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Social Care Procurement Scottish Procurement Directorate Joint Improvement Team PowerPoint PPT Presentation


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Social Care Procurement Scottish Procurement Directorate Joint Improvement Team. Social Care Procurement Guidance Framework. Definition and Terms of Reference.

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Social Care Procurement Scottish Procurement Directorate Joint Improvement Team

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Social Care Procurement

Scottish Procurement DirectorateJoint Improvement Team


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Social Care Procurement Guidance Framework


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Definition and Terms of Reference

Strategic commissioning is the term used for all the activities involved in assessing and forecasting needs, agreeing desired outcomes, considering options, planning the nature, range and quality of future services and working in partnership to put these in place. (SWIA Guide)

Strategic Joint Commissioning – Step Process

Preparation

and

Stakeholder

Involvement

Vision

Analysis of

Performance in

outcomes, quality,

timescales, cost

Option

Appraisal,

Policy

Decisions,

Commissioning

Strategy

Change

Management,

Service

Development,

Procurement

& Contracting


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Joint Commissioning Model for Public Care (Institute of Public Care model)


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Commissioning Cycle

Analyse

Plan

Review

Do

Procurement


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Commissioning

Cycle

  • Procurement

  • Guidance

  • Legislation

  • Policy

  • Analyse

  • Plan

  • Do

  • Review

Analyse

Plan

Analyse

Plan

Review

Procurement

Procurement

Cycle

Review

Do


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Social Care Procurement Programme

Meetings with Service Users

Learning Disability Alliance

Learning Disability National Involvement Network


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Service User Views

Anxiety about the procurement process – what will be the end result?

Will my support worker/care staff/support team change?

Lack of information and service user involvement in some areas.

Complex role for service providers and support staff in the process.

Context of staff anxious about their personal situation.

Individuals feeling disempowered, with little control .


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Service User Views – Specific Issues

Direct Payments - if requested, in some cases it takes a considerable time to be accessed

Discontinuity of service provider and support workers

Continuity of support workers but not service provider

Care management role–confusion about care managers’ role in the procurement process

Citizen leadership– profile of Citizen Leadership needs to be raised

Advocacy – should be made more available

Lack of ‘joined up thinking’– re-tendering cuts across policy of choice and control

Purpose - information about why the process is being undertaken is essential

Cost Cutting Exercise– if this is the case, make it clear

Post tender–information on individual service users does not always get passed on

Number of providers– reducing service provider numbers may limit choice

Information – want information about potential changes early on in the process

Communication - would like this information conveyed to them face to face.

Specifications/Tendering/Evaluation - not clear how they should be involved


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Service Users

There was an overwhelming sense that current procurement processes provide service users with little sense of control over their lives or an ability to impact on the decisions made around them, and that they want this situation to change.


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Social Care Procurement Programme

Local Meetings

Local Authorities and Service Providers


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Local Meetings – Common Agenda

General experience of local procurement arrangements

Key issues/difficulties in relation to local procurement

Local principles, policy, procedure and approach

Relative strengths and weaknesses in local procurement

Expectations of proposed guidance


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Local Meetings – Agenda Issues

  • Local principles, policy, procedure and approach

  • Grounds for tendering/re-tendering and the tendering/re-tendering process

  • Service user and carer involvement in tendering and re-tendering

  • Nature of contracts and approach to contracting

  • Service change and/or transfer including TUPE

  • Market analysis, nature and expertise

  • Implications of self-directed support

  • Partnership with providers

  • Special features of social care procurement

  • Contract monitoring and review, including service user, carer, provider and regulator involvement

  • Staff skills and training needs for procurement


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Policy, Strategy and Approach

  • Experience of variation -- case for consistency and how much?

  • Merits of case for a national policy and frameworks for:

    • Approach to social care procurement;

    • Interpretation of European regulations;

    • Cost and quality;

    • Service user involvement;

    • Roles of regulators and local purchasers;

    • Shared services;

    • Outcomes personalisation and self-directed support;

    • Following more closely the approach with care home providers.


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Local Meetings – Key Issues

Balance in national policy/consistent approach v. local discretion

Nature of partnership between local authorities and service providers

Nature of involvement of service users and carers

Relationship between and evaluation of cost and quality

Local arrangements, training and skills in social care procurement

Market change strategy – number and scale of providers

Differential approach to directly provided/purchased services

Level of specificity/flexibility in service specifications

Approaches to framework agreements

Experience and planning for re-tendering or roll forward contracts

Balance between fairness and competition v. stability and continuity

Knowledge, roles and responsibilities with TUPE

Contract monitoring and management approaches and resources

Links with assessment, care management and personal outcomes

Implications of self-directed support


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Partnership -- Councils & Service Providers

Councils believe they are working in partnership -- service providers don't.

Issues of:

Size -- increasing dominance of large/reduction in small providers?

Innovation -- need for methods to promote flexibility and development?

Flexibility and Security -- spot contract flexibility/block contract security?

