STRATEGIC COMMISSIONING FRAMEWORK FOR THE SOUTHEND CHILDRENS PARTNERSHIP

Transcription

1 STRATEGIC COMMISSIONING FRAMEWORK FOR THE SOUTHEND CHILDRENS PARTNERSHIP November 2010

2 Contents page Current Commissioning Practice 3 The Southend Partnership Vision for Children's Services 4 The challenges of commissioning in the new world 5 Principles & Standards 7 How we arrived at the 4 step model 8 Capacity & Competencies 10 Southend Commissioning Skills 11 The Strategic Commissioning Unit 12 The Strategic Commissioning Sub Group 13 Training, support & Guidance 14 Workforce Implications 14 Bibliography 16 Thanks & Acknowledgements 16 2

3 Current commissioning practice in Southend on Sea It is recognised that whilst commissioning activities form the entire basis for some posts, many staff within the Southend Children s Partnership have commissioning responsibilities alongside their core role as a provider of services. This dual role can make objectivity in commissioning processes and decisions challenging for these staff particularly where training for these elements of their role has been patchy or simply picked up on the job. It is also noted that many commissioning decisions are made independent of complementary workgroups or agencies and that this can lead to areas of duplication in service provision. In some cases commissioning decisions are made without the benefit of review, scrutiny or service user and stakeholder feedback. As part of the development of the Children and Young People s Plan (CYPP) work was undertaken to map the current financial resources for services for children and young people in Southend. To date the work has identified top level spending across the five Every Child Matters outcome areas by all partners, and this is included in the CYPP. Further work is needed to drill down to additional detail and use this financial mapping as an aide to commissioners in determining the gaps in provision and where there is duplication and potential for re-aligning some services. Since December 2009 Southend has been engaged with the national Commissioning Support Programme (CSP) making use of both the universal offer (national conferences, workshops, website and archive) as well as the targeted support through the a local lead facilitator. Through a self analysis workshop involving key stakeholders across the Partnership strengths and areas for development in twelve commissioning standards were identified and an action plan for three priority areas of work was drawn up in January 2010 (see below). This has helped Southend to consider its current position and future aspirations in commissioning practice. For whilst there is significant commissioning experience amongst staff within the Children s Partnership, consistency, minimum standards and better links to procurement processes needs to be created and maintained to improve outcomes for children and young people. Priority 1. Develop a strategic framework for commissioning Priority 2. Develop a clear vision for the strategic commissioning unit model Priority 3. Develop clear arrangements for Service Level Agreements (SLA s) and Performance Management with commissioned services. These three commissioning priorities have formed an integral part of the work of the Strategic Commissioning Manager, Group Manager for Plans Performance and Commissioning and Southend s Commissioning Champion, along with the Strategic Commissioning Sub Group, culminating in this strategy and its accompanying documentation. The future will consist of partners embedding the contents and principles of these documents in their departmental ethos and way of thinking, and self evaluating performance against them. (See the Toolkit for details of the Commissioning Skills Audit Powerpoint, summer 2010 and more on this subject in Capacity and Competencies on page 10) 3

4 The Southend Partnership Vision for Children's Services The agreed revised vision for children s services in Southend (June 2010) is to: Help children and young people to raise their aspiration and achievement Ensure they have opportunities for inclusion Facilitate their participation in decision-making that affects their lives Provide excellent services and excellent outcomes for children and young people Excellence in outcomes for children and young people means: a) Children and young people aspire to be the best they can be b) Outcomes for children and young people are consistently in the top quartile of all councils and wherever possible in the top 10% c) Outcomes for all minority groups are consistent with peers We should look at how commissioning relates to each point of the vision to understand why improving commissioning standards matter: Partnership vision Help children & young people raise their aspiration and achievement Ensure children & young people have the opportunities for inclusion Facilitate their participation in decision-making that affects their lives Providing excellent services and excellent outcomes for children and young people Relates to commissioning how? By improving our early intervention services we remove barriers which may prevent children & young people from aspiring higher and achieving all that they can. Best commissioning practice demands that all our children & young people have equal access to the opportunities on offer regardless of race, gender, religion, ability, socio-economic factors or sexual orientation: this is why monitoring returns sometimes ask for some information to demonstrate we have a varied client base representative of our communities. If we don t already we need to ask whether we are doing all we can to ensure services are made known and accessible for to the groups residing in our communities. Best practice commissioning guidance states that children & young people, and their families should be encouraged to participate in the way services are planned, delivered and then improved after review or evaluation; this gives families services that fit around them and their needs as far as possible so that they engage in interventions more willingly, taking ownership of the issues that are affecting their lives and livelihoods By checking factors such as achievement of outcomes and key milestones we hold providers to account for delivering what we ask of them. Southend Children s Partnership aspires to the top quartile performance. This means being clear about we want from providers in the first instance, then ensuring we have a clear and transparent purpose for services, grounded in evidence of need. Even when services deliver we additionally need to ensure that we are getting value for money for our communities, and that in these economically challenging times we reconsider better, smarter ways to deliver services in order to make our funding allocations go further. 4

