Fairer ContractingPersonalising Services in

Brighton & Hove

Context

• History of good partnership working with providers and local (commissioning only) PCT

• Key drivers for change:• Outdated contractual arrangements in Council and

no formal arrangements in PCT• Variable cost to purchasers • Concerns re clinical quality in nursing homes• Lack of coherent information available to the

public on cost and quality issues

Initial Steps

• Agreement between Council and PCT to joint contractual arrangements

• Sign up from politicians

• Engagement with CSCI

• Winter 2007- 8 Active engagement with providers on tying quality to cost

• Recruitment of Quality Review Nurse

Process

• Consideration of contract models and negotiation on Specification

• Agreed set rates - with incentives• Developed user friendly web based

information for public and professionals• Sign up from providers to Preferred

Provider list• Implementation of Fairer Contracting April

2009

Rating comparisons

Ratings Chart

0

5

10

15

20

25

30

35

40

45

Apr-09 May-09 Jun-09 Jul-09 Aug-09

N/K

Poor

Adequate

Good

Excellent

Month/ Year N/K Poor Adequate Good Excellent

Apr-09 8 2 18 30 7

Aug-09 4 1 15 39 6

Challenges

• Future partnerships with the NHS:• Introduction of NHS contracts - where does

this leave use of Local Authority contracts? • NHS use of Procurement Hub• Uncertainty with future role of CQC/QRN

• Balance of block and framework agreements: • Choice versus security• Future market development - role for the

statutory sector commissioners, hard commissioning or soft influencing?