Making a Change

1. Making a Change Cllr David Parsons Chair of Leicestershire Together

2. Leaders 1 11 10 Integrated Services that put the Community First Why? • Substantial reduction in public expenditure • Need to get maximum value from what we spend by: • minimising back office and maximising front line • targeting spend at what is cost effective • reducing demand for high cost services – prison, hospital, residential care How? • A truly place based approach • Full sharing of responsibility with local people – ‘Community First’ • Not just Councils - the whole public sector, the voluntary sector and the private sector • Not enabling but ‘commissioning’ which involves localities as well Objective • The best possible frontline services from the funding available.

3. What does ‘commissioning’ mean? It’s a process to ensure services meet need. We already do it for individual services. It’s a culture as much as a process to ensure services are designed around evidence of need, procured cost effectively and performance reviewed.

4. Leaders 1 11 10 We have already started • Leicestershire Together agreement to single governance, pooled budgets, single service design, single back office services • Developing 5 frontline and 1 back office commissioning hubs • LCC/NHS health and social care commissioning hub agreed • LCC/NHS early transfer of PH agreed • Community budget (CB) • ‘Big Conversations’ on ‘Big Society’

5. Big Society • Bigger VCS/Social Enterprise role in delivering services – commissioned from the hubs • Supporting Communities to deliver services that are withdrawn • Helping Communities help themselves – local/theme volunteering • Increased engagement – general volunteering • Influencing the services redesign commissioned by the hubs

6. Mixed Provision Other Funding Streams LCC/ Police / GP’s / School’s Aligned Funding Streams Commissioning Board Accountable Body Placed Based Budget/s Allocations to Commissioning Hubs Health Social Care & Well Being CYP LEP Safer and Stronger Back Office Services Environment Leicester City Single Support Services— Intelligence, Performance, Engagement, etcetc. Stakeholder Groups Customer Insight District & County Members Community Engagement and Support Joint Action Groups—Targeted interventions People & Places VCS Local Councils Commissioning Structure

7. Environment Hub Structure This would mark a reduction from 18 partnerships to 7.

8. Leaders 1 11 10 Key Tasks • Remove the sovereignty barrier – service design approach • Put Members in the driving seat – County and District Cabinet Lead Members involved in deciding priorities, wider role for scrutiny and fundamental role for Members in localities • Get partner agencies on board • Agree best use of funding to help VCS support ‘Big Society – delivering more services and working with communities.

9. Moving from partnership to a ‘virtual organisation’ John Sinnott Chief Executive Leicestershire County Council Leicestershire Together: Change & Challenge

10. Government wants: • About 19% less public expenditure on average. • More to be spent on the frontline • More emphasis on prevention • More emphasis on people and communities helping themselves • More decisions to be made locally: • GP Commissioning • More independent schools • Elected police commissioners • Councils to have greater ‘co-ordinating’ role

11. What’s happening in Leicestershire • Good performance • GP commissioning clusters forming • Joint Health and Social Care Commissioning • Transfer of public health • A commissioning LEP proposal submitted • Personalisation of social care budgets being rolled out • Defining how the VCS can support ‘Big Society’ • An improvement and efficiency programme having some success in reducing costs • Community Budget for Families with complex needs • A plan for six commissioning hubs

12. The Impact of CSR • National • 28% real terms cut for local government (2011/12 – 2014/15) • Large reductions in capital including 60% for CYPS • Frontloaded (National c.11% next year) • Uncertainty/risk surround specific grant income • LCC • Revised forecast in September from emergency budget c.£90m over 5 years. Still uncertainty about specific grants

13. Community Budgets • Families with complex needs • 16 prototypes • 20 other places • Service redesign – better outcomes at less cost • Pooling of budgets

14. What is commissioned strategically, commissioned tactically or coordinated locally? • What activities should be strategically commissioned at County level? • not necessarily related to point of delivery e.g. waste, personalised budgets • standard services vs variable services. • where do choices about priorities need to be made: • geographic • groups of people • But which activities would be more effective if they were secondary commissioned close to the customer • geographic • groups of people • What delivery activities need to be coordinated locally e.g. health & social care professionals or PCSOs and street wardens • What do we mean by local – area/district/neighbourhood?

