1. Incapacity Benefit reforms pilot The Condition Management Programme
The Role of Independent Providers
Eric Sharp
February 2006

2. Use of independent Providers
Seven pilot areas
Models used are fully in-house, largely contracted out, and mixed
Reasons for choosing these models are related to local factors
Derbyshire and Essex have substantial contracted-out services
Mixed models seem to be preferred by the 14 ‘new’ sites

3. Contracted-out models
One model is for assessment to be carried out in house, and provision to be contracted out – Essex use this
However, assessment can also be contracted out - Derbyshire do this
Modules of service can be contracted out – these can range from exercise tuition to elements of clinical service

4. Independent providers can bring:
Specialist knowledge
Capacity and capability
Enthusiasm
Credibility with service users
An independent perspective

5. Challenges for independent providers
It can be difficult to recruit and manage health care professionals in a non-health organisation
Long term funding may not be guaranteed
The services required may fall outside the direct experience of the organisation
There may be the need to share knowledge and materials with potential rivals

6. Challenges for commissioners
Timescales are tight
Usually there is no right or wrong approach, but decisions are needed
Existing commissioning structures are not set up to initiate these sorts of service
There is no ready-made marketplace for services

7. Shared Challenges
The commissioner will have an outline of the services needed, but providers will have perspectives to offer
Providers are competitors, but may have to work together
Services have to be delivered within a cost framework
Funding is time limited, and subject to review

8. Contracts
The contract should reflect not only the type of service, but the approach to delivery – eg a groupwork contract will tend to inhibit individual interventions
Contracts can reduce but not eliminate the risks for both parties
Formal monitoring is not enough in itself – good dialogue and trust is essential
Volume-related or block contracts each have their advantages and disadvantages

9. More Challenges!
The project is fast moving – providers should be able to follow the specification, but make creative suggestions for change
CMP needs to stay within boundaries, and not duplicate existing services
The requirements may change over time in the light of experience, or external pressures
But the rewards can be gratifying, in terms of customer feedback