Working together: a provider’s perspective on commissioning

Maria S. Parsons Dementia Lead for Sanctuary Care

Where are we?

• Significant commissioning agenda, especially for PCTs, in the context of targets for heath, personalisation and other policy change

• Complex needs of people with dementia

• Need to commission services across whole trajectory of dementia ( from prevention to end of life care)

• Market anticipating increasing demand BUT cautious given economic downturn

Sanctuary Care

• Part of Sanctuary Care, UK’s largest housing association: social housing,market rented and care

• 52 care homes for older people, adults with learning disabilities, physical disabilities and those with mental health difficulties

• 12 Extra Care schemes

• 3 Home care services in south west England

Supporting people with dementia

• Majority of service users across 33 care homes, Extra Care and Home Care services have a dementia

• Like other providers we are shifting services to focus on specialist dementia services

• We have limited block contracts and are geared to private purchasers ( hence not as vulnerable as some providers reliant on publicly funded care)

• Looking at new service developments in the wake of the National Dementia Strategy: younger people with dementia, ARBD and older people with learning disabilities

These things help providers

• LA/Health Trusts sharing commissioning intentions

• Transparent tendering and contracting processes

• Working together on contract compliance and continuous improvements in quality and outcome

• Long term contracts and risk sharing as part of strategic partnership

• Joint development of skilled workforce

Effective commissioners…..

• Recognise the costs of individuals with dementia - complex and changing needs

• Make allowance for inflation; recognise the real cost of delivering a high quality service

• Negotiate prices fairly and don’t simply drive fees down

• Trust our financial motivation and activities

We can help you by sharing…..

• Local needs profiles, demand trends and other information that we routinely collect to make business decisions

• Data on good outcomes for users of our services

• Our strategic direction of travel and ideas for improved models of care

• Results of our research and development about what works

• Design and building development expertise

Things we like to hear…..

• ‘We will be looking for more extra care’ rather than ‘we won’t be buying so much residential care in future’

• ‘We are going to work with you on kite marking system for local homes’

• ‘We envisage a need for an additional 3 Intermediate Care beds for people with dementia in 3 months time

• ‘We would like to offer your staff free training’

Partnership working

• Working with local councils and PCTs where we have a critical mass of resources ( home care, extra care and care homes) that can be used flexibly to deliver on service improvement

• Oxfordshire: Nursing dementia and Intermediate care with Oxfordshire Social and Health care and PCT/MHT + 2 new care homes planned

• Redbridge – progressing residential and nursing home care and plans for Care Village

Personalisation ..providers perspective….

• The challenge of managing operations whilst responding to personalisation agenda, Individual Budgets and Personal Budgets

• Shift in balance of risk in places where providers have large block contracts

• Need to transmit information to personal budget holders about real costs of our services

• Gaps in local brokerage might offer potential for joint work

The future together

• Developing new models of service – flexible home care and telecare with a base in care homes to promote enablement/reablement

• Premium for quality in volume market

• Incentivise and share risks

• Make decisions in good time • Trust, transparency and accountability

Thank you and contact

Maria Parsons

Dementia Lead

Sanctuary Care

Maria.Parsons@sanctuary-housing.co.uk

Mobile 07554 115681