5 The Challenges of commissioning in the new world These are challenging times for Public Sector Agencies to be operating in, and commissioning practice will have to shift up a gear if we are to make visible improvements to services with ever dwindling resources. This is where the importance of having clear outcomes focused services which offer genuine value for money will play an ever greater role. There are huge implications arising from the coalition Government, with their drive for a Big Society, centred on decentralisation and encouraging localism, whilst tackling issues around massive national debt. Funding streams which have traditionally enabled non statutory, early intervention or preventative services will become scarce or non existent, but we still need to deliver long term benefits whilst addressing these short term efficiencies. The prioritising of service provision and selection of providers with excellent track records of service and success will be more crucial than ever. Yet communities will rightly have anxieties about possible loss of entitlement to much needed services and protecting the genuinely vulnerable whilst still addressing inequalities will need to continue. In the near future we will need to start accepting some changes to the commissioning landscape, including: Health - going through a period of huge change and uncertainty with the dissolution of Primary Care Trusts, and the use of GP consortia as vehicles for making commissioning decisions around health services. Police forces - facing 22% budget cuts between 2011 and , alongside a drive to recruit more Special (unpaid) Constables, which some claim may impact on crime rates. Voluntary and charitable sector organisations - being invited to run schools with businesses and parents and play a bigger role in the delivery of services as part of the Big Society Schools - invited to become academies. Whilst there are only 3 academies in Southend so far, there may be more in the future. These schools will be given more direct accountability for school budgets and decision making (commissioning) and there will be changes to LA school improvement services as a result of this. Schools will also be eligible to buy services from LA s other than Southend, so in order to be competitive Southends internal services will need to be of the highest standard in order to compete. (For an up to date picture of how commissioning will link to Essex GP consortia and other arrangements please click here - hyperlink) 1 is London.co.uk

6 Where improving commissioning processes might once have been seen as a nice idea, we now need to use commissioning improvements made as part of greater efficiencies, whilst not compromising on the qualities of services provided to children and young people. We are doing this at a time when accountabilities are being devolved to more local groups for running services but whilst we risk losing the strategic joined up approaches that we have been investing in, with the potential for increased silo working of recent years. However, the SCP was in operation before the statutory duty to have a Board was introduced. Southend has reviewed its partnership arrangements and has decided that the benefits that have been gained from the effective partnership working support the continuity of a Children s Partnership at the current executive level. The details of how this will link with the Local Strategic Partnership as a whole and the Health and Well Being Board still need to be defined. We will need to educate the wider workforce about the role they play in the commissioning process whether as stakeholders or practitioners giving feedback on life at the coalface, or as managers balancing budgets, quality and volume of provision in constrained financial times. It seems certain that some of the implications over the next 3 years given the current political and financial climate will be to use the increasing importance of commissioning as a means of testing, verifying, and reconfiguring existing service provision and where it does not meet need or is not making sufficient progress towards improving outcomes, to use it as the basis for decommissioning some services. (Remembering that in Southend our definition of de-commissioning is the process of planning and managing a reduction in service activity or terminating a contract in line with commissioning objectives, including non/under performance issues) Whilst there will be some sensitivity around the issue of decommissioning, there are many reasons for decommissioning some services: Some time limited funding streams will be about to end Some externally funded streams of work may have revised their priorities or changed their criteria for funding Some funding bodies are being more critical about what they continue to support There is no longer a need for the service Despite attempts at reconfiguration the service provision is not of a high enough standard to continue As it would be essential to gain political and wider stakeholder support in order to decommission any services it is key to be clear and transparent about why the decommissioning decisions have been made. It is also likely that commissioning processes will be used to help target where some universal services should still be made freely available, so that we can best narrow the gap between the haves and the have nots, focusing attention on where support will have the greatest effect. 6

