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SERVICE USER INVOLVEMENT IN COMMISSIONING- a Stockport perspective

SERVICE USER INVOLVEMENT IN COMMISSIONING- a Stockport perspective. Nick Dixon, Joint Commissioning Manager Lily Redman, Service User June 2009. Workshop Format. Setting the scene- commissioning and the current agenda Levels of Involvement Challenges

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SERVICE USER INVOLVEMENT IN COMMISSIONING- a Stockport perspective

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  1. SERVICE USER INVOLVEMENT IN COMMISSIONING- a Stockport perspective Nick Dixon, Joint Commissioning Manager Lily Redman, Service User June 2009

  2. Workshop Format • Setting the scene- commissioning and the current agenda • Levels of Involvement • Challenges • The Stockport experience- good and not so good • Exercise on tendering • User Involvement in Self Directed Support in Stockport • Discussion

  3. Commissioning • A way of getting best health and social care outcomes for people • Understanding what local people’s and local communities’ needs are • Being clear about what services are required to address those needs • Contracting with services with clear agreements • Ensuring best value • Monitoring performance and outcomes

  4. Setting the scene • Public Involvement and Local Involvement Networks (LINks) • Citizen and person-centred services • Patient led services • Putting People First • The Personalisation Agenda • Direct Payments and Individual Budgets • Self Directed Support • Independent Living Centres

  5. Involvement Ladder • Giving Control • Participating • Consultation • Information

  6. Barriers and Challenges (1) • Consultation v Empowerment • Consumerist approach to involvement • Accountability • Consultation overload- nothing changes • Adequate funding and resources • Training and meaningful involvement

  7. “the closed culture of health and social care services and their own inadequate resources restrict service users’ capacity to develop and share their knowledge” Branfield and Beresford 2006

  8. Barriers and challenges (2) • User led training and education • Culture change • Evaluation of the National User Involvement Project • Involvement at planning stage • Expertise not recognised • Involvement should be adequately funded • Training should be adequately funded and accredited

  9. Any questions at this point?

  10. The Stockport Experience • Four perspectives- the Commissioner, the service user, the carer and the Contracts Manager • Willing partnership • Culture Change underway • Recovery, Social inclusion, Values Based Awareness, Service user and Carer Involvement

  11. Recent Contracts • Stockport Wellbeing Centre • Stockport Crisis Accommodation and Home Support Service (CAHSS) • Mental Health Housing Related Support • Independent Mental Capacity Advocacy • Carer Development Worker • Service User Involvement & Development Worker (SUIDW)

  12. CAHSS- what worked well • Involvement from the outset • Working Group advising on the project • Research • Needs Analysis • Service Specification • Presentation to Interested Organisations • Accommodation location- politics

  13. CAHSS cont. • Accommodation specification • Panel make up • Decision making process • Agreeing cost/quality ratio • Questions and presentation • Submissions and Interviews marking • Informing successful organisation

  14. CAHSS cont. Post Award of Contract • Advisory Group • Performance Monitor • Partnership Contract Monitoring meetings

  15. Exercise time…… • Aim- to give a sense of the reality of decision making around awarding a contract • Aim- to draw out some of the issues and challenges • Process- marking just one section of an actual but anonymised submission to Stockport commissioners for the contract for the Service User Involvement and Development Worker

  16. What we would now like you to do please……. • Firstly, divide yourselves into small groups of up to 5 people with your neighbours • Secondly, each person individually read the three organisations’ answers to the question: ‘Please describe in detail your understanding of the principles and importance of effective service user representation’ • Individually, score each answer out of 5 marks using the provided sheet and jot down comments to share with the group

  17. Then… • In the small groups, discuss your marking and comments • Each group be willing to feedback a comment or observation • Suggest 5-10 minutes to read and score and a further 5-10 minutes to discuss as a small group

  18. The Panel disagreed…… • 5 questions, possible 25 points from each of 5 panellists • One Organisation awarded 25, 23 and 20 by the 3 paid staff on the Panel; awarded 5 and 7 by service user reps • Another Organisation awarded 10, 11 and 20 by paid staff; awarded 22 and 22 by service user reps

  19. Decision taken to convene a second panel….why? • In discussion it emerged that the service users had not fully understood the need to mark the responses based solely on what was before them; to some degree prior knowledge of the organisations had been considered • The service users marked down an organisation for their use of language • The outcome of the first panel would not have been legally defensible- view of the Contracts Service Manager

  20. Second panel convened • Applications anonymised as best they could be • Totally new panel but still with two service user reps • The first panel members agreed a set of preferred answers to mark the submissions against • Outcome was subsequently agreed by all partners

  21. Learning • There must be absolute clarity on the process and what can be influenced • Involvement not consultation, and right from the start • Accountability and power clarified • Process must be clear around costings and quality • Questions to be asked of the organisations in their submissions to be agreed by all partners and preferred answers agreed to mark against • Smaller contract- no less attention to be paid to the process and preparation • Service user reps should always have training and reach a level of awareness of commissioning process • Appropriate payment must be agreed and be available • Guidance to organisations on language

  22. Personalisation • An alternative approach to commissioning • Meets the recovery agenda • Enables control to be given to service users more effectively

  23. Commissioning and Self Directed Support in Stockport • Pilot Feb 09-10, 60 service users with Individual Budgets • Recovery in action, supports culture change • Self assessment, resource allocation, brokerage, individual and group support planning • Peer support networks and peer commissioning • Accentuate The Positive and Thrivers • Recovery Budget • Recovery stories and blogs

  24. Early Issues • Personalisation- what does this mean for rights of the individual vs duty of care? • Is there enough money in the pot? • Prevention vs ‘Critical and Substantial’ • Quality of Life extras? • Will we see recovery and discharge?

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