Risk and Responsibility -- balance between local authorities and service providers

Procurement Arrangements -- greatest enthusiasm across partnerships for framework agreements, but different approaches to them

Bureaucracy -- staff resourcing, duplication and paperwork

Re-Tendering -- variation in promotion of regulations/continuity

Culture -- can do and can't do cultures

Communication and Involvement -- variations in approaches

Cost and Quality -- variation and uncertainty

If you invest in higher quality standards for higher grades you are unlikely to win contract because of higher costs?


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1. Analyse -- Structure and Market

Preparation

Organisational arrangements -- governance (e.g. Purchase Services Board), social care policy, leadership, balance between social work and corporate procurement, skills and experience, formal training and staff development (Council and providers), career structure

Analysis

Current Supply Arrangements

-- large organisations with capacity, risk to small organisations, implications of supply reduction, effects of rurality and remoteness

Market Analysis

-- impact of differential approach to directly provided/purchased services (service allocation, cost, uplift, staff drift) - implications of decommissioning services - skills in options appraisal and risk analysis -understanding of transaction costs - implications of changing the range and number of providers


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2. Plan

Service Specifications

Variations in:

the level of collaboration and involvement of key stakeholders, including service users (role of advocacy?) and providers – variations in specificity and flexibility and promotion of innovative practice – variations in negotiability and potential for annual change in service specifications - consideration of quality and cost against specification and task/time – question of standardisation across the country of contract terms with the main variation being in service specifications and particular elements of cost

Contracts

Issues:

Outcomes based contracts - many providers don't have a contract -- spot purchase and choice -- place of Individual Service Agreements -- variations in approach to framework agreements ( wide range of providers/narrowing range of providers) -- roll forward contracts -- problem of accommodation of specialist providers within general framework -- national contracts -- care home contract issues concerning flexibility -- care home contract and approach has resolved issues

Procurement Plan

Variations in:

use of procurement processes (open, restricted, competitive dialogue), grounds for tendering and re-tendering, purpose, contract length, views on market shape including number of providers, service user information, communication and involvement, objectives concerning cost and quality, objectives concerning change and continuity, strategic partnerships, mobilisation plans and timelines -- transparency and transfer arrangements – risk sharing -- attention to service delivery at the back end of the process


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3. Do -- Tendering and Bidding

Tendering

Issues:

Tender documentation very different but content very similar -- variable proportional balance of quality and cost -- cost is the main driver? -- taking account of additional resources brought by provider -- potential for cost guide and price negotiation -- Due diligence investigations -- application of local knowledge and market knowledge -- decision-making process and involvement -- provider interviews -- service user involvement -- quality assessment frameworks -- use of Care Commission gradings -- implications of outcomes frameworks -- scoring system -- scoring quality -- clarity about scoring -- commercial confidentiality -- influence quality of writing -- approach of one area in relating cost proposal directly to quality proposal -- dislocation from service specifications -- knowledge and skills of tender evaluators

Contract Award

Issues:

assessments of service quality -- involvement of service users and carers on evaluation panel -- use of care commission reports and third party information -- consistency in assessments -- price and quality indicators -- transparency of scoring system against agreed criteria -- links with Care Commission grades -- weighting given to service user and carer views - performance bonds - timing and extent of information to service users and carers

Re-tendering

Issues:

fairness and competition, stability and continuity -- promoting innovation -- enabling new providers, making budget savings -- transaction costs -- transition process -- length of contracts -- service user and carer involvement -- impact on service users and carers -- decisions about open and restricted tendering -- function of framework agreements and roll contracts forward – TUPE ( lack of knowledge and expertise -- arrangements for information sharing -- Council role -- response to additional costs -- balance of risk between local authorities and providers)


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4. Review -- Contract Management & Review

Is there too much focus on the early process and not enough on service delivery?

What resources are available for contract monitoring and review?

What are the arrangements for placements and resource allocation into services?

Contract monitoring issues:

difficult to sustain contact with suppliers, are there too many? -- duplication with Care Commission -- links with social workers, care managers and care management, and home care management -- role of case reviews concerning individuals -- arrangements for and role of contracts/compliance staff -- monitoring cost and quality -- management information (quarterly or annual reporting?) -- performance bonds and penalties -- very different approaches to contract monitoring and review

Market Management, Relationship Management and Framework Management

Issues:

Business development -- service reviews -- involvement of service users and carers -- links with regulators -- contract management where there is no contract -- contract reviews -- re-tendering or rolling forward contract


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Social Care Procurement

Scottish Procurement DirectorateJoint Improvement Team

National Survey on Social Care Procurement Local Authority Results


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Purpose

Obtain information about current practice and policy issues

Identify good practice examples

Identify areas of difficulty which should be addressed in national guidance

Returns

22 responses from local authorities

37 provider responses – mixture of both private and voluntary sector

National Survey


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Procurement policy and procedures

Analysis and planning

Tendering and contracting

Review

Key issues for improvement

Conclusions

Survey Sections


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Acceptance that generic procurement policies and procedures do not reflect the specific issues relating to social care

Majority of Councils (73%) stated that they have specific policies and procedures relating to social care procurement

Not always made available to service providers and users

Limits service providers’ ability to shape and develop their organisations to meet future social care demands.