7 Principles & Standards A set of commissioning principles have already been prepared and agreed with the Southend Children s Partnership. These have now been further developed creating a supporting set of standards. (Click here to view the full document) It is intended that these principles and standards guide all commissioning activity undertaken on behalf of Southend Children and Young People by: Acting as a blueprint and model of good practice of what effective and appropriate commissioning is (for all involved) Setting standards and principles for both commissioners and providers Showing where and how the principles should be reflected in the right kinds of behaviours and practice Offering a template that commissioning can be evaluated against and as a tool to help focus improvement. The nine principles are: Commissioning Principles for Southend Children s Partnership 1. All decisions should be based on improving outcomes for children, young people and their families, and consider how best to remove barriers to equality of access and opportunity 2. Commissioned services will comply with shared processes (E.g. CAF) reflect and align to priorities in National, Regional and Local Plans (E.g. Children & Young People s Plan) 3. Services should operate on an earliest possible intervention basis, meeting needs at the lowest level of intervention and/or working to move service users down the levels of intervention as soon as they are able 4. Children, Young People and their families should have their views taken into account when designing new services and the be involved in the review and decision making processes for existing services 5. Commissioning processes should be open, transparent, impartial and timely, involving the voluntary sector and other community partners where possible 6. Partners involved in commissioning should regularly share information, data and combined expertise in an atmosphere of mutual trust and respect. 7. All services should observe and adhere to a value for money policy, by providing information to the SCP regularly in a prescribed way, to an agreed format, to enable considerations of performance management and participate in annual service reviews to evidence that they are effective, efficient, sustainable and improving outcomes. 8. In undertaking commissioning duties the SCP should be confident that all legal and regulation issues including finance and governance are being properly adhered to, ensuring that accountability lines are clearly drawn 9. All organisations need to take responsibility for commissioning appropriately and responsibly. 7

8 How we arrived at the 4 Step process Since the first guidance on joint commissioning was published in 2006, the processes have subsequently been redefined, shaped and mapped against other models such as the DoH World Class Commissioning (WCC) Framework. The simplest and most current description of the commissioning process is of the cyclical 4 step model, described in the executive summary of this framework and toolkit. This refines the original 9 step & WCC frameworks (below) into the elements of Understand, Plan, Do and Review. Original 9 step Framework model Joint Planning and Commissioning Framework 6 8

9 Department of Health - World Class Commissioning Model

10 Capacity & Competencies Guidance from the National Commissioning Support Programme states that: A joint commissioning unit should contain a real or virtual team of commissioners. Functions need to cover the following skills (not an exhaustive list): Engage & draw on experience of local community leaders & partners Engage & draw on experience of local leaders from statutory partners Engage & draw on the experience of local C,YP & their families of needs and/or services Collaborating with providers Mapping resources Specifying & measuring outcomes Managing knowledge & assessing needs Prioritising investment Shaping & Managing Markets Promoting improvement & Innovation Securing procurement skills Implementing project & change management Making sound financial investments Ideally commissioners qualities should include being: Tenacious, challenging & open minded. Credible & robust leaders, able to effect change & achieve better outcomes by working with & through others Aiming for continuous improvement, verify & revisit assumptions, responding to evolving local need and sharing learning points The best commissioners actively build their credibility with partners, potential providers & users when commissioning public services and have a range of negotiation, persuasion & communication skills Identifying barriers to change & developing solutions with a range of partners to allow innovative practice Develop processes for selecting innovative providers, such as using outcomes based contracts specifying ends but not the means etc. Effective leaders in change management & its methods, Developing deep understanding of strengths, weaknesses & gaps in the skills & competencies of children s workforce Develop systems for sharing learning from other sectors, agencies & teams