15. Service design the key • Putting blocks of activity/service/budget together to allow • a better overview of relationships between services from user perspective • better decisions about what works • lower cost solutions for lower priority activities to be chosen • a move to prevention • more manageable relationships with potential suppliers e.g. VCS • Joining up support services for efficiency • more cost effective procurement • better use of assets • Joining up support services for a level playing field • single set of priority outcomes • joined up performance monitoring • joined up engagement • single evidence base

16. This is Leicestershire Update • An updated evidence base, “This is Leicestershire 2010”, produced by the Research & Information team, LCC • Provides a sound base for establishing priorities across the partnership • The report was signed off by both the LT Executive and Strategic Boards at the end of September 2010

17. A refreshed Sustainable Community Strategy • Consultation across the Partnership on 1st Draft Outcomes between now and spring 2011 • Two questions need asking: • Are these the right Outcomes? If not, what are? • How can we achieve these Outcomes?

18. Health & Social Care Mick Connell, Director of Adults and Communities, Leicestershire County Council Peter Marks, Director of Public Health, NHS Leicestershire County & Rutland

19. Leaders 1 11 10 Our Priorities • Improved life chances for vulnerable individuals and families • More older people are able to live independent lives at home

20. Our Priorities • Improved health outcomes for people in Leicestershire, in particular a reduction in health inequalities • Fewer people smoke • Reducing the harm associated with alcohol • More people are physically active at a level which makes them healthier • A healthy weight in all age groups is promoted, encouraging a whole family approach to eating well and being active • Improved mental health and well being

21. How are we going to deliver this? Current Stage of Development • Joint Change Programme in place across NHS LCR and LCC • Agreement that joint commissioning is a priority for 2011/12 • Agreement to share resources in terms of staff resources and to seek greater pooling and alignment of budgets • Joint recognition of financial challenges in public sector and the need to work in partnership to tackle this challenge. • Public health integration plan in place per the white paper requirement • Starting to plan engagement with GP consortia • Wider stakeholder engagement

22. Joint Prioritisation/Service Design in the Health and Well Being Hub • Putting blocks of activity/service/budget together to allow • a better overview of relationships between services from user perspective • better decisions about what works • lower cost solutions for lower priority activities to be chosen • a move to prevention • more manageable relationships with potential suppliers e.g. VCS • Joining up support services for efficiency • more cost effective procurement • better use of assets • Joining up support services for a level playing field • single set of priority outcomes • joined up performance monitoring • joined up engagement • single evidence base

23. Next Steps • Nov - Dec 2010 • Transition plan for LCC and NHS LCR (incl interim governance arrangements) for NHS LCR Board and LCC Cabinet Co-location of commissioning teams across health and social care, plus public health functions (Jan 2011) • Jan – April 2011 • Understand the outcomes/performance management framework for 2011/12 for health and social care • Confirm the NHS operating framework and LA settlement for 2011/12 • Agree joint commissioning priorities (with GP engagement) for 2011/12 with reference to SCS, plus the potential and scope for aligned/pooled budgets • Implement the new Health and Well Being Board

24. Next Steps (2) • April onwards: • Plan longer term “offer” with GP consortia – e.g. the future place of the joint commissioning arrangements in the new commissioning landscape and relationship to GP consortia • Develop team structure to support the above across health and social care

25. Children & Young People Gareth Williams, Director, Children’s Services, Leicestershire County Council Leicestershire Together: Change & Challenge

26. Legislative Changes • Statutory requirement for Children’s Trust, Children’s Trust guidance and Children and Young People’s Plan regulations withdrawn • Duty for schools to cooperate to be withdrawn - Schools White Paper expected end of November • Duties for most partners to cooperate, and Lead Member, retained

27. Response • Partners remain committed to working in partnership – exploring how in practice • Potential for pooling budgets around shared priorities • Opportunities through Community Budget pilot

28. Draft priorities • Safeguarding • Health • Young people’s morale and self-esteem • Attainment • Approach: • Focus on vulnerable children/young people - personalisation • Centrally planned, locally delivered • High quality information and signposting

29. Stronger Communities Mark Grant, Chair, Stronger Communities Partnership

30. Lead and supported by the VCS & Partners Priority Neighbourhoods and Rural Communities Activity that engages people across the County in their Communities Leaders 1 11 10 Background

