. In ten years’ time this could increase by 8%. 2817 people (majority Older People) received Homecare in 2011/12. c.14,000 hours of Homecare delivered every week.

4. Y O U R C O U N C I L Current Homecare Provision Current spend £12 million p.a 7 providers deliver c.90% of volumes (by spend). 9 providers delivering c10% of volumes (by spend) Price variation Zone commissioning Rely on contractual relationships for continuous improvement No incentive to improve Lack of choice for customers Target savings £1.4m

5. Y O U R C O U N C I L What did we do? Short term strategy A procurement can take between 9 and 12 months, so we renegotiated contracts £600,000 in year savings achieved Longer term strategy We researched what other local authorities were doing – redesign eg placement team Identified Dynamic Provider Framework – KPI’s Met with providers to discuss framework and ideas Framework built on 70% quality and 30% price We encouraged competition – removal of bond requirement/ Parent guarantee

6. Y O U R C O U N C I L Timeframe 25 May 2012 – Deadline for receipt of RFI July 2012 - Issue of OJEU notice July 2012 - Issue of PQQ / ITT documentation August 2012 - Deadline for receipt of tenders September 2012 - Evaluation of tenders October 2012 - Contract award November 2012 - Mobilisation December 2012 - Contract ‘go-live’

7. Y O U R C O U N C I L Pricing Regime – 30% Current position: Each provider has different prices for visits 2 options considered Fixed price - Save on Council transaction costs - The right price: achieve required savings level and not too low to exclude SME’s. Pricing envelope - Achieves flexibility for providers - Savings built in, and less risky/restrictive than a single price.

8. Y O U R C O U N C I L Quality Regime – 70% Quality evaluated on the areas outlined below: Meeting Care Plan needs and creation of Service User Support Plan Management Structure, incl. supervisions, checks, risk assessments Care Worker recruitment, development and training Exceptions and variations to Care Plans Continuity of care and more challenging service users Enabling care and increasing user independence Service User choice and flexibility of care Service User safeguarding Communication and information provision Complaint response and Service User Feedback Contract management and performance monitoring Service innovation and future development

9. Y O U R C O U N C I L Framework Evaluation Score out of 5 given for each section 19 evaluators – paired according to specialisms Pricing 30% - 15% - 30min calls - 7.5% - 45 & 60 min calls each Quality – 70% - Enablement, safeguarding & Staff recruitment attracted high weighting

10. Y O U R C O U N C I L Outcome 129 expressions of Interest 20 providers – 5 gold, 8 silver, 7 bronze 7 unsuccessful providers 6 new providers entering the market, of which 4 were local providers Outcome focused service Savings of £1.9m achieved ( £0.5m over target) Pricing envelope 30 Minutes (£6.90 - £7.30 ) 45 Minutes (£9.30 - £9.60) 60 Minutes (£11.65 - £12.15 )

11. Y O U R C O U N C I L Mobilisation Existing care packages with provdiers on the framework would remain, but move to the new prices from 1 st December All New care packages will be presented to the gold providers, then silver, then bronze. Placement team – new care packages Existing care packages with providers not on framework, will be looked at case by case basis. Possible mini-tender for any providers with a large number of cases

12. Y O U R C O U N C I L Mobilisation cont. Establishment of a placement team Update systems to reflect new prices Decisions on providers not on framework Provider briefing 25 th October KPIs – defined set of KPIs, monitored 6 monthly Annual review of Framework ETMS – built into framework to improve invoicing, payment, performance management

13. Y O U R C O U N C I L Questions