‘Working together to improve mental health’

The Lancashire Mental Health and Social Care Partnership Board Made up of representation from Local Authorities, NHS Trusts, the Third Sector, Service Users and Carers

The Lancashire Partnership Commissioning Model:

facilitating third sector participation

Dr Christina Lyons and Michelle LyonsFaculty of Health, University of Central

Lancashire (UCLan)

Rationale

2006 public consultation on future of mental health services

Service user and carer aspirations for more choice

Limited third sector provision of mental health services

Who is the model for?

Usual suspects: Commissioners, finance and procurement officers, informatics,

contract monitoring officers

Third sector organisations Service users, carers, members of the public Practitioners (including students) Businesses

What is the model?

Framework and toolkit supported by evidence and values

Whole commissioning process not simply procurement

Wider social and economic aspirations

What is the model?

Evidence based – literature and field observations Values based – openness, transparency, fairness and

respect Field tested Mapped against World Class Commissioning

competencies

What is the model?

Framework outlines three sequential phases: Pre-procurement Procurement and contracting Post procurement

A systematic process

Toolkit with detailed guidance

Commissioning Framework

Procurement phase:do

Post procurement phase:review

Pre-procurement phase:analyse and plan

Timescales

Stakeholder engagement

Project implementation

Service user & carer involvement

Health needs assessment

Research

Financial modelling

Service model & outcomes

Market stimulation

Service specification

Procurement planning

Procurement process

Contracting

Bidder feedback

Evaluation / contract monitoring

Impact assessment

Lessons learned

Third sector feedback

Lancashire Third Sector Consortium for Mental Health (LTSC)

Miracle question

Developed a wish list

Third Sector Wish List

Commissioning steering groups – little TSO representation

Third sector provider group – sit along side

steering group, for any TSO to attend to

find out about the commissioning

process

Commissioners should review all services in an

area before making changes

Any changes that are made should be based on an inclusive

needs assessment

Commissioners should broaden views from the community

Commissioner & provider to collect info, collate and

compare

Move towards outcomes

Early warning signs of forthcoming tenders

More notice should be given to allow TSO’s time to prepare as they don’t always

have the same resource to allocate to

tendering

Service specification should be clear to

understand

Bidders should be allowed to clarify their

understanding of terms used by contacting the commissioner

More detail should be given at the

expression of interest stage

Service need/capacity should be quantified

by commissioners and included in the service

specification

It is then the role of providers to specify how they intend to

meet the need

More creativity from commissioners about how solutions could

be provided

Contract monitoring

Arrangements for monitoring should be agreed at the

outset/commissioner specify their expectations

Commissioner should give early warning if they feel the provider

is not meeting the conditions of the

contract

Lack of notice for tenders

Produce tender prospectus with

annual timescales

Commissioning resources

Are commissioners adequately resourced?

Do commissioners plan far enough

ahead?

Tender feedback – could use a proforma

Ability to appeal if you feel your tender presentation addressed all

requirements but you were unsuccessful in your bid

All the relevant information is required

in order to create a level playing field

amongst providers

Commissioners should take into account the value of TSO local

knowledge

LPB train cohort of service users/carers

to sit on commissioning panels

2 way feedback – but a better mechanism that doesn’t damage

commissioner/provider relationship

TSO’s could be used as a consultative body in a paid capacity, to help

define needs.

Be aware of SU/carer allegiances with certain providers, try to ensure

objectivity when scoring tenders

Commissioners should have a better

understanding of costs, 17-18% running/

management costs is realistic, not 10-12%

Improve timescales for tender

application, presentation etc

Outcome measurement – there are many measurement tools that can be

used – would be good if commissioners understood more

about outcome measurement

TSO and commissioners

could jointly develop

measurement tools

Strengthen capacity building initiatives. Build

consortia capacity – funding for a network of

TSO’s. Full Cost Recovery – a Compact way of

working

Transparency regarding funds available for the

tender

Commissioners should learn

lessons from best practice

Pre-tender stage – early notification of

commissioning intentions

Longer spec development period

beneficial – pilot funding to test

models of working, specs that allow for

innovation

Improved commissioner

communication skillsImproved

consultation, separate events for

providers, SU/carers

Set up provider group – open

invitation to work with commissioners

to develop their tender process

Realistic implementation phase i.e. more

than 3 days

Timescales

Annual prospectus to indicate commissioning intentions over the forthcoming year

Distribute prospectus to all stakeholders

Timescales

Commissioner

Proactive Planned

Third Sector

Consider which tenders are most appropriate

Increase bid quality Collaboration

Market Management

Develop the market

Capacity building

Market stimulation

Reciprocal relationship between commissioners and third sector

Choice agenda

Market Management

Commissioner

Mixed economy Choice Quality

Third Sector

Services tailored to needs Opportunities for

development and innovation

Contract Monitoring

Monitoring service user outcomes

Information and data collected is used more effectively/purposefully

Inform future service developments

Service user role in contract monitoring

Contract Monitoring

Commissioner

A useful exercise Quantitative and

qualitative feedback Demonstrate effectiveness

and efficient use of resources

Third Sector

Expectations clearly articulated

Problems can be rectified Opportunity to

demonstrate quality and effectiveness

Service user & carer engagement

Engagement at the right time for everyone

Continuous programme of engagement and involvement

Open and honest communications

Transparency

Service user & carer engagement

Commissioner

Harness creativity Innovative solutions Meet requirements of

World Class Commissioning

Third Sector

Maintain understanding of local contexts

Understanding service user aspirations

Next steps

Snap shot of the model

Model dynamic and will change in response to feedback over time

Toolkit being prepared for publication

Contact details: clyons2@uclan.ac.uk michelle.lyons2@nhs.net 01254 282229

Questions