Written evidence submitted by the Princess
Royal Trust for Carers and Crossroads Care (LOCO 085)
1. INTRODUCTION
The Princess Royal Trust for Carers and Crossroads
Care welcome the opportunity to respond to the Communities and
Local Government Committee Inquiry on Commissioning. Jointly,
we make the following points and recommendations in our response:
¾ Councils
need to use a variety of funding methods to ensure a range of
services provided and service providers are available in the community.
¾ Promote
community engagement through commissioning of user/carer led groups.
¾ Monitor
performance for effective oversight.
¾ Transparency
is key to local accountability.
2. COUNCILS NEED
TO USE
A VARIETY
OF FUNDING
METHODS TO
ENSURE A
RANGE OF
SERVICES PROVIDED
AND SERVICE
PROVIDERS ARE
AVAILABLE IN
THE COMMUNITY
2.1 Local authorities have for many years funded
other agencies to deliver local services and the networks of The
Trust and Crossroads Care receive money in this way from local
authorities. Two things are changing regarding this: firstly,
more local authorities are doing this and doing so regarding more
services; secondly, there is a shift from grant or contractual
arrangements to an open tendering process to decide who will deliver
the services on behalf of the council.
2.2 However, tendering can be a costly process
for the local authority in terms of finance and resources. It
also places extra costs on bidders who expend resources on being
involved in the tendering process. Relying on full tendering processes
can exclude local community groups and charities from being involved
in delivering local services as they may not have the experience
or resources necessary to be successful through a tendering process.
The tendering process can often focus on organisational strength
rather than records of successful delivery, which can favour national
and commercial organisations.
2.3 It also appears that there are common misconceptions
among many local authorities when European Union procurement laws
apply which forces them to apply an open tendering process. We
welcomed the Department of Health guidance on commissioning to
Primary Care Trusts in December 2009,i which
encouraged the use of grants to commission self care support for
people with long term conditions, and to develop low level community
activity. They also advised that third sector organisations will
have an increasingly important role to play and that grant funding
fits the purpose of working in partnership to achieve objectives
and is a good fit with commissioning for outcomes. We think that
its message should be repeated and also aimed at local authorities
as its lessons are relevant.
2.4 Benefits from opting for grant-funding are:ii
¾ Providers have the flexibility
to design activities to achieve outcomes; they are not tied to
a service specification. It is a very good fit with commissioning
for outcomes.
¾ The concept of a "conditional
grant" links the funding to the specific activity, but without
small, local groups taking on the risks associated with delivering
services under contract.
¾ Capacity building with local
voluntary groups can progress during the life of the grant, whilst
a contracting process would have had far less flexibility to work
on capacity building during the process itself.
2.5 The process of grant making can still be
a rigorous process that holds the provider to account for performance
against outcomes and ensure necessary services are available for
the local community. Bromley Carers' Centre, a member of The Princess
Royal Trust for Carers network, has been given a seven year contract
to cover the core costs of running the Centre. This is being jointly
funded by adult services, children services and the Primary Care
Trust. Contracts for specific services, such as respite, are being
awarded on an annual basis.
2.6 Adult services, which brought the partners
together, have cited Bromley Carers' Centre as a strategic partner.
The contract contains expectations on either side and the Carers'
Centre will be monitored against measures. The Council advised
the following reasons influenced their decision to award negotiate
such a contract without tendering:
¾ There were no other potential
providers and the Carers' Centre has successfully worked in partnership
with the Council in the past.
¾ The Carers' Centre can bring
added value through charitable fundraising and volunteering.
¾ There was no specialist
expertise on carers within the council and it would cost more
to develop that "in-house".
¾ Carers are a group of people
who will still be needing support long term into the future and
will remain a feature of government policy so the council should
invest in building capacity of organisations who will support
them.
3. PROMOTE COMMUNITY
ENGAGEMENT THROUGH
COMMISSIONING OF
USER/CARER
LED GROUPS
3.1 As described above, Whitehall departments
should provide strong guidance outlining the benefits of alternative
funding process to open tendering processes. Guidance could also
be issued highlighting that whilst considering commissioning decisions,
the following should be considered:
¾ Will funding a provider
enable additional value to be gained enhancing the delivery of
that service or other services that would be valued by local communities.
