Commissioning Support Programme- VCS engagement with commissioning

29 June 2010Ros Cassy

Workshop objectives

• Outline ways to engage more effectively and strategically in commissioning process

• Consider how to position VCS to better engage in CT needs analysis, planning and commissioning

• Discuss collaborative approaches

What is commissioning?

Commissioning is the word that describes the process for deciding

how to use the total resources available for children, young people,

parents and carers in order to improve outcomes in the most

efficient, effective, equitable and sustainable way.

3

What is Commissioning?

What is purchasing?

The operational activity, set within the context of commissioning, of

applying resources to buy services in order to meet needs –

either at a macro\population level or at a micro\individual

level. (DoH definition)

What is joint commissioning?

The process in which two or more commissioning agencies act together to co-ordinate their commissioning, taking joint responsibility for translating strategy into action

The Children’s Trust represents the total resource pool

7

Districts

Job Centre

Plus

Local authorit

y

Local business

Strategic Health

Authority

Private provider

s

Sixth forms and FE

3rd SectorCommuniti

es

Families, parents and

carers

Police

NHS

Primary care trust

Youth Justice Board

Schools and academies

Connexions

Fire Brigade

Children & young people

Probation

Outcomes for children and young people

Parents

8

So what does it mean in practice?

• Children’s Centres and Educare

• Extended Schools• Integrated Youth Offer• Common Core• Climbing Frame of

qualifications • Multi-disciplinary Teams &

Lead Professionals• Support for parents, carers

and families• Support for children with

additional needs• Integrated Safeguarding

Integrated Front-Line Delivery • Common Assessment Framework

• Information Sharing• New Barred List/

Registration Scheme• Re-engineered local

processes

Integrated Processes

• Needs Analysis & CYPP• Local workforce planning• Joint Commissioning• Pooled Budgets

Integrated Strategy

• Co-operation arrangements with partners (e.g. VCS, Schools, GPs)

• Local Safeguarding Children Boards

Inter-agency Governance

• Directors of Children’s Services & Lead Members

• Multi-disciplinary team leadership

Leadership

• Integrated Inspection of Children’s Services• Annual Performance Assessment• Annual priorities conversation

Performance Management

• Children’s Commissioner• Views into local planning

Involvement of CYP

Exercise in groups

9

Current engagement Opportunities to engage

The Commissioning Process

11

Many Trusts use the DCSF model of commissioning to underpin the activity

12

It works well alongside the World Class Commissioning framework

Patient/ public

Petitions

Published prospectus

Review service provision

Assessing needs

Seeking public and patient views

Managing performance (quality, performance, outcomes)

Referrals, individual needs assessment; advice on choices; treatment/ activity

Managing demand

Shaping the structure of supply

Designing services

Deciding priorities

National targets

Look at outcomes for children and young people Look at particular

groups of children and young people

Commission – including use of pooled resources

Identify resources and set priorities

Decide how to commission services efficiently

Monitor and review services and process

Develop needs assessment with user and staff views

Plan pattern of services and focus on prevention

Plan for workforce and market development

Phase 1Needs assessment and strategic

planning

Phase 2 Shaping and managing the

market

Phase 3Improving performance,

monitoring and evaluating

13

1) Look at the current pattern of outcomes for children and young people in their area, and recent trends, against national and relevant local comparators.

2) Look within the overall picture at outcomes for particular groups of young people.

3) Use all this data, and draw on the views of children, young people and their families, local communities and frontline staff, to develop an overall, integrated needs assessment.

14

4) Agree on the nature and scale of the local challenge, identify the resources available and set priorities for action.

5) Plan the pattern of service most likely to secure priority outcomes, considering carefully the ways in which resources can be increasingly focussed on prevention and early intervention.

6) Decide together how best to purchase or provide (commission) those services, including drawing in alternative providers to widen options and increase efficiency.

15

9) Monitor and review to ensure services are working to deliver the ambitions set out for them..

8) Plan for the workforce development and other changes in local processes and ways of working necessary to support delivery.

7) Develop and extend joint commissioning from pooled budgets and pooled resources

Three key aspects to achieving better outcomes through commissioning

Achieving Better Outcomes through activity and culture

Activity - we are encouraging commissioning at all levels• Individual level commissioning

– Lead professional and user led – Personalised agenda

• Operational/community level commissioning– Groups of children with particular needs – Localities with particular needs

• Strategic commissioning – Whole population commissioning across the

partners of the children’s trust– Regional level commissioning

18

Commissioning at all levels...

Individual budgets care management

Practice-based commissioning,schools or children’s centres, or area commissioning.

