1. Key messages from the National Market Development Forum and Care Provider Alliance Personalisation Summit, 11 th September 2013

2. Background The National Market Development Forum was established in 2010 It brings together more than 50 leaders from across the sector to explore challenges for commissioners and providers in developing diverse markets of personalised care and support It has published a range of briefing papers and practical tools to move things forward, including: 1.A model for market facilitation (genesis of Dev Care Markets for Quality and Choice) 2.A protocol to improve market relations 3.A framework for quality – what, how and who?

3. Key messages Personalisation requires different ways of working from commissioners who will cease over time to be the primary purchasers in markets opened up to personal budgets As well as significant changes in the diversity and flexibility of supply Choice and control is of little value if there is not a wider range of local, quality, personalised services to choose The only way this will come about is through commissioners, providers and people using services working together in respectful collaboration towards shared solutions Cost pressures and process driven commissioning practices are in many areas impacting negatively Commissioning for outcomes is part of the solution – but procurement practice needs to support commissioning strategy

4. The vision is strong & shared Real choice of support approach & provider The advocacy needed to open choice to all Light touch, creative & empowering processes Citizens involved in commissioning decisions, not just decisions about their own care Development of non-service approaches and of services which enhance informal networks Info on outcomes gathered & fed back in See: The New Social Care: strengths-based approaches at www.RSA.org

5. … but the reality? Same narrow range of approaches & providers Advocacy & brokerage scarce: the most vulnerable remain least able to express choices More bureaucracy, more gatekeeping Price-only procurement, including below-cost Across the board, no-choice resource cuts Little evidence of new commissioning culture See: Investing in families & communities, via www.SharedLivesPlus.org.uk

6. So what do we do? The duties in the Bill will help Invest in choice-making & citizen voice Learn from TLAP & co-production: Make it Real Accelerate the development of community- building and networked approaches Balance focus on demand (through personal budgets), with focus on supply Make good on no more per-hour purchasing

7. Top challenges and opportunities ChallengesOpportunities 1. Protecting and further stimulating market diversity The Care Bill duties and associated regulations, guidance on market facilitation and agreed commissioning standards 2. Protecting and enhancing choice and control alongside commissioning practices predominantly designed to drive out efficiency savings 3. To take risks in a climate of fear Finding the right balance – demonstrating the efficacy and efficiency of working in coproduction To get serious about co-design and co- production with citizens and providers, which would get us focused on good lives, not cheap services: there is capacity in communities, but its ignored or undermined