Archived decisions
REPORT OF THE
EXECUTIVE MEMBER
ADULT SOCIAL CARE
PART II
JOINT HAMPSHIRE COMMISSIONING STRATEGY FOR OLDER PEOPLE'S MENTAL HEALTH
1. Following a twelve week consultation with a broad range of stakeholders involved in the development of a Joint Older People's Mental Health Commissioning Strategy the Executive Member was pleased to approve the strategy.
2. The Strategy provides a commissioning framework for Hampshire County Council and Hampshire Primary Care Trust to deliver older people's mental health services via:
_ Clear statements of commissioning intentions.
_ A modernisation programme for health, social care and voluntary sector providers.
_ Priorities that make a real difference in the short to medium term.
3. The Strategy aims are to secure services that deliver:
_ Holistic, person-centred health and social care, which address mental as well as physical health, needs which provide dignity and respect.
_ Flexibility and are able to change in line with people's unique circumstances, enabling independences and choice.
_ A comprehensive specialist older people's mental health service as part of a fully integrated pathway of care.
_ Promotion of equity of access to services and support based on individual and population needs.
_ Treatment and care based on the best available evidence of effectiveness.
4. Five key strategic priorities have been identified which target the areas that need the most attention:
_ Supporting carers, so that they themselves are enabled to provide care and support and are actively involved in planning care for the older person with mental health needs.
_ Promoting independence and access to universal well-being services, so that individuals can maintain their independence and live as "normal" a life as possible for as long as possible.
_ Balancing specialist and generic services through skilling up mainstream staff, removing barriers to services and gaining clarity on the respective roles and functions of specialist mental health and mainstream services, so that the majority of mild and moderate severity mental health needs can be managed in mainstream settings.
_ Pathways in and out of hospital, so unnecessary admissions are avoided and the older person with mental health needs receives timely and appropriate care in response to their individual needs while in hospital and the focus is on maintaining independence on discharge.
_ Mechanisms to enable organisations to work together towards shared goals, so that shared governance arrangements support delivery of the joint strategy.
5. In order to get the maximum benefit in terms of achieving outcomes for older people and their carers when implementing the strategy, and given that so many elements of it are integrally related to others, it is proposed to focus the first stage of strategy implementation on one health and social care economy area. This should provide the best chance of delivering on whole systems change. It is, therefore, intended to test out proposals in one area and move on to other health and social care economy areas in due course, transferring learning from the initial implementation site.
6. The Winchester health and social care economy area, consisting of Test Valley, Winchester and Eastleigh districts has been identified as the preferred area since:
_ It primarily serves Hampshire residents.
_ It contains a mix of urban and rural areas.
_ The County Council, the PCT and the Acute Trust are happy to engage.
_ There are other related projects about to commence which could be influenced and engaged.
_ It is a manageable area, but large enough to have a significant impact in the County.
7. The development of a Joint Older People's Mental Health Commissioning Strategy influences and improves the delivery of health and social care services in Hampshire and, in doing so, support the Corporate Strategy aim of maximising well being,
ADULT SERVICES GRANTS
1. The Executive Member has given approval for consultation on the review of the Adult Services grants programme. The aim being that of ensuring that grants are used in the most efficient and effective way possible, that the opportunity to receive grants is available to all third sector organisations, that the programme is fair, clear and transparent and that the grants programme supports the County Council's corporate priority of wellbeing.
2. The purpose of the consultation is to seek views on the proposed changes to the grants criteria and the process from currently funded voluntary and community organisations and to actively seek the views of groups which are not in receipt of County Council funding, volunteers and Hampshire residents. The consultation will be undertaken over a three month period commencing on 6 May 2008.
3. The consultation will focus on:
· Criteria: This suggests developing a move toward a focus on well-being activities and setting annual priorities on this basis; encouraging new and innovative activities; assisting development through pump-priming; the development of some longer-term funding agreements (up to three years); encouragement for organisations to actively seek other longer term and sustainable funding arrangements.
· Process: This suggests the development of formalised but proportionate monitoring and evaluation methodologies; implementation of final year reviews for three year and pump-priming agreements; the possibility of setting the grant application date earlier in the financial year; movement toward an electronic application and administration process.
4. The following methods will be used to consult:
_ A questionnaire seeking views - This will be available via Hantsweb and in hard copy. Dissemination of the questionnaire will be via a range of networks, including Councils for Voluntary Service, Hampshire Health and Social Care Network and via specialist networks such as faith based networks. All material will be available in alternative formats should that be required.
