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Commissioning for personalisation in the round

Clive Miller, Principal , Office for Public Management (OPM)

‘Consumerist - . In the first approach the users are patients in need of timely and effective services from the NHS that are personalised to their needs. In the first approach the professionals – medical practitioners – must deploy their knowledge and skills in a timely and effective way to solve a problem for the user. The more that is done in a personalised, considerate and responsive manner the better.

Personalisation - the users are co-producers of the good in question. They are active participants in the process – deciding to manage their lives in a different way – rather than dependent users…. the key is to build up the knowledge and confidence of the users to take action themselves, to self-manage their health without turning to the professionals. The professionals deploy their knowledge to help the users devise their own solutions – smoking cessation programmes, exercise regimes – which suit their needs.’

Source: Charles Leadbeater ‘Personalisation through Participation: a new script for public services’, Demos, 2004

From consumerism to personalisation

Outcomes

Public sector

Contracted Private Sector

Voluntary Organisations

Commercial services - shops, jobs, finance, housing

Adults and children

and their Families

Communities

and

Friends

ORGANISATIONS SERVICE USERS

SOCIAL CAPITAL

Coproduction

Based on: ‘Coproduction in Children’s Services’, Clive Miller and Sue Stirling, OPM, 2004

Personalisation: the key components

Individualised purchasing and coordination of services

Integration of non individually purchased services around individuals

Based on: ‘Putting People First, the whole story’, DH 2008

Personalisation of public and commercial universal services

Building and utilising individual capacity and social capital

Primary, secondary and tertiary prevention

Personalisation: the key components

Sports clubs pro-actively include

Expert patients

Personal budgets and self directed

support

Integration of non individually purchased targeted services around individuals

Individualised purchasing and coordination of services

Personalisation of public and commercial universal services

Building and utilising individual capacity and social capital

Integration of non individually purchased targeted services around individuals

Individualised purchasing and coordination of services

Building and utilising individual capacity and social capital

Personalisation of public and commercial universal services

Personalisation and social capital

Integration of non individually purchased targeted services around individuals

Self care: current role and potential

Source: ‘Coproduction in public services: a new partnership with citizens’, Matthew Horne and Tom Shirley, Cabinet Office, March 2009

The role of social capital in everyday life

Source: Clive Miller, Social capital, co-production and the delivery of Putting People First: scoping a framework for social capital’, DH August 2009

Personalisation of universal services

Personalisation of public and commercial universal services

Building and utilising individual capacity and social capital

Individualised purchasing and coordination of services

Integration of non individually purchased targeted services around individuals

Well-being Care

Universal services

Targeted services

Current use of the universal - targeted services continuum

Universal services

Universal services

Targeted services Targeted

services

Well-being Care

Universal services

Targeted services

Potential use of the universal - targeted services continuum

Universal services

Universal services

Personalising universal services

Refocusing• Non health and social care transformation programmes – make use of wider personalisation or linked initiatives such as Total Place and Respect.• Ownership – all public and commercial universal services see people who use social care as integral to their customer base• Targeted services – focus on supporting use of universal services rather than creating substitutes

Service redesign• Coproduction – work with socially excluded people to identify how they can be supported by the universal service to enable more effective coproduction of outcomes.• Differentiation – to enable universal services to be directly accessible, affordable and acceptable to a much wider range of people and life styles• Collaboration – with other universal and other targeted service providers to enable people to easily find a way of using the service that suits their requirements and abilities.

Service organisation• Community run – where possible enable local people, including those who are socially excluded, to run part or all of any universal service, including budget devolution• Voluntary and community sector – move away from targeted to universal service provision

Based on: ‘Service Transformation through Market Reshaping’, Report for Department of Health, OPM July 2009

Individualised purchasing and coordination of services

Building and utilising individual capacity and social capital

Integration of non individually purchased targeted services around individuals

Personalisation of public and commercial universal services

Personalisation of non individually purchased targeted services

Personalising preventive, early intervention and re-ablement services

Refocusing• Whole system access – view prevention and re-ablement as a whole system use of services rather than specific health and social care targeted services• Self directed support – apply the principles and devolve funding to individuals wherever possible

Service redesign• Pathways – analyse the typical pathways that people experience and work with them to reshape services and pathways to enable choice and achieve more effective coproduction of outcomes• Individual control – enable the individual to self assess, make choices and secure the supports that meet their own requirements and resources• Information – proactively provide information and advice to individuals and carers as soon as possible, and on a continuing basis to enable them to consider support options

Service organisation• Coordination – ensure the individual rather than a lead professional and the care pathway are at the centre of service coordination. • Business case – develop a robust business case and funding process to support a multi sector approach Based on: ‘Service Transformation through Market Reshaping’, Report for Department of Health, OPM July 2009

Individualised purchasing and coordination of services

Building and utilising individual capacity and social capital

Integration of non individually purchased targeted services around individuals

Personalisation of public and commercial universal services

Personalisation through individualised purchasing and coordination of

services

Framework contracts

Service personal-isation

Personal budgets

Three key componentsPersonalised: PB holders using direct payments or ISFs, and self-funders purchase personalised services within the framework contract, sometimes using person-centred ‘mini tenders’

Source: ‘Contracting for personalised outcomes’, DH 2009

Personalisation and prevention

How do we know the service system is personalised?

Fully personalised

Not personalised

Personal budgets in PbBorough

Information – accessible and timely; pro and interactive

Coordinated - with individually relevant services; individually controlled

Choice - type of service, provider, staff; cost and quality; when and intensity; support planning and management support; only constrained by genuine risk and legality

Individual capacity and social capital – affordable; ability based; developmental and reciprocal; efficient for all

Individual or community ownership and control – designing, managing, delivering, evaluating; decision making; portable budgets Life centred – whole life; outcomes focused; what ever works; all services and how they are organised and delivered

In Control- OPM: Commissioning for personalisation support

programmeAim • Provide a practical guide to personalisation in the round• Bespoke support to build on existing local developmentsAudience• Commissioners and providers within social care and other relevant sectors -

24 participantsFormat• 2 day briefing and action planning module – plus 2 days action learningTailoring• Format can be varied and shortened and programme tailored to local needsStaffing• Adrian Smith (In Control), Andrew Tyson (In Control), Clive Miller and Ayesha

Janjua (OPM)Cost • £8,000 ex VAT (10% discount to In Control members)

Two day workshop: programme overviewDay One – understanding ‘personalisation in the round’

Personalisation: what does it cover? overview and group work (identifying current examples in your area)

Personalisation outside of personal budgets briefing, group work on scenarios backed by examples of personalisation

Once personal budgets are up and running: the commissioning implications

briefing, group work on the PBsville case study (contains key questions and starter answers)

Two day workshop: programme overviewDay two: the commissioning implications and action

planning

Personalisation: mapping the current position Whole workshop exercise - applying the ‘commission for personalisation

self assessment tool’ to your local area

Developing a LA commissioning for personalisation plan Whole workshop exercise - tailoring the In Control commissioning for

personalisation strategy framework for use in your local area

Identifying the key areas for change Identifying the key areas for further development

Action planning Who will do what, by when Support, if any, required

Follow up – one day workshops

• Focused on key parts of the Action Plan identified in the two day workshop

• Designed to provide support not available from other sources

• Co designed with local project managers

• Targeted on key people who need to be engaged to move developments on

• Aimed at developing agreements and practical ways of taking developments forward