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Intelligent Commissioning - summary
Report of Strategic Director, Communities to follow.
- Item 56 IC summary presentation 2, item 56 PDF 236 KB
- Item 56 IC briefing for OSC, item 56 PDF 263 KB
- Webcast for Intelligent Commissioning - summary
56.1 The Chair of OSC Councillor Gill Mitchell reminded the meeting of the scrutiny workshops on pilots for Intelligent Commissioning (IC) held in March, and invited the Chief Executive to present the report.
56.2 John Barradell (JB) thanked the representatives from all the services involved in the pilots and IC to date and set the context: the need to reduce the cost of public services for the foreseeable future, making the biggest impact with the resources available; more opportunities to work differently with partnership organisations including the community and voluntary sector to ‘unlock value’ for the City and its citizens; and delivering the aspirations of the City as outlined in the Sustainable Community Strategy, at a time of increasing demand eg around people of working age, older people and addressing more equalities issues. There was also a Council re-alignment to bring skills and capacity to enable work in this way.
56.3 The Chief Executive outlined the three initial pilots; the impact of alcohol on the City, drug-related deaths and domestic violence; that were interrelated and could not be ‘fixed’ by one organisation alone.
56.3 The Strategic Director, Communities David Murray (DM) detailed some of the lessons learned from the pilots. Less time should be spent on gathering information and more on analysing it. A better early understanding of available resources was needed, plus an acknowledgement of the time taken for a culture change to new ways of working to bring about better outcomes for the community. There was no ‘one size fits all’ – flexibility and understanding was required for different circumstances. The lessons were now being applied widely to IC within the Corporate Plan, and the Local Strategic Partnership on a day to day basis.
56.4 The Lead Commissioner, ASC and Health Denise D’Souza (DD) said commissioning had been undertaken in ASC for many years with NHS colleagues. The difference with IC was that other public services such as licensing and the police were closely involved, so preventive measures could be better coordinated and the impact felt across a wide range of services rather than ASC alone. DD said formerly there were many different targets and action plans relating to alcohol in the city; there was now a Commissioning Plan that dealt with not only services but also policy, culture and a Strategy across different organisations.
56.5 Dr Tom Scanlon, Director of Public Health, (TS) outlined the Alcohol Programme Board that covered four key aspects - the culture of alcohol use, availability of alcohol (licensing), Night-time economy(led by the Police), and treatment and prevention of alcohol misuse - and dealt with strategic oversight, performance and problem solving. The ‘intelligent’ part was bringing more people together and giving them joint responsibility for a problem affecting us all. This new approach has allowed culture change to be addressed eg via the innovative big alcohol debate events to bring about a better understanding of the issues, more early identification and explicit treatment work and therefore more positive results. The funding available to deal with alcohol problems in the city is also now clearer, he said.
56.6 Having formerly been somewhat sceptical, TS said he was now more convinced of the merits of IC in areas such as alcohol and substance misuse as it brought a much more coherent approach and this bodes well for the future.
56.7 Acting Police Superintendent Simon Nelson (SN) stated that formerly it had been frustrating that there was no coordinated strategy on alcohol. There was now effective collaboration both with medium and long-term plans and IC now extended to the operational level. Police licensing officers and trading standards officers were now successfully working together on the threat of counterfeit alcohol. There was close working with A&E on alcohol-related harm and during the year 250 fewer people had been assaulted due to partnership measures and a comprehensive plan, he said.
56.8 DM gave the example of advice and financial inclusion services; another area of increasing need and reducing resources that was applying the lessons learned from the IC pilots. This was already a data-rich area, and there was working with the CVSF and advice agencies and across the council on a needs analysis and ‘co-production ‘ (agreed shared outcomes). It was being developed faster than the pilots although using the same IC principles, to maximise the money available and maximise the outcomes for people. There was still much to do; but this is how we now work, he stated.
56.9 Terry Parkin, Strategic Director, People (TP) said that ‘People’ spends 2/3 of the council’s spend and employs ¾ of the council’s staff. Securing services through commissioning had been happening since 2006 and was central to the way we now work. Working jointly with West Sussex had already reduced significantly costs of commissioning independent fostering places. The Child Poverty Strategy was adopting a similar approach that has clearly identified outcomes, which is central to any effective commissioning and essential to drive up standards, he said.
56.10 Children with disabilities was also an area based around commissioning principles working with parents, the third sector and providers and again there had been significant reductions in cost even though children’s needs are generally more complex than before. We can drive down the cost of placements by being clear about what we want the placements to achieve, he said.
56.11 Head of Adult Assessment Brian Doughty (BD) described the Assessment and Delivery Unit that assesses the social care needs of vulnerable care adults and older people – people with disabilities, mental health and/or substance misuse issues. This had a gross budget of £83 million, 90% of which was commissioned in the independent and voluntary sector. He reiterated that commissioning was not outsourcing, nor was it new since the NHS and Community Care Act (1990), but there was a new move from individual commissioning to aggregated commissioning of services.
56.12 Giving more control to individual customers often involved giving individuals their own budget via Personalisation or Self-directed support and also fitted people’s needs with agreed outcomes. This was a different type of IC process; to ensure that services were available for people to buy. Two particularly effective examples were; ensuring there are enough Personal Assistants, and ‘operationalising’ in partnership with Health and Police colleagues and a range of other service areas regarding hospital discharge, better re-ablement and safeguarding adults at risk.
56.13 IC work on alcohol drugs and financial inclusion would reduce demand on the services and therefore also on the budgets, he stated.
SN: Hen and Stag parties are good examples where we now have a broader understanding of the impact of events in the City.