31. Our Priorities Communities are empowered to play a role in decision making and to influence and shape services. There are a wide range of well supported volunteering opportunities. Thriving integrated and cohesive society of many faith and cultures

32. Our Challenges ahead Doing more with less Maintaining and building on social cohesion Involving our partners and influencing other hubs The Big Society

33. Safer Communities Chris Thomas Leicestershire Constabulary

34. Leaders 1 11 10 Overview • Strategy - to provide “safer communities” within the County • Delivery – the 4 agreed priorities • Opportunities – new working arrangements

35. Leaders 1 11 10 Strategy The Leicestershire safer communities programme board sets the strategy – CSP chairs & statutory agencies • Jointly commissioned annual strategic assessment • Mixture national strategy & local need • Considers: performance, local surveys, horizon scanning, local intelligence • Focus on 4 priorities

36. Leaders 1 11 10 Our Priorities People feel (and are) safe from violence • A reduction in violent crime ~ serious violent crime -30% ~ less serious assaults -22% • A reduction in repeat domestic violence

37. Our Priorities The public feel that anti-social behaviour is being tackled effectively • Anti-social behaviour ~ overall reduction CSP focus post Pilkington ~ 58% satisfaction in police & local auth ~ 83% customer satisfaction v 75% • Criminal damage ~ 14% reduction, 900 less victims

38. Our Priorities The harm caused by drug and alcohol misuse is reduced in local communities • Number of drug users in effective treatment ~ 10/11 1161 users, increase of 77 • Drug related offending is reduced

39. Leaders 1 11 10 Our Priorities The lives of offenders and those at risk of offending are improved so they are less likely to offend • Re-offending is reduced ~ predicted re offending down – off target ~ Risk regarding sentences of 12 months or less ~ The focus on IOM • Number of first time entrants to the criminal justice system has fallen significantly

40. Leaders 1 11 10 Opportunities The opportunities provided by joint commissioning & sharing services • Concept of creating IOM a referral & escalation process for prolific active offenders ~ joint working to divert offenders from crime ~ no finance to create team in County ~ introduction of virtual team, police, probation,YOS ~ shared office space & joint working 2 days a week ~ effective working, efficiencies regarding joining business processes

41. ENABLE Peer Review RIEP supported process Number of Partnerships (ENABLE, CLIMA, Waste, Flooding) Big issues Leicestershire Together: Change & Challenge

42. Issues and Outcomes Strengths Achievements and Impact Vision and Strategy Governance and Accountability Leadership and Relationships Performance Management Leicestershire Together: Change & Challenge

43. Strategic Environment Partnership Democratic involvement and community engagement Waste / Cleaner Natural and Historic Environment Climate Change Flooding • Waste • Street & Environmental Cleanliness • Carbon Management • Air Quality • Renewable Energy • FRMB • Bio-diversity • Historic / Environmental Protection • Local Access • Green Infrastructure • Parks and Open • Spaces

44. Next Steps Ownership Voluntary sector Governance Timetable Relationship to LEP Leicestershire Together: Change & Challenge

45. Leicester & Leicestershire Enterprise Partnership (LLEP)Andrew GrangerChair, Leicestershire Business Council Leicestershire Together: Change & Challenge

46. LLEP Governance

47. Scope of LLEP • Employment & Skills • Enterprise and Innovation • Transport • Housing & Infrastructure

48. Role of LLEP • Strategic Commissioning Body • Develop vision and strategy • Secure national and EU resources • Align mainstream programmes • Influence national policy

49. LLEP Vision ‘To create a prosperous economy, secure and well paid jobs and a sustainable environment through wealth creation by innovative businesses and a highly skilled workforce, we will make Leicester and Leicestershire destinations of choice for successful businesses by clearly differentiating the sub-region, as a place to do business, work and live’.

50. Strategic Priorities • Increasing productivity and private sector job growth. • Creating a balanced and sustainable knowledge-based economy. • Addressing the physical requirements for success. • Raising skills levels and educational attainment. • Providing effective business support. • Increasing inward investment and international trade. • Growing the Green Economy and investing in our communities.