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1.
The extent to which the Government has, so far, delivered on the commitments
it made in Independence and
Opportunity: Our Strategy for Supporting People .
· Improvement
in partnership working - statutory and voluntary sector agencies - developing
new services, outcomes built into contracts leading to better services for
service users. New more specific
services to meet unmet need with bespoke outcomes.
· More
joint commissioning - positive examples of cross authority and third sector
involvement.
· Needs
analysis - leading to more strategic working - know more about services in
each locality, and linking in to NW needs estimation work. Responding to identified needs rather than
anecdotal evidence.
· Service
user involvement at service level -
feel that service users can now
go to their SP teams if they have concerns about their service
provision - feels able to empower them.
Example given of where service users not happy with one scheme and now
involved in working to resolve situation through a pilot. Service user involvement at service level
embedded through the QAF - can expect certain things to happen in each
service which they could not previously.
Service users involved in peer reviews.
· NW
contracts officers group -allowed common practice, for example, QAF lite,
contract review toolkit. Outcomes are that the burden is easier on providers
(same approach across many authorities), improved outcomes for service users,
consistency across the region.
· Service
users involved at more strategic level such as in commissioning services.
Examples given of service users involved in development of specifications
with commissioners. Within the NW
service users are involved in commissioning plan development. NW responsible for www.serviceuserinvolvement.co.uk
, a national website with best practice in the NW and nationally.
· More
services - can target better than before and focus on areas of high need and
deprivation e.g. income deprivation at neighbourhood level. Wider choice of services and service
models. Development of more
community based support services - improved focus on floating support which
can be developed quickly to meet needs and reducing those users who meet
crisis situation, and reducing need for individuals to move home/change
landlord.
· Improved
communication leading to increased awareness of services - has reduced the
negative view which many people may have had schemes in the past, elected
members know more and view them more positively.
· Access
to services for service users has improved - know what services provider, who
can be included/excluded, increase knowledge of choice available.
· QAF
driving up service standard and improving consistency for service users (all
meeting minimum standard), with key outcomes being improvements in
safeguarding, reduced risk etc.
Validation ensures that the QAF works - at risk now with the way
things are moving forward.
· Outcomes
framework starting to be used to explore outcomes with service users and to
explore barriers to achieving outcomes.
Also helped to identify the working being done across the five broad
headings and common outcomes with other commissioner's priorities.
· Improved
benchmarking helping to lead to improved services for users.
· Single
funding pot bringing together the market and enabling SP teams to have
strategic lead over the market - improved quality for service users, value
for money outcomes, greater number of people benefiting from a small,
decreasing pot of money
· Development
of the third sector - removes the stigma of people going to the council for
services - have greater choice in the organisations which they can go to. HIA
seen as good example of this. SP has
helped to nurture the provider network - brings benefit as other agencies can
now follow this model. Increased investment in providers compared to adult
care etc which has helped to benefit the programme and lead to better
services for service users. Working
with small providers to increase quality of services provided.
· Commissioning,
procurement, and oversight in one place - puts programme in favourable place
and ensures all three are connected.
Not seen in other service areas e.g. delivery of care services.
· Sharing
of information/learning between providers - examples of working with
providers to do things differently.
· See
above - continued reference to
service user involvement, partnership working and some success with joint
commissioning.
· North
West working together as a collective group seen as being a key driver in
ensuring consistency and sharing learning/experience. .
· Lack
of growth in budget - budget declined nationally but productivity has
increased.
· Constraints
around spending arrangements - separation of admin grant and programme grant
- no ability for cross over
· Lack
of forward financial planning which has led to inefficiencies - only able to
let contracts for 1 yr/18 months.
· Difficulties
in connecting with capital spend - easier early in the programme - links to
lack of forward planning on the financial side. Disjointed nationally impacting regionally. NW supported housing strategy being
developed for June 09 - needs modelling being put together for the NW
currently.
· IT
systems - development within
individual authorities was wasteful
· Local
awareness of the SP programme within the authority - some only now getting a
clearer identify but lot of effort to get this.
· Accessibility
of the concept of SP - difficulty in communicating to others what this is to
service users, members, etc. Some
issue with the name - very generic name.
· Partnerships
not always as effective - sometimes only engaged through the financial
opportunities available not always seen the services which can contribute to
the partnership - seen as a funding mechanism only in some cases.
