Voluntary Sector Partnership Joint

Commissioning and Procurement

Presentation

20th October 2016

Ian Mello, Borough SRO Locality Plan

Susan Crutchley, Programme Manager

Agenda1) What is joint commissioning?

2) Why RMBC & CCG are doing it?

3) How it is being done (i.e. staff working as teams around theme such as dementia, older people, children, joint commissioning boards etc.)?

4) Will there be the opportunity for co-design of services with the sector and the communities they serve as part of joint commissioning?

5) Will there be a commissioning strategy developed, if so, will this be shared with the sector?

6) How will this affect current funding/contracting arrangements between the sector and CCG or between the sector and RMBC?

7) STAR Procurement – short presentation about the process –Development of Tender Specifications, Advertising the opportunity, Pre-Qualification Questionnaire, Invitation to Tender, Timeframes for submission of documents, decision making

8) Locality Plan update

1) What is joint commissioning?

Joint Commissioning is a strategic approach to planning and delivering services in a holistic, integrated joined-up way. It is a means for the different partners commissioning public health and health services and social care provision, to deliver positive outcomes for local populations. We also jointly commission with other north east sector localities such as Bury and Oldham.

2) Why RMBC & CCG are doing it?

The NHS Five Year Forward View set policy clearly that CCG’s and Councils must deliver integrated services and work towards new models of health and social care in one single joint commissioning context. The Greater Manchester Health and Social Care Partnership is also taking this policy forward more locally.

3) How it is being done (i.e. staff working as teams around theme such as dementia, older people, children, joint commissioning boards etc.)?

To date we have created an Integrated Commissioning Board and throughout this financial year we are in a shadow or learning year for adult services commissioning. We have also worked together on major projects such as the Oasis Unit at Rochdale Infirmary.

4) Will there be the opportunity for co-design of services with the sector and

the communities they serve as part of joint commissioning?

Both the CCG and Council are fully committed to this principle and want to

take this forward locally. Last year we held over 40 engagement events for

the Locality Plan and we will be establishing another programme of them

very soon.

5) Will there be a commissioning strategy developed, if so, will this be shared

with the sector?

The Locality Plan will soon have an Operational Plan and this effectively will

be our five year commissioning strategy. This has to be completed by third

week of February 2017 for submission to GMHSCP: we want to engage and

consult with you and the public and our stakeholders about this.

6) How will this affect current funding/contracting arrangements between the

sector and CCG or between the sector and RMBC?

We are currently working with CVS and partners on the Health and Well-Being

Alliance model and see this as a formal part of our Locality Plan. We are also

working towards one single procurement and contracting approach across the

CCG and Council: we are happy to develop this with the sector going forward.

7) STAR Procurement

See following slides

STAR Procurement – The Process.

• All clients must complete a Procurement Initiation Document before

starting their process. This includes budget available, current arrangement

and service outcomes. This is then signed off by Finance and Operational

Leads. Any contracts above £250,000 total value are sent for Cabinet

approval at Rochdale.

• Needs Assessments, Market Engagement Sessions, Service User Feedback

are all collected as part of developing the Tender Specifications.

• All Procurements over £50,000 are advertised via the Procurement Portal

The Chest. This is a clear audit trail of the process from start to finish.

https://www.the-chest.org.uk/ Procurements over EU Thresholds are

advertised for Minimum 30 days

STAR Procurement – The Documentation .

• Suitability Assessment Questionnaire - Pass/Fail Document which checks

Organisations Policies E.g Health and Safety, Safeguarding, Financial

Standing and Economic Capability.

• Invitation to Tender – Document which instructs all bidders on timescales

and evaluation criteria for each project. Organisational proposals are also

detailed in this document. These are evaluated using a strict Quality

Guidance document briefed with Evaluation Panel.

• Decision Making – All bids are evaluated in conjuntion with the Council’s

Contract Procedure Rules and Best Practice. Moderation meetings to

determine an agreed score and bidder feedback is undertaken. Common

place to try and get Service User representation on the panel providing no

conflict of interests occur

Locality Plan Update

• LCO development

• Transformation Fund Bid

• Locality Plan Service Model: (over 50

engagement and co-production sessions held

to develop service model, biggest process in

any GM Locality Plan: will be repeated

throughout Winter 2016 until February 2017)

As you are no doubt aware the locality has to

establish an LCO under the Greater Manchester

Strategic Plan and guidance on this is clear:

“ Fully integrated Locality Care Organisations (LCOs) will be established in

each part of Greater Manchester. These Organisations, including all health

and social care providers in a locality will be working together collaboratively

to provide care to a defined population within a defined budget with primary

care at the centre, predicated on the GP registered list. Each area will develop

and design their delivery models. However, there will be core features of these

new organisations to be defined and agreed locally.”

What are LCOs?

• Multiple organisations working together to deliver health and care services within a defined budget;

• Have the ability to manage and co-ordinate the care of individuals along full length of clinical and social care pathways;

• Demonstrate a standardised approach to quality improvement activity, including patient safety;

• They treat and support patients in different more appropriate settings as a result of improved co-ordination;

• Importantly they demonstrate increased involvement and engagement of patients and service users in design, delivery and improvement of services;

• They are proactive in the management of population groups to inform early intervention and prevention;

• They have integrated IT solutions to support the collaboration.

