Agenda Item No 5
The Vale of Glamorgan Council
Scrutiny Committee (Social Care and Health): 11th April, 2016
Report of the Director of Social Services
National Collaborative Commissioning of Placements: Integrated Health and Social Care Programme
Purpose of the Report
- To inform Members about ongoing development of the National Collaborative Commissioning Integrated Health and Social Care Programme.
- This report describes the Programme, which has been awarded Welsh Government Invest to Save funding. It has the following objectives:
- Improve health and wellbeing of patients / citizens within publicly funded, externally provided care settings;
- Improve quality and safety of the care provision within publicly funded, externally provided care settings;
- Demonstrate value for money / reduce the publicly funded costs of externally provided care.
- That Members note the work completed to date.
Reason for the Recommendation
- To ensure that Members continue to exercise effective oversight of important collaborative programmes with which the Social Services Directorate is involved.
- The South East Wales Improvement Collaborative (SEWIC) 'brokerage' or placement finding service was established in 2012. It seeks to match service users with providers of long term placements for people who have mental health problems, learning disabilities or physical disabilities. Typically, these are high cost/low volume placements. The service is run on behalf of the nine South East Wales local authorities and it reports to the SEWIC Programme Board of Directors of Social Services.
- The Care Assurance and Performance System (CAPS) was developed by the NHS Wales Commissioning Collaborative for Mental Health and Learning Disability Services to manage the external provision of secure hospital and rehabilitation services across Wales. It has been running for a similar time as the SEWIC 'brokerage' service. The issues faced by the NHS and by social care are similar. These include:
- Insufficient quality and safety of placement choices;
- Increasing demand and complexity of need in the part of people needing placements; and
- Increasing costs within a largely independent sector, market-driven economy of care.
- The South East Wales Adults Brokerage Service has also found:
- Service users' needs are becoming much more complex;
- Service providers are not adequately skilled or equipped to meet complex needs;
- There is an over-provision of 'general' needs supported accommodation;
- Specialist services are not local enough and this is a key factor for individuals / family members when needing to access a placement;
- Business models used by service providers do not support recovery and progression;
- New ways of commissioning social care services are required;
- Social care services need to be procured on the basis of their contribution to supporting independence and move on.
Relevant Issues and Options
- SEWIC has collaborated with NHS Wales on enhancing the existing Care Assurance Performance System (CAPS), with the aim of integrating the commissioning and quality performance management of high cost / low volume placements.
- Working with the NHS Wales Informatics Service, NHS Wales and SEWIC were awarded a grant from the Welsh Government Health Technology and Telehealth Fund in April 2014. This funding has been used to enhance the CAPS system, moving it from a 'database' of patient and provider information into a tool which supports the ongoing care, treatment and support of those within non NHS Wales or local authority care settings. It is now called CCAPS (Commissioning Care Assurance and Performance System).
- CCAPS allows direct access to the system by care managers, commissioners and providers (with appropriate security controls) across health and social care. As such, it will act as a key enabler for further integrated working.
- A data collection exercise has been completed for participating organisations (12 local authorities and all health boards) with the aim of creating a national strategic commissioning position for local authority and Continuing Healthcare (CHC) funded care packages. The results have informed a national 'once for Wales' market analysis in respect of external providers and helped to determine the scope for the first project in the next phase of the programme. This will involve producing framework-based agreement(s) for adults (aged 18-65) with mental health and/or learning disability needs in residential care, with/without nursing.
- This collaborative programme for integrated commissioning on the part of NHS Wales and Local Authorities has received a Welsh Government Invest to Save grant.
- All seven health boards, the South East Wales Local Authorities (Blaenau Gwent, Caerphilly, Cardiff, Merthyr Tydfil, Monmouthshire, Newport, Torfaen, Rhondda Cynon Taff and the Vale of Glamorgan), the Western Bay Local Authorities (Bridgend, Neath Port Talbot and Swansea) and Powys County Council have all confirmed that they will participate in the programme.
- The Integrated Health and Social Care Commissioning Programme Board was established in September 2015 and started a procurement process for a 'Collaborative National Framework for younger adults (18-64 years) in Mental Health and Learning Disability Care Homes and Care Homes with Nursing'. A highlight report for the period 4th January to 24th February is attached at Appendix 1.
- There have been several consultation events. One was held with professionals (health and social care practitioners, procurement officers, commissioners) in December 2015 and another with providers in January 2016.
- All 22 Welsh local authorities confirmed their willingness to be named on the Official Journal of the European Union (OJEU) notice with all 7 health boards in January 2016. The notice was published on 'Sell2Wales' on 5th February 2016 with a return date for Pre-Qualification Questionnaire (PQQ) responses by 26th February.
- The planned programme of work identifies that the framework will be in place on 1st October, 2016.
Resource Implications (Financial and Employment)
- As a member of the SEWIC region, the Vale of Glamorgan Social Services Department benefits from programme management across nine local authority areas. Our contribution for the project team supporting the Adults Brokerage Hub and CCAPS Programmes total £6,054 per annum. It has been agreed that we will continue to be involved and invest in the programme.
Sustainability and Climate Change Implications
- Effective delivery of commissioning responsibilities helps to ensure that the Council's assets are managed efficiently and effectively and that best use is made of the resources available for social care services, establishing sustainable models of assistance and support as well as contributing to the most appropriate ways of meeting the needs of vulnerable people.
- There are no climate change implications as a direct result of this Report.
Legal Implications (to Include Human Rights Implications)
- An integrated approach to commissioning services by local authorities and Local Health Boards is consistent with requirements of the Social Services and Well-being Act (Wales) 2014.
- Part 1 of the "Commissioning Framework and Good Practice guidance" is issued under Section 7(1) of the Local Authority Social Services Act 1970 and it provides standards with which local authorities are expected to comply. Commissioning practice should not place constraints on people's statutory rights to have their need for social care met by the services which the Council makes available under the relevant legislation. Legal Services are consulted in respect of issues in respect of commissioning and/or de-commissioning decisions.
Crime and Disorder Implications
- There are no direct crime and disorder implications as the result of this report.
Equal Opportunities Implications (to include Welsh Language issues)
- Commissioning of care services has to ensure that they are accessible to all those eligible to receive them and this will require Equalities Impact Assessments to be carried out, where appropriate.
- No significant adverse impact is anticipated on citizens. However, where citizens with a learning disability or a functional mental illness are placed in high cost / low volume placements, then a greater assurance of quality is expected. The placing authority should also have greater confidence that they are receiving value for money.
- The IHSCCP programme has identified the need to complete work on an Equalities Impact Assessment and the Centre for Equalities and Human Rights has been engaged to assist with this task.
- The work outlined in this report addresses the following corporate objectives outlined in the Corporate Plan 2016 - 2020:
- Wellbeing Outcome 1: An Inclusive and Safe Vale.
- Objective 2: Providing decent homes and safe communities.
- Action: Provide appropriate accommodation and support services for particular vulnerable groups.
- This is a matter for Executive decision.
Consultation (including Ward Member Consultation)
- The issue relates to all areas supported by the Vale of Glamorgan Council. Therefore, there has been no individual ward consultation in relation to this matter.
Relevant Scrutiny Committee
- Social Care and Health.
Suzanne Clifton, Interim Head of Business Management and Innovation
Head of Finance
Team Manager, Contracting and Finance
Operational Manager, Learning Disabilities
Philip Evans, Director of Social Services