· Original
funding - admin grant basis not reflective of current position (but separate
admin grant seen as strength)
· Lost
opportunity for joint reviews across authorities
· Too
much wasted time looking at ineligibility and lack of flexibility - on the
ground was irrelevant in many cases.
· Large
non recurrent budget in some areas - results in under spend - linked to the
lack of certainty in the future and fear of future reductions.
· SP
involvement mechanisms are more structured than others.
· In
terms of young people, it took a while for SP to acknowledge their needs, but
now really good examples of agencies working together around the individual
and their needs.
· The
QAF has made a big difference. SP
commissioners can now have confidence in what they are commissioning and know
what sort of service they can expect to be delivered.
· 2-tier
authorities have seen big improvements in terms of partnership working.
· At
the beginning of the programme, the needs of socially excluded people were
'at the bottom of the pile' and services 'on shoe string budgets'. Services are now more stable and partners
understand the impact of housing related support..
· Having
said that, although not much evidence of actual joint commissioning (where
partners contribute to the overall service budget) there is plenty of
evidence of proactive partnership working to provide 'wrap-around services'
that focus on the individual as a whole.
2.
What needs to be done to ensure that the successes of the programme so far are not lost or services
cut following the removal of the ring-fence?
· CAA
- there is a need to ensure that this will pick up any issues relating to
housing support, or lack of it. There
is variation in how authorities will interpret integration of SP so critical
CAA picks this up.
· Ensuring
skills and knowledge of SP team contribute to the LAA so not now lost
· Need
for ongoing cost benefit analysis of how the SP grant used and ability to
show meeting local priorities. There is a view that savings SP has made for
other partners could potentially be fed back to SP.
· Concern
over future of QAF as SP loses its identity - services will not be monitored,
and will lose the quality validation as believes authorities will not be
focusing on this.
· Not
clear if integration or leaving teams as they are brings the best benefits
for the future - needs to be a clear expectation of delivery for the LA for
the delivery of housing related supports, and clear guidance on how this will
be assessed and scrutinised to ensure it does not disappear and security in
partnering means they would be more comfortable losing SP teams. Needs to come from a national government
drive. Issue relates to balance of SP
budget to social care budget.
· JSNA
- getting housing related integrated into this. North west needs model
has ensured housing related support needs can't be ignored with GONW
and CLG involved in it.
· Confidence
in the programme and lack of certainty about the future - can only be created
nationally and centrally - political portrayal.
· Views
of the LAA - depends on the commissioning body and links to the LAA, stronger the links have become the more SP
is becoming lost in terms of other partners -public health agenda integrated
- but leads to challenge for the future is around probation can then engage
with this and making structure relevant to other partners.
· Small
providers driven out of the market in some areas due to QAF etc. and administrative burden on them. Needs to be looked at in light of unringfencing
· Partnerships - works at
governance strategic level, but not so well at day to day operations,
commissioning with e.g. PCT.
Partnerships which work well tend to be those led by SP. Tend to fall apart where not led by SP -
want more balance in future
· Collective
involvement of providers - issue with engaging some of the larger national
providers, and encouraging smaller providers in seeing they have a voice - NW
provider forum should help address
· Reporting and communication -
need to be better at demonstrating impact of the programme - outcomes and
quality and also in cost improvements. More scope to do consistently and
constructively
· Areas
where they are focusing on improving e.g. service user involvement, single
access points, service specifications but challenge in future to maintain
these with removal of ring fence, and potential loss of leverage.
· There was little evidence of
effective joint commissioning. This
was felt to be one of the greatest risks in terms of transition, because
practices are not yet well embedded.
The SP outcomes framework could have acted as an effective lever to
joint commissioning
· "Housing"
is often responsible (primarily through statutory homeless duties) for the
most excluded households, from gypsies and travellers to rough sleepers, yet
those working in housing have not been supported to develop to become effective
commissioners in the same way as counterparts in health and social care.
Regardless of this housing involvement in the programme has achieved
considerable success in enabling support for most vulnerable - often leading
work in this, being the most inventive and preventative. However as SP goes
into the ABG ,there is concern that the housing influence will be
marginalised as a result of lack of commissioning capacity.
· Concerned about potential gaps in
system - need for more seamless working between different agencies
· Small providers have suffered as
a result of the national drive towards large-scale tendering and driving down
costs. It would be interesting to see
how many small providers have actually won tenders. Larger providers may be
cheaper but they won't necessarily have same skills or local knowledge.
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