For instance, funding from local authorities can allow local charities
to raise additional funds for more services and engage with volunteers
to use their skills and experience that otherwise would not be
used.
¾ Will funding a provider
enable local people to be involved in the design and delivery
of services in their own area. This can help make services more
responsive and give people more control of the services that they
use in their own life.
4. MONITOR PERFORMANCE
FOR EFFECTIVE
OVERSIGHT
4.1 Local authorities should be monitored against
performance indicators that measure a variety of desired outcomes
for people in their communities and as communities as a whole.
These should involve recording experiences of people in their
communities and their opinions of services provided or commissioned
by local authorities.
5. TRANSPARENCY
IS KEY
TO LOCAL
ACCOUNTABILITY
5.1 Accountability depends on access to information
thus transparency of funding received and how it is spent at a
local level is needed for citizens and Parliamentarians to hold
local decision makers to account. We accept arguments against
ring-fencing but Parliamentary funding given to local authorities
for specific areas should still be given in identifiable amounts
which although are not ring-fenced means that local people and
Parliamentarians can see how much each local authority has been
given. Local authorities can then be asked how much of the indicative
budget they have used with accompanying explanations for their
decisions.
5.2 Currently the Carers Grant given to local
authorities operates in this way. £256 million was distributed
amongst local authorities in England in 2010-11. The share of
this received by each local authority was published but it was
not ring-fenced allowing local authorities autonomy. Contrastingly,
£150 million was given over the financial years 2009-11 to
the NHS to increase breaks for carers. However, what each Primary
Care Trust (PCT) received was not published leading to huge confusion
amongst politicians, primary care trusts and the public.
5.3 National and local politicians, and local
people and carers' charities found it impossible to get information
from PCTs who advised that as they had not been given identifiable
amounts then they did not have to say how much or what they were
doing to support carers.iii This was a case of money
given by Parliament to local government but nobody knew how much
each PCT received of the total amount nor what was done with the
money. This made accountability for implementing the Government
Carers' Strategy impossible.
5.4 The following example may be extreme but
does show the value of transparency in ensuring proper behaviour
and holding people to account. In Uganda, diversion of education
resources was reduced from 87% to 20% as a direct result of increased
public information about the resources allocated to each school.iv
The Princess Royal Trust for Carers and Crossroads
Care are the two biggest providers of
services for carers in the UK and work together at a national
level to promote policies and guidance that will support carers.
The Princess Royal Trust for Carers (The
Trust) is the largest provider of comprehensive carers support
services in the UK. Through its network of 144 independently managed
Carers' Centres, 85 young carers' services and interactive websites
(www.carers.org and www.youngcarers.net), The Trust currently
provides quality information, advice and support services to around
354,000 carers, including 20,000 young carers.
Each Carers' Centre within the network is an independent
charity in its own right, delivering a wide range of local support
services to meet the needs of carers in their own communities.
Each provides expertise specific to their particular area of the
UK. Carers' Centres' core services include:
¾ finding
hidden carers via outreach in GP surgeries, hospital wards and
schools;
¾ finding
the right information for every carer, whatever their circumstances;
¾ making
sure carers' voices are listened to by local decision makers;
¾ supporting
carers emotionally and practically throughout their caring journey;
and
¾ helping
to make caring a positive experience by helping carers to share
experiences and by ensuring access to breaks, education, training
and employment.
Crossroads Care is Britain's
leading provider of support for carers and the people they care
for. We work with over 35,000 individuals and their families,
helping carers make a life outside of caring. We employ over 5,000
trained professionals, providing flexible services to people of
all ages and with a range of disabilities and health conditions.
Crossroads Care is a network of approximately 100 independently
managed Crossroads Care schemes that are each charities in their
own right.
REFERENCES
i PCT Grant Making
Powers to Commission Long Term Conditions Self Care Support from
Third Sector Organisations, Department of Health, 2009, Gateway
Ref: 12947.
ii PCT Grant Making
Powers to Commission Long Term Conditions Self Care Support from
Third Sector Organisations, Department of Health, 2009, Gateway
Ref: 12947.
iii Conochie, G "No
breaks for carers", The Princess Royal Trust for Carers and
Crossroads Care, 2009.
iv Reinikka, R &
Svennson, J "Explaining leakage of public funds", Policy
Working Paper Series, 2001.
October 2010
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