Westminster Introduction

Strategic commissioning - prioritising the allocation of resourcesIntroduction from Cath Attlee

Assistant Director Joint Commissioning Care & Health

Westminster City Council and NHS Westminster

November 2009

Strategic Commissioning - prioritising the allocation of resources

Welcome to Day Two of our On-Line ConferenceHosted by Westminster City Council,

one of the four Strategic Commissioning Beacon authorities

We will be addressing three issues:Targeting resources based on understanding of need to

reduce inequalitiesGood practice in sharing of risks and resources with

partner agenciesEmbedding cost/affordability in the strategic

commissioning process


During the day:

Mike More, Chief Executive of Westminster City Council, will discuss the recent transformation of the Council and our approach to prioritisation and the targeting of resources

Councillor Ed Argar, Cabinet Member for Health & Adults Services, will report on the development of Unified Public Services in the City as a way of maximising value and achieving better outcomes


Team Hackney will contribute two sessions on:

Supporting the local strategic partnership to prioritise the area based grant

The third sector and strategic commissioning


Colleagues from Devon will report on the delegation of commissioning budgets to local Children's Trusts

The Communities of Practice Library will also hold a range of reference material relating to this subject, in case you want to find out more

http://www.communities.idea.gov.uk/c/1505808/doclib/index.do


An Introduction to the Issue - prioritising the allocation of resources

Addressed through other Beacons, particularly Total Place and Economic Prosperity

Also theme of NHS World Class Commissioning - evidence based and efficient

Use of Resources assessments of public services

Our approach in Westminster…………


Identifying needs and priorities of the community

Specifying a service or range of services to meet those needs

Monitoring/evaluating the quality/quantity of service provided; and the impact of the service on meeting the identified needs.

Procuring a service or range of services through service agreement(s) or contract(s) against the specification

Strategic Commissioning

Cycle

Finance - Financial Parameters

Legal - Statutory Duties

Members / SEB - set Strategic Priorities

Resources available: property; people; IT


Targeting resources based on understanding of need to reduce inequalities

One information portal - JSNAHealth Inequalities Strategy

One Involvement Strategy -Local Area Renewal Partnerships

Joint performance framework -Comprehensive Area Assessment

example:


Family Recovery ProjectComplex needs across a range of ‘domains’: parenting, health, employment, debt,

housing, education, offending and anti-social behaviour, family functioning and engagement with services.

78% of parents are engaging with the teams and improving how they parent their children. 67% of families are now registered with and engaging with a GP 61% of parents and children, where applicable, are attending treatment at GP or hospital. Support is provided to domestic violence victims in 17% of the families. In housing and debt we have now put a plan in place or cleared housing arrears in over

half the families. Debt has been resolved in 39% of the families. Benefits have been checked and corrected in over 80% of the families. School attendance has been improved in over 60% of the families. Over half of the cohort have demonstrated no further anti-social behaviour.

“My family has seen a lot of change since we’ve started working with them”

“I have found them very helpful” "It’s working!”

Views of FRP parents and participants


Good practice in sharing of risks and resources with partner agencies

S75 Joint Commissioning Agreement with NHS Safer Westminster Partnership & the Living CityEvery Older Person MattersTackling Overcrowding Westminster Carbon Alliance

example:


Improving the quality of life for older residents in WestminsterProportion of respondents who said that going to (or being in receipt of) a particular

preventive service helped them ‘A very great deal’ or ‘A great deal’ in the way they felt about four Quality of Life dimensions (with 95% CI for 2006)

0.0

10.0

20.0

30.0

40.0

50.0

60.0

Health and well-being

Live kind of lifewant

Contact with others Personal safety

% o

f re

sp

on

de

nts

2006 baseline 2009 target 2009 outcome


Embedding cost/affordability in the strategic commissioning process

Public finance mappingApplication of Total Place approach Involvement of Partnership in prioritisation of whole

budget not just LAA resourcesCause and effect programme > prioritisationStronger procurement and governance processesEconomic Recovery PlanWhole Council transformation


City Council Corporate Changes:

Strategic Executive BoardCommissioning TeamDelivery units (and external providers)Support units

Strategic Commissioning takes the high level objectives of the City and commissions across departmental and agency boundaries to meet the needs of the community and achieve City priorities


Transforming Commissioning & Contracting

Outcomes Based

User LedIdentifying the needs of the local community, and what works?

Specifying a service or range of services to meet those needs

Monitoring and evaluating the quality and quantity of the service provided; and the impact of the service on meeting the identified needs. Implementing a

service development, or procuring a service or range of services through a service agreement or contract

The NEW Commissioning

Cycle

Outcomes based – flexible – quick to respond to changing needs.

User led – more direct relation-ship with providers.

Emphasis on user input – self assessment by individuals and communities – market surveys – forecasting – predictive modelling – capturing unmet needs via GIS – tracking DP use – what works?

Wider, more flexible market. Outcome based contracts – new models – higher risks.

User feedback showing outcomes achieved. Aggrega-tion of individual outcomes to indicate overall service outcomes


To find out more about Westminster’s approach follow the link:

http://www.youtube.com/westminsterccWest End LiveBeat the recessionLeaders speech - Living CityClean StreetsGo GreenSport & LeisureSafe Streets - City GuardiansParkingLibraries

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