LaingBuisson

Northern Long Term Care Seminar

Wednesday 5 December 2018 #SocialCare

THE COMMON GOOD THE PUBLIC AND THE PRIVATE SECTOR IN CARE.

Some thoughts on how the public and private sector might hate each other less and work together effectively.

Paul Simic, CEO, Lancashire Care Association and Director, GM Independent Care Sector (GMICS) Network

LaingBuisson Conference

5 December, 2018

INDEPENDENT

SECTOR

REPRESENTATION

& PARTNERSHIP

IN LANCASHIRE

& GM

Some background on Lancashire Care Association and the LancsHealth and Social Care Partnership

The GM Independent Care Sector Network and the GM HSCP

Independent sector…

- Alignment

- Engagement

- Governance

- Voice and message

- Programme and priorities

- Influence and contribution

www.lancashirecare.org.uk

www.gmicsn.org.uk

THE “TIPPING POINT”

“We cannot continue to

support people in the same

way as existing models of

care will simply not be

sustainable…

transformational

change…is required to

create a sustainable and

vibrant market.”

NW ADASS market sustainability and

oversight report (2018)

Social Care

|5

➢ Social care is critical to the …achievement of clinical and financial sustainability

➢ ADD HOW MUCH WE SPEND the country’s local authorities are facing significant budget pressures. Within GM, the funding gap has been calculated as £70m in 2017/18 rising to £113m by 2020/21

➢ Increasing demands on the social care system, which include demographic pressure and increased costs to implement the National Living Wage, are a contributory factor to:

➢ Significant increase in delayed discharges

➢ Unprecedented pressure on the urgent and emergency care system

➢ Significant market challenges in both domiciliary care and residential home provision.

Slide with permission from TG’s CE pres, November 2017

Greater Manchester Independent Care Sector Network

|6

➢ Effective engagement with the independent sector is crucial to effective service design

➢ Engagement needed a different spatial levels

➢ Independent sector needs to generate sector leadership

➢ Commissioner/provider dialogue has to change

➢ GM is setting up an effective representative body to support partnership working led by Paul Simic and Mark Cunningham.

Slide with permission from TG’s CE pres, November 2017

CARE HOMES,

FOR…

The private residential care sector

is at the heart of Britain’s health

and care system. It is where we

house and care for some of our

most vulnerable citizens …It is

already home to over 425,000

people and to 1/6 people >85.

The need for this vital part of our

health and care infrastructure will

only increase …between 2010

and 2035, the number of people

aged over 85 will more than

double, from 1.4 million to

3.5million. Res Publica 2016

CARE HOMES,

AGAINST…

“I hope all care homes

have shut within 50

years.” “The

combination of team-

working, technology

and better social

support, I hope means

that they go the same

way [as TB beds] over

time.” Simon Stevens, 2014

GM ‘SUMMIT’

2017:

“..TO GO

BOLDLY…”

Mayor Andy Burnham:

…”early intervention…” …”NHS

which promotes not just illness

model…” …”radical, forward-

thinking…set aside some of our

old loyalties…”

Jon Rouse, COO, GMHSCP:

…”audacious…counter-

cultural…paradigm-

shifting…extraordinary scale…it is

now going to get tougher…walk

in the other party’s shoes

…extending trust…believe the

best of each other…collective

ownership…”

THE CARE

NARRATIVE –

PRIVATE

SECTOR

“…it is time for social care to come fully within the public national health service…if you want one example of where outsourcing really has [seen] the worst kind of capitalism it is in social care where older people have seen services utterly slashed and there has been profiteering on the back of the most vulnerable people in our society.” Andy Burnham, Question Time, 2018

‘SYSTEMS

LEADERSHIP’

Question. How to deal with tribal

identities, complex systems and

unpalatable (“brutal”) truths?

Answer = strong systems

leadership.

Question = who can deliver

systems leadership? Who is able

to? Who is empowered to?

Answer = There is a role for

strategic intermediary structures

(provider associations and

partnership bodies) working on a

joint programme.

IMPROVING

NUMERACY

AND LITERACY

Numeracy:

Understanding

the costs of care and EBITDA

commissioning

profit and surplus

the role of markets

the ‘mixed economy’

Literacy: “when did we become the enemy”.

SUMMARY:

SOLUTIONS

KEY POINTS 1

Independent sector needs to shape up in terms of strategic engagement

But it also needs to be allowed to and supported to succeed

Relationships across organisational and sectoral fault lines crucial

“There are no beautiful surfaces without a terrible depth.” Nietzsche.

SUMMARY:

SOLUTIONS

KEY POINTS 2

Dealing with ‘Brutal truths’

Reflections on authority & power:

‘avoidership’ & leadership

Creating an intermediary space

between worlds

Making progress through projects

(eg joint MPS) and ‘learning

together’ processes.

Creating a culture of nurture

rather than fear.

Are ‘we’, collectively, up to the

task?

SUMMARY:

SOLUTIONS

KEY POINTS 3

Cohesion

Continuity

Coherence

LCA: engagement strategy for

the independent sector and

the Lancs and Sth Cumbria ICS

SUMMARY:

SOLUTIONS

KEY POINTS 4

- ‘sleeping with the enemy’ & systems

leadership

- relationships: allow myths and

stereotypes to be challenged

- clear messaging from the top

- transparency in process

- formalised partnership

- mutual respect

- working on projects together: e.g,

‘MPS’ as a joint project

- ‘Gunning principles’ re consult:

genuine dialogue at a formative

stage making a difference

RETHINK

We need to rethink the

process of dialogue and

engagement between

the public sector and

private sector.

Transparency and

honesty are key. Leave

the playground behind.

Audit

GETTING A CARING CULTURE:

MOVING BEYOND A PUNITIVE DISCOURSE.

NOT ‘PROJECT FEAR’

IMPROVING

NUMERACY

AND LITERACY

A deeper and more layered understanding of

- Costs (eg Which?)

- Markets, their role

- The mixed economy of care

- Adult to adult conversation

CONTACT

Paul Simic, paul.simic@gmicsn.org.uk

paul.simic@lancashirecare.org.uk

Sarah Luton, Administrator, sarah.luton@gmicsn.org.uk

sarah.luton@lancashirecare.org.uk

01772 455574

www.gmicsn.org.uk

Mark Cunningham, CEO, The Fed, GMICSN Chair

Ken Nolan, Chair, Springhill Group, LCA Chair

www.lancashirecare.org.uk