11 Southend Commissioning skills A commissioning skills audit carried out with 32 SBC staff members/partners during the summer of 2010, found that knowledge about the national commissioning picture was patchy, and all respondents wanted to find out more and take part in information workshops and training. (See Toolkit for- Results of Southend Commissioning Skills Audit) A further analysis of current commissioning performance management activity showed a wide range of differing styles and variable approaches to the processes involved. Involvement of Children, Young People and service users in commissioning processes is an area which requires particular improvement (in Southend and many other Local Authorities according to their strategies). As mentioned at the beginning of section 1, a revised participation and engagement strategy will be available in early 2011, and this will help focus attention on practical ways that engagement can be woven into commissioning processes utilising some of the excellent practice, and engagement skills which are already available locally. In the meantime a community engagement strategy is available from the Southend Together Partnership, and further advice and guidance will also be available through the commissioning toolkit, and further documents and case studies added in time. Over 50% of audit respondents also admitted they didn t share or discuss information about current service market & supplier configuration very or at all well. Market shaping was one of the areas that the SCP members scored poorly on in the self evaluation workshop with the CSP in Dec It is an area of work which is gaining in significance particularly during these projected financially lean periods. However, actively shaping the market relies heavily on accurate and timely information and data which can be fed into the planning stages of new service requirements and also at the review and evaluation points of existing provision. It also relies on stimulating relationships with (and supporting in an ongoing way) existing or potential providers of services, to enable a more diverse pool of resource to choose from, avoiding being somewhat held to ransom by historical providers of off the peg services. Over 50% of respondents shared commissioning processes with partners only a little/some. At a time of budget cuts, service depletions or vacancies remaining unfilled colleagues and partners can no longer afford the luxury of working alone and unchallenged. This will require a change in mindset which may be difficult for some to accommodate initially, but the rewards of sharing the tasks (and burdens) will make this the process of the future. Case studies on this can be found in the commissioning toolkit. Reviews, monitoring & evaluation are also areas requiring improvement. 14/32 respondents said they did only a little or some monitoring, only 15/32 said there was only some or a little performance and stakeholder feedback reported and analysed for the new financial year, and 13/32 revisited service priorities a little/sometimes (of these 5/32 said they didn t feed this into the CYPP.) There are a number of documents within the three toolkits on Outcomes, (general) commissioning and VfM which will help to address issues around monitoring and evaluation. 11

12 The Southend Strategic Commissioning Unit In considering what type of commissioning unit Southend should have two options were available: the centralised and the dispersed commissioning models. There are a variety of both models in use nationally, with claims of varying degrees of success in both. All organisations have a view about the best commissioning unit model and about where the future of commissioning lies given the current financial and political landscape; the coalition Government wants to de-centralise many functions and localise provision. As an organisation the Southend Children s Partnership had to consider where its skills base lay, and this led to the previously mentioned skills audit. Practically, Southend was not in a position to follow the centralised unit model as Essex are planning to do. In pursuing a dispersed commissioning model we would still need to ensure that all staff involved in commissioning are appropriately trained, thus requiring some kind of central unit function to ensure that support and skills training was available to the workforce in general. Currently the small Strategic Southend commissioning unit is part of the Partnership and Commissioning team within the department of Children and Learning. The Departmental Management Team for Children and Learning has decided that whilst the unit is not intended to undertake all operational commissioning it will support other staff in an advisory capacity. The unit is supported by the Strategic Commissioning Sub Group, whose membership is described below. The full and potential scope and remit of the Southend Commissioning unit will ultimately be led by the needs and wants of the DCS & Southend Children s Partnership members and may evolve in the light of the Comprehensive Spending Review (CSR) as changes to commissioning practices are made by the new coalition government. Depending on the outcomes of the CSR in the Autumn/Winter of 2010 the Strategic Commissioning Unit, with the support of the Strategic Sub group has some challenging aspirations in the next three years which it hopes will transform the way commissioning is considered, planned and implemented in Southend. Departmental chart - Hyperlink to current version 12

13 The Strategic Commissioning Sub Group (also known as an enabling group) Guidance from the national Commissioning Support Programme says that priorities in the CYPP should drive the commissioning plans & strategies for particular groups... and these plans should specify in more detail the commissioning priorities for those groups and how they will be delivered. In Southend the Strategic Sub group is responsible to the SCP for helping drive forward the commissioning agenda as agreed by the Partnership; assisting with planning, strategic development of joint commissioning for Children s Services and with an oversight of the monitoring of existing jointly commissioned services. The strategic sub group should include one place for any partner or LA department where a manager/officer has local strategic commissioning responsibilities (current or proposed) that can share their experiences and work towards aligning processes for the benefit of the Partnership: these members will carry voting rights in decision making processes. Membership of the sub group has been hugely increased and varied over the past twelve months, now also including council corporate procurement with whom better working links are being established. Additionally, in an effort to refine and align existing commissioning practice the Young Carers commissioning sub group was subsumed into the strategic group in April 2010 as many of its members were already part of the strategic group and this seemed to duplicate time and effort, whilst having separate but similar processes. The Young Carers development group still have a separate remit to collect and feed information into this group to inform future commissioning decisions and the Young Carers Strategy, and the processes will be reviewed for use from the new financial year onwards. Current membership includes representatives from: 1. NHS SEE/CAMHS 2. Early Years 3. DAAT/ Substance Misuse 4. Children & Learning - LDD 5. Children & Learning - Locality Boards 6. Children & Learning - Specialist Services 7. Children & Learning/Connexions 8. Children & Learning provision 9. Voluntary & Community Sector 10. Voluntary & community Sector -Young Carers 11. Corporate Procurement 13

