1. Care Act implementation support – care markets and commissioningSlide 1 University of Wolverhampton MSc Commissioning in Health and Social Care Tuesday 23 rd June 2015 Glen Mason Director of People, Communities and Local Government Department of Health

2. Slide 2 Care Act implementation support – care markets and commissioning Overview Context The Care Act Wellbeing, prevention and the whole population Market shaping Commissioning for Better Outcomes Care Act implementation support materials How do we make the most of our assets?

3. Slide 3 Care Act implementation support – care markets and commissioning Care and Support affect a large number of people Many people need some extra care and support during their adult years to lead an active and independent life. Three-quarters of people aged 65 will need care and support in their later years…

4. Slide 4 Care Act implementation support – care markets and commissioning Drivers for Change in the English Care System Demographic pressure Unprecedented financial challenges Raising expectations Technological Change Systems failure eg: Mid Staffs Hospital and Winterbourne View A drive to integrate services

5. Slide 5 Care Act implementation support – care markets and commissioning A shift in the care and support system FromTo Repair Focusing only on response after a crisis Prevention Acting earlier to prevent or delay needs Fragmentation Isolated services focused internally Integration Joined-up services working as partners Paternal State knows best Personal Person knows best Exclusive “Doing to” Inclusive “Doing with”

6. Slide 6 Care Act implementation support – care markets and commissioning National Assistance Act 1948: established the welfare state and abolished the Poor Laws 19481960…1970… Chronically Sick and Disabled Persons Act 1970: reforms to key entitlements to community services A brief history of care and support NHS and Community Care Act 1990: first major set of reforms, including first right to assessments and start of commissioner/ provider split. 1980…1990…2000…2010… Carers (Recognition and Services) Act 1995: the first Act to recognise carers Community Care (Direct Payments) Act 1996: new powers to make direct payments Carers and Disabled Children Act 2000: extending direct payments to carers Health and Social Care Act 2001: updates on direct payments Social care law and policy has evolved over more than 65 years, incorporating around 30 Acts of Parliament, but reform has usually been piecemeal.

7. Slide 7 Care Act implementation support – care markets and commissioning Promote people’s wellbeing Enable people to prevent and postpone the need for care and support Put people in control of their lives so they can pursue opportunities to realise their potential The care and support White Paper was published in July 2012 and set out the Government’s vision for the future system. If adult care and support in England is going to respond to challenges it must help people to stay well and independent: Caring for our Future

8. Slide 8 Care Act implementation support – care markets and commissioning The Care Act represents the most significant reform of care and support for a generation Puts well-being at heart of every decision puts carers on the same footing as those they care for; Prevents and delays need for care and support embeds rights to choice, personalised care plans and personal budgets, and ensuring a range of high quality services are available locally Introduces a cap on care costs and provides for a new universal deferred payments scheme; provides for a single national threshold for eligibility; supports people with information, advice and advocacy; ensures continuity of care when people move between areas; ensures that no one goes without care if their provider fails; Sets out duties on local authorities to facilitate a diverse, sustainable high quality market for their area.

9. Slide 9 Care Act implementation support – care markets and commissioning ALL LOCAL PEOPLE Market shaping and commissioning Duty on local authorities to promote a sustainable, diverse and vibrant market for care and support that delivers high quality services for all local people. Wellbeing SustainabilityDiversity

10. Slide 10 Care Act implementation support – care markets and commissioning Commissioning for Better Outcomes A framework of standards Designed for self-assessment & peer challenge Prototype available now: http://www.adass.org.uk/policy -documents-commissioning-for- better-outcomes/ http://www.adass.org.uk/policy -documents-commissioning-for- better-outcomes/ Designed for self-assessment & peer challenge

11. Slide 11 Care Act implementation support – care markets and commissioning Commissioning for Better Outcomes Good commissioning…. Promotes health and wellbeing for all “This covers… maximising people’s capabilities and support within their communities, commissioning services to promote health, wellbeing, preventing, delaying or reducing the need for services…” Is coproduced with people, their carers and their communities. Demonstrates a whole system approach “ensure[s] the best use of all resources in a local area through joint approaches between the public, voluntary and private sectors”

12. Slide 12 Care Act implementation support – care markets and commissioning The Standards 1.Person-centred and focuses on outcomes 2. Promotes health and wellbeing 3. Delivers social value 4. Coproduced with local people, their carers and communities 5. Positive engagement with providers 6. Promotes equality 7. Well led 8. A whole system approach 9. Uses evidence about what works 10.A diverse and sustainable market 11.Provides value for money 12.Develops the workforce

13. Slide 13 Care Act implementation support – care markets and commissioning

14. Slide 14 Care Act implementation support – care markets and commissioning Outcomes-based commissioning Fifteen-minutes visits vs “time & task” Reablement Prevention Personalisation System transformation

15. Slide 15 Care Act implementation support – care markets and commissioning Market Shaping Toolkit (MaST) Expected: June 2015 Supporting SME providers and LAs to work together Market Position Statements Micro-providers Promoting innovation Case studies, and practical tools Meeting local need, procurement, workforce, sustainability, technology…

16. Slide 16 Care Act implementation support – care markets and commissioning Think Local Act Personal Top tips for commissioning for diversity  Asset based approaches  Unpicking ‘diversity’ Co-production in commissioning  Personal outcomes Both expected: June 2015

17. Care Act implementation support – care markets and commissioningSlide 17 Thoughts and questions?