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
Mobile 07554 115681