PCT & local authority strategic commissioning

Pan –Region or sub-regional commissioning of more specialist services

Highly specialist commissioning

National

Regional/ Sub regional

Children’s Trust wideLocalityIndividual

19

Every Child Matters Outcomes

Public sector

Contracted Private Sector

Voluntary Organisations

Private Sector - shops, jobs, finance, housing

Children

and their Families

Communities

and

Peer Groups

ORGANISATIONS SERVICE USERS

SOCIAL CAPITAL

Outcome focused co-production

The new CYPP – scope

The CYPP includes:

• All those in the area aged 0 to 19

• Young people aged 20 and over leaving care

• People up to the age of 25 with learning difficulties

• Services for adults / families that impact on children

CYPP should focus on cross cutting priorities and joint activity

CYPP should reflect the shared priorities of all the key local agencies, including the PCT

Needs assessment results in a profile of children in the local area by age area and type – including vulnerable groups

The new CYPP – and needs assessment

Each plan must include a needs assessment for all children and young people against the five outcomes

Needs assessment – becomes statutory responsibility of all partners on the Children’s Trust Board

Needs assessment links to JSNA

The new CYPP – needs assessment

Data

• Draw on JSNA – using same database where possible

• Drive strategic commissioning priorities

Analysis

• Focus on outcomes and identify gaps in service provision

• Include service user views – consultation is vital

• Identify priorities for joint actions across partnership

• Draw on routinely collected children and family data sets

The link between the LSP/ SCS and CYPP has been made clearer

24

Effective Children’s Trust Board leadership, governance, accountability and joint working to drive local CYP priorities

Commissioning arrangements that build on the strengths of NHS, education and third sector

commissioning and linking them to joint arrangements through the CYPP

Service delivery through a workforce with the right skills and capacity, focused on prevention and early intervention

to improve outcomes

Inspection and

assurance systems to help drive

improvements in

quality and outcomes

Needs assessment using data in

JSNA and engagement of children, young

people and families to

inform CYPP and the design, commissioning and delivery of

services

Sustainable Community Strategy

Children and Young People’sPlan linking to partner plansand driving down to alignedoperational plans developedwithin the Children’s Trust

partnership

JSNA aligned with SCS and feeding into CYPP needs assessment

Local Strategic Partnership

Each element is critical to good commissioning

1) Look at the current pattern of outcomes for children and young people in their area, and recent trends, against national and relevant local comparators.

2) Look within the overall picture at outcomes for particular groups of young people.3) Use all this data, and draw on the views of children, young people and their

families, local communities and frontline staff, to develop an overall, integrated needs assessment.

4) Agree on the nature and scale of the local challenge, identify the resources available and set priorities for action.

5) Plan the pattern of service most likely to secure priority outcomes, considering carefully the ways in which resources can be increasingly focussed on prevention and early intervention.

6) Decide together how best to purchase or provide (commission) those services, including drawing in alternative providers to widen options and increase efficiency.

7) Develop and extend joint commissioning from pooled budgets and pooled resources.

8) Plan for the workforce development and other changes in local processes and ways of working necessary to support delivery.

9) Monitor and review to ensure services are working to deliver the ambitions set out for them.

25

Compact Commissioning Guidance

Effective analysis involves timely, transparent and accessible engagement with service users, communities of interest and organisations acting as advocates for service users and as service providers

Commissioners will have (after analysis) a clear understanding of the impact of funding decisions on local supply and service provision

An effective planning process allows commissioners to manage the risk of service delivery failure, by creating the right conditions for providers to focus on delivering outcomes

Proportionate reporting allows third sector providers to focus resources on service delivery rather than bureaucracy

26

Moving to an effective jointly commissioned model

1. How joint and how commissioning-led is our model now?

2. What are the rational enablers and blockers to move to a joint commissioning based model? (25 mins)

3. What are the emotional and political enablers and blockers to move to a joint commissioning based model? (25 mins)

4. Plenary feedback (10 mins)

27

Moving to a joint commissioning-led model

28

Rational

Emotional

Political

Enablers Blockers

Collaborative work

Partnership, consortium working or a prime contractor model for service delivery may be considered the most appropriate approach to delivering outcomes. 

Compact Commissioning Guidance 2009

Collaborative work

Other challenges identified by voluntary organisations include diversifying income sources and the need to identify gaps in service delivery and develop appropriate partnerships to respond to these opportunities. Overall the sector is slightly less optimistic compared to the last quarter, with less than two fifths of respondents believing that the current economic climate has created opportunities for their organisation

SEEDA economic review May 2010

 

Exploring collaborations

31

Opportunities Threats

• Engaging with the Children’s Trust in your area

• Engaging with the development of the CYPP

• Seeking out collaborations

3 key actions to take away

33

www.commissioningsupport.org.uk