_ Hampshire County Council officer attendance at meetings and forums - Officer time throughout the 12 week consultation period will be allocated to attend voluntary sector forums and other meetings through prior arrangement or on request. Details of issues and comments made will be recorded and contribute to the final outcome.
5. Following consultation a report will be produced detailing the final proposals for agreement by the Executive Member.
REVISION TO SINGLE CRITERIA FOR AWARD OF CONTRACTS
1. Following a twelve week consultation the Executive Member has approved the following as the appropriate criteria for the use of single tenders:
_ where the provider is a specialist provider that is required to meet the specific needs of a client, or group of clients.
_ As an interim arrangement whilst a service is being reviewed or is in transition, for example the move to self-directed support.
_ where joint contracts with other agencies represent demonstrable value-for-money for the County Council.
_ where the provider is service user and/or carer led and that this adds value to the provision.
_ where there is a need to pump prime a new or innovative service.
2. The proposed single tender criteria which formed the basis of consultation were:
_ Specialist Provider - where there is clearly no alternative provider,
_ Initial `pump-priming' to enable new and innovative services to start, but
tendering to be considered if the service is to continue after the initial pilot
period,
_ Interim arrangements whilst a service is being reviewed, subject to evidence of a review programme,
_ Where joint contracts with other agencies represent demonstrable value-for-money for the County Council.
_ Service user led and community based services which give added value.
3. It was also proposed that the single tender criteria should have regard to:
_ those situations where there is clearly not an alternative provider and having to consider bids that are not sustainable.
_ protecting community based services.
_ protecting service user led services.
_ the need to continue to demonstrate Best Value through cost and quality tests.
4. The consultation process took two forms:
_ All voluntary providers delivering contracted services were invited to a workshop at Shawford Village Hall on 1 October 2007. The key points arising from the workshop were:
- the definition of grants/contracts respectively.
- the most appropriate method of pump-priming new services, i.e. grants or contracts? A straw poll of delegates clearly showed that, if organisations were told that services had to be tendered, it would be viewed as unfair, possibly less effort expended in developing the service and perhaps raise issues about intellectual property rights.
- the ability of voluntary organisations to cover the costs of tendering; many felt they would need support in drafting a tender bid.
- a discussion on added value confirmed the need to have regard to protect service user led and community based services, and also to empower service users and carers.
_ A questionnaire was posted on The County Council's web site for a period of three months. The key issues identified from the questionnaire were:
- fears that competitive tendering could put smaller organisations at risk.
- the most appropriate mode of pump-priming.
- the added value provided by voluntary organisations.
- impact on service users from a more competitive process.
- opportunity for service users to become involved in selection.
HAMPSHIRE CARERS STRATEGY
1. Following a twelve week consultation the Executive Member has approved the Hampshire Carers Strategy.
2. It is estimated that there are between 113,835 to 126,000 carers in Hampshire with approximately 19,808 carers providing over 50 hours of unpaid care per week.
3. Increasing demand is being placed upon the caring role and a large increase in demand for support and services is anticipated over the coming years due to demographic changes and growth.
4. Services need to be aligned and coordinated across health, social care and voluntary sector systems in order to improve support to carers.
5. The development of the strategy has been led by local community stakeholders and involved the establishment of a multi-agency stakeholder group and a multi-agency steering group and a consultation exercise undertaken by Carers Together in Hampshire. More than 200 carers contributed views to the first draft via four consultation events.
6. The strategy provides a commissioning framework for Hampshire County Council for carers' services that delivers clear agreed statements of commissioning intentions, a modernisation programme for all providers and agreed priorities for policy and action to effect change, a robust analysis of carers' needs to inform commissioning, a whole system focus for improvement and cohesion with other related health and social care commissioning strategies.
7. The commissioning approach will focus on specialist and community based services. All investment plans will be balanced with a disinvestment plan to demonstrate affordability within the available resources and links between business cases will be demonstrated. Where redesign of services is required, this will be subject to the usual scrutiny and public consultation process. Service level agreements will be agreed that set out the modernisation programme with identified outcomes and standards. Consideration of the implications of the strategy for market management will be given and the County Council will continue to proactively engage with all partners in the market. The County Council will learn from the outcomes and recommendations of the Commission on Personalisation and incorporate findings within the commissioning framework.
FELICITY HINDSON, MBE
Executive Member for Adult Social Care
4IR440608