SEND Reform & Joint Commissioning

1. SEND Reform & Joint Commissioning Karen Kenton Associate Director – Joint Commissioning Children’s Services HMRCCG/RMBC 25 March 2014

2. Context • close partnership working between RMBC, PCT and now CCG in relation to children’s services • Identified child health commissioner in PCT (with clinical/disability background) – now jointly funded children’s commissioner post across CCG and RMBC • Recognition of commissioning as an enabler of service transformation, integration and improvement. • Improvement Notice • Public Service Reform

3. Progress • Jointly funded associate director post to lead development of joint commissioning- April 2013 • Joint Commissioning Strategy ratified by HWBB June 2013 • Establishment of Children’s Joint Commissioning Steering Group • SEND agenda embedded in wider strategic planning and developments • Business Case –due to go to HWBB June 2014

4. Joint Commissioning Strategy • Agreed set of principles that underpin strategy • Clear definitions of commissioning terminology • Joint commissioning continuum • Aspiration to establish a joint/integrated commissioning unit by April 2015 • Twin track approach

5. The Business Case – What’s in it? • Background, rationale and case for change • Links to strategic priorities • The Functionof the CICT • The Scope i.e. what’s in/out of remit • Initial Structure • Legal Framework • Governance • Costs • Success Factors/Performance Measures • Exit Strategy

6. Function • Needs assessment and Strategy development for children’s service provision • Service planning and specification development • Develop and implement service review process to ensure commissioned and in house services are effective, efficient and value for money. • Re-design existing commissioned and in house services (subject to procurement regulations) to support commissioning strategies/priorities • De-commission services, including in house, who do not deliver the required outcomes or demonstrate value for money • Market and workforce development • Co-ordination of procurements for children’s services supported by RMBC and HMRCCG procurement services • Development and management of partnership agreements and pooled budgets • Contract development and management for commissioned services • Service performance monitoring for commissioned and in house services within the context of commissioning strategies • Co-ordination of Quality assurance for commissioned services, supported by RMBC and HMRCCG quality functions

7. Where does the SEND agenda fit in? • Developments re SEND reforms embedded into wider borough wide strategies – eg Early Help, Joint Commissioning and Children and Young People’s Plan • Intention to jointly commission an integrated borough wide service for children with disabilities to support delivery of SEND reforms • Requirements included in health service commissioning intentions/service specifications • Governance

8. Challenges…joint commissioning • Shared understanding of what commissioning is and isn’t • Provider and commissioner ‘separation’ • Whole systems, strategic approach • Complex commissioning landscape post health reforms • Different approaches/requirements e.g Procurement • Quick fix/wins vs sustainability

9. Commissioning Challenges for SEND • Joining up multiple ‘commissioners’ and helping people understand the health system • CCG ownership/clinical leadership & understanding of implications • Health vs LA local offers, personal budgets, choice • Moving the money • EHCPs - quality assurance/clinical safety • Integration - leap of faith