ADASS / SCIE Seminar 02 July 2014 ‘Care Act 2014 & Commissioning for Better Outcomes’

1. ADASS / SCIE Seminar 02 July 2014 ‘Care Act 2014 & Commissioning for Better Outcomes’

2. Commissioning for Better Outcomes Jon Glasby and Catherine Mangan June 2014

3. Work so far • Literature review • Interviews with 21 key stakeholders from a range of perspectives – representatives of national organisations, commissioner, provider and social care users • Two workshops at the ADASS Spring seminar • Five stakeholder events: prevention, co-production, market development, outcomes based commissioning, workforce

4. Initial findings • Ambiguity of terms • Commissioning • Co-production • People using social care

5. Findings from literature review • Evidence base for the impact of commissioning is patchy and under-developed. • Wealth of guidance and good practice to drive quality and outcomes for health and wellbeing for people using social care services and their carers. • Often not clear on what basis examples of good practice are being cited. • Conclusions about how commissioning is working to achieve better outcomes is limited.

6. Wicked issues • Financial pressures, increased expectations and demographics • Lack of evidence of impact for commissioning • Challenge of meaningful co-production with social care users, family, carers and communities • Integrated commissioning and the need to adopt a whole life, whole system perspective • Potential tension between personalisation and population focused commissioning. • Intelligent use of information and data limited by capacity, accuracy of data held and information sharing issues

7. Wicked issues • Changing the relationship with providers • Prevention or diversion? • Tensions around cost and quality • Economy of scale or granularity of services? • Disproportionate attention given to the needs of particular groups • Challenge of equity • Outcomes based commissioning – how to do it and likely impact • Workforce - commissioner capacity and provider staffing quality

8. Draft principles – good commissioning…… • Is supported within local Councils • Is coproduced with people and their communities • Promotes health and wellbeing for all • Focuses on outcomes • Is person centred • Is integrated with other public services

9. Draft principles – good commissioning…… • Uses evidence about what works • Promotes equality • Delivers social value • Facilitates the diversity and quality of the market • Ensures sustainability • Provides value for money

10. Developing the standards • Two key areas: • Good commissioning is championed within local councils • Good commissioning is integrated with other public services

11. Example: Good commissioning is supported through the leadership, values and behaviour of elected members, senior leaders, and commissioners of services. It is underpinned by principles of co-production, personalisation and integration.

12. Example: Good commissioning coproduced with people and their communities. Co-production is a relationship with social care users; their family carers and communities that is underpinned by the principles of equality, diversity, accessibility and getting something back from putting something in.

13. Developing the standards • What standards would you want to see? • What might excellent/good/acceptable look like? • What evidence would you expect to draw on? • What format would be of most use? • How could you use the standards?

14. Next steps • Development of standards – by end August • Testing in areas in September – volunteers?? • Development of peer challenge approach • Launch at NCAS conference – October

15. Contact #commissioning4outcomes Jon Glasby J.glasby@bham.ac.uk Catherine Mangan c.mangan@bham.ac.uk Twitter: mangancatherine

16. ADASS / SCIE Seminar 02 July 2014 ‘Care Act 2014 & Commissioning for Better Outcomes’