Developing Accountable Care Local Care Organisation

1 Impact aspiration What difference will we make?

What are needs of population by population, activity, spend, needs2

3

4

5

6

7

8

Population needs

Changes in Care

Delivery

requirements

Changes in

information

Changes in

payment

Governance

Development

What are the highest priorities to address?

What are the key changes in how care is delivered to key segments of population?

What changes are required in who does what from where?

(core processes, workforce, delivery in person vs electronic, setting)?

How will flow of information will change to enable these changes?

(Information governance, patient level data set, core functions of delivery, engaging

patients, performance and payment)

What changes in payment need to be made to: a) directly reimburse costs, b)

incentivise behaviour, c) transfer accountability/risk will be made?

How will this operate and how will it be phased in?

What are key functions the need changes (e.g, function of teams, operational control,

managing financial risk, accessing capabilities)?

Identify changes in governance and delivery model (e.g., accountable care, group, etc)

Support the transformational changes needed in behaviour and interactions in the

system31

Example of LCO operating model

13

Review of performance andprocesswithin thecareteam

5

ü

ü

12

Multi-disciplinarycare team Case conference toworking discusscomplex

cases/issues

7

Navigation to

Specialist1 Patient access supportresources

1 2

Identification Patient

ofhigh risk enrollmentpatients In CC programme

3

Identificationofpatienthealth goals

4

Developmentofcare planwith patient

GPP2 Alliedhealth

professional

Care

coordinator Social

worker

Pharmacist

Behavioral

health

8

Discharge planningand coordination 11

Regular reviewandupdate ofcare plan

9 with patient/family

Accessto specialistopinion

10

Integrated healthand social careteam in home

1 Specialists in both inpatient or outpatient settings 2 Includes primary care physicians, advanced practice nurses, physicians assistants37

SOURCE: North West London Integrated Care Pilot; Dorling, & Richardson - Evidenced interventions for integrated care (2014)

GM Devolution Plan: Transformation

Fund• The Plan enabled GM to secure a £450 million Transformation Fund.

• The Fund was designed to enable places to develop new models of care

which began to change the nature of demand and to keep existing services

safe and sustainable while the radical change was happening.

• The agreed £450m is to be used to drive the transformation required by

the 5 Year Forward View and as such the funding from NHSE is to be

phased through a 5 year period, as outlined below.16/17 17/18 18/19 19/20 20/21 Total

TF (£m) 60 120 150 70 50 450

In order to align the spending of the TF with the wider work of GM

Devolution, outlined in the Strategic Plan, the following outlines the approximate resource assigned to each GM Theme

GM Theme Size of Fund

Radical upgrade in prevention £75m-£100m

Transforming care in the localities £250m-£275m

Standardising Acute Care £25m-£40m

Standardisation of support and back office £15m-£30m

Enabling better care £40m-£60m

Five assessment criteria for the Fund have been approved by the Strategic

Partnership Board

The assessment criteria for funding proposals will be based around five main areas outlined below.

Alignment to GM

strategy

• The proposal will need

to demonstrate

alignmentto the GM

transformation

initiatives in both its

strategy and vision as

well as its plan design.

• This will includecreating a link between

the programme and

GM/STP outcomes as

well as articulating

how the proposed

solution will close the

financial gap.

Readiness to deliver

• The proposal will need

to demonstrate that it

is ready to be

delivered.

• This will include

demonstrating:

Ø Project management

infrastructure is in

place

Ø The local system is

capable of delivery

Ø The intervention

specifics, such as

target patient groups

have been developed

Stakeholder engagement

• In order to be

successful, applicants

need to provide

evidence of wider

stakeholder support.

• This will need to be in

the form of:

Ø Formal sign-offs and

agreements

Ø Evidence of co-design

Ø Patient engagement

Robust financials

• Proposals will need to

clearly demonstrate

that the locality 5 year

financial and activity

plan contributes to

closing the gap and

underlying opportunity

for GM (or specific

localities).

• The programme

specific finance

template (see slide 10)

should demonstrate

the investment ask,

impacton activity and

finance and therefore

the return on

investment (ROI).

Foundation for Further

Transformation

• Final proposals will

need to demonstrate

the replicability and

forward planning

involved in their

programmes.

• This will include:

Ø Identifying the

evaluation framework

in place

Ø Identifying the

approach to sharing

best practice and

lessons learnt

The five criteria will be the same for GM initiatives, however the requirements will be adjusted to ensure they are appropriate.51

• Six main programmes within locality plan:

Prevention Thriving and Coping, Getting Help in the Community

and Getting More Help, Mental Health and Specialist Help and

System Transformation(enablers such as estate, IT and workforce

• Hubs x 4 located in Heywood, Middleton, Pennines and

central Rochdale: indicative locations identified

• Integrated Neighbourhood Teams and Integrated

Intermediate Care Service (health, social care and voluntary

sectors working under prime provider model)

• Prevention and Wellbeing Service Directory

• Behaviour Change Programme

• Health and Wellbeing Alliance model

Service Model

But this is a lot to do so…..

• GM has offered ‘Seed Corn’ Funding

– Any allocation of development funding will be based on detailed

costing and kept to the minimum amount commensurate with

producing a full business case.

– Localities will need to show evidence of demonstrable commitment

to the delivery of their development funding proposal

– This is to get team/governance/partnership/risk etc arrangements

and costed plans together to:

• Put a bid in for Transformation funding by 3rd Week February

2017

– But this will form part of the TF and needs to show 3:1 ROI as well

– And seed corn funding bid needs to be in very soon so allow time to

develop full TF bid