14 In addition guest members who can bring financial, legal or participation skills for the benefit of commissioning discussions, workshops or processes also attend where appropriate. Sub group members have agreed that current managers and members should attend existing children and young people forums to engage in commissioning processes rather than ask selected individual members to join the strategic sub group on behalf of all young people. The revised Voice and Influence Strategy will support this approach. This will give us greater reach to a variety of children and young people s views across the borough through a number of ways including: Various school council representatives (primary & secondary) Leaving care forum Southend Youth Council Current sub group members have identified where they have links to other strategic local or sub regional groups: Regional Commissioning Champions Group CAMHS Transformation Group TAMHS Implementation Group Early Years Partnership DAAT group ER5 Foster Care Placements Updates from these linked groups are incorporated onto a rolling programme of monthly agenda items to ensure the fullest possible picture of strategic commissioning issues are considered. In Southend it is in our professional nature to network beyond our immediate remit, for the purposes of joining up. Main Aims of the Sub Group & Outcomes The main aims of the Strategic Commissioning sub group will be outlined in the current version of work plan, which is reviewed annually and is available to view on request through the chair of the group. Training, Support & Guidance Within the work plan for the Strategic Commissioning Sub group is a proposal to trial a Commissioners Network which would meet as part of the sub groups scheduled meetings. This network would take an Action Learning Set approach to its meeting, as well as the usual information and experiential sharing. Group members would also be supported as they begin implementing the 4 step commissioning model approach to their own services, and act as a strategic reference group, whose views would feed back not only into the strategic sub group but also into reviews and refresh of the CYPP. The work plan for has scheduled devising and implementing training opportunities covering awareness of commissioning and an introduction to the framework, associated toolkits and strategies, and links and areas of crossover with corporate procurement. 14

15 Whilst the commissioning skills audit 2010 was conducted with current partners evolution of the framework will need to consider the needs of schools and GP s and accommodate them accordingly. The sub group will therefore review the training support and guidance needs lined to commissioning on a rolling basis, including whether the many National Occupation Standards should be actively pursued in future. Workforce Implications Given the variety of skills required in any commissioning unit, and ideally from commissioners themselves, another key concern at a time of budget cuts and service efficiencies is the prospect of losing valuable staff members and skills as services are reconfigured before being re-commissioned or possibly decommissioned. Implications of these actions should be considered as early as possible, to allow TUPE or redeployment considerations. The commissioning toolkit has more on this issue, and the corporate procurement team are available to advise further on this matter. It is however always advisable to make sure that high quality, comprehensive handover documentation allows for continuity of provision for other colleagues, increasing the core knowledge base. 15

16 Bibliography (March 2006), Joint Planning and commissioning framework for children, young people and maternity services, DfES Smyth, J. (December 2007) Integrated Commissioning for Children s services; A practical guide to the development of simple commissioning frameworks and clear structures for children s services authorities, Office for Public Management Ltd. (July 2009), Achieving Better Outcomes Commissioning in Children s Services, Commissioning Support Programme (February 2009) Securing better health for children & young people through world class commissioning (A guide to support delivery of Healthy Lives, brighter futures: The strategy for children & young People s Health), DCSF & DoH White, N. Williams L. & Lorimer, R. (July 2009) Strong Partnerships & Commissioning Governance within Children s Trusts, Frith, L. (April 2007). An Outline of Joint Commissioning Units CSP, Sept What should be included in a Commissioning framework? Thanks & Acknowledgements The Author wishes to thank the many Local Authorities, Primary Care Trusts and other partners who allowed their draft and final versions of their commissioning frameworks and documentation to be viewed through the Commissioning Support Website, for the purposes of sharing best practice, particularly: Royal Borough of Kingston on Thames, Joint Planning & Commissioning Framework, October Kent Integrated Commissioning Guidance for local Children s Services Partnerships Brighton & Hove Children & Young People s Trust Commissioning Framework, Draft Jan 2010 The Framework for Strategic Joint Commissioning, Peterborough Children s Trust (April 2009) CSF Commissioning Options Appraisal Tool V6.2, Hertfordshire County Council (June 2009) Additionally thanks go to Peterborough Council for sharing their progress through a whole day of their staff time, and observing a strategic sub group and other meetings. This document is published by Southend-on-Sea Borough Council November