Policies and Procedures


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Key issues – local authorities

Inconsistency in the approach taken within Councils and across Scotland

Lack of clarity around Part B services

Conflict between central procurement policy and guidance and social care procurement

Better engagement with service users

Appropriate procurement approaches to support personalisation

Policies and Procedures


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Key issues – service providers

Inconsistency in the approach taken within Councils and across Scotland

Lack of partnership between service providers and local authorities

Better engagement with service users

Better understanding of what procurement approaches are appropriate for the particular kind of service

Policies and Procedures


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Key issues - local authorities

Extent to which services should be exposed to market forces

Involvement of service providers, service users and carers

Potential for collaborative procurement

Impact of direct payments

Ensuring a level playing field for smaller providers

Incorporating feedback from contract monitoring in the planning cycle

Analysis and Planning


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Key issues - service providers

Potential implications of tendering for service providers and service users

Capturing providers’ ideas and expertise

Clearer link to values and national care standards

Focus on outcomes for service users

Better planning for TUPE

Advance notice of procurement exercises and more realistic timescales

Analysis and Planning


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Procurement Routes


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the needs of service users

client and/or service risk analysis

personalisation/client choice

the duration of the contract and its estimated value

legal obligations to tender

the size of the market

the availability of funding

the highly specialised nature of some services

the operation of an approved providers list or equivalent

the potential for innovation

strategic re-alignment of services

urgency

Procurement Routes - Rationale


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Information for service users

Through their representation on the procurement planning team

Through their involvement in development of the service specification and/or representation on the evaluation panel

Through service user consultation

In person, by social workers or their existing providers

By letter and/or story board publications.

Timing of any communication with service users is critical

Poor communication increases anxiety and means service users

unaware of the choices/alternatives available to them

Tendering – Involvement of Service Users


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Key issues:

Lack of understanding of TUPE Regulations – local authorities and service providers

Role of local authority in providing advice and facilitating the exchange of information

Level of risk for tenderers if not allowed to adjust tender price post-award

Allocation of time within implementation phase for TUPE process

Use of contract clauses to require providers to make TUPE information available at the tender stage

Tendering – application of TUPE


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Local authorities

Selection criteria: track record, Care Commission reports, financial standing, policies and procedures, references, service user feedback, staff qualifications and training

Award criteria: understanding service requirements, achieving outcomes for service users, implementation proposals, staffing structures, cost

Variation in quality/cost ratios

Service providers

Focus on cost rather than quality

Evaluation of tenders


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Need for re-tendering when Council already satisfied with quality of service and best value

Potential for tendering to lead to increased costs

Joint purchasing – differences in practice between Health and Local Authority

EU legislation and terminology does not sit well with social care procurement

Current budget restrictions have impact on final decision making

Establishing and evaluating award criteria relating to quality

Level of Council resource required

Tendering – Local Authorities’ concerns


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Level of disruption to services and service users

Poorly planned procurement exercises with very short timescales

Inconsistency in approach taken between Councils

Volume of information required from tenderers

Pressure to reduce costs below level at which service can safely be delivered

Breakdown in relationships between providers

Poor/insufficient feedback post-award

Lack of partnership with local authorities

Tendering – Providers’ concerns


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Suggestions

National Core Contracts

  • care at home services

  • residential schools

  • fostering

  • secure accommodation for children

  • adult residential care

  • day care services for a range of client groups

  • aids and adaptations

  • OT equipment

  • telecare equipment

  • remote call handling centres


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individual case reviews

providers’ performance reviews

monthly/quarterly returns

spot check by the Council and/or provider

individual service user and carer feedback

feedback from staff

feedback from care managers

review of Care Commission inspection reports and action plans

review of complaints

regular provider meetings

ongoing operational dialogue

Contract Monitoring and Review


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Maximise the information/data from the national care home database

Ensure that information generated at individual service user/carer reviews informs decisions about service development and links into the commissioning cycle

To avoid duplication, users of a service should be asked to complete one survey annually and the results shared with the Council, regulators and service provider

Review - Improvements


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The extent to which procurement legislation applies to social care services

Options for social care tendering and step by step processes

Joint commissioning

The application of TUPE

Evaluating outcome based tenders

Ensuring continuity of service

Frequency of tendering and contract duration for social care services

Service user involvement

Developing the social care market

National Guidance – Local Authorities


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Recognition of the true cost of care

Link between local procurement plans and single outcome agreements

The development of consortia bids

Release of information by Councils about providers’ pricing, policies and contractual arrangements under FOI(S)A

Use of e-auctions

Recommended content of tender packs

Appropriate quality/cost ratios

National Guidance – Service Providers


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Key Issues - Discussion


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Key Issues 1

  • Balance in national policy/consistent approach v. local discretion

    • Interpretation/application of legislation/regulations for Part B services

    • Market analysis and strategy (including number and scale of providers)

    • Contractual arrangements (incl. framework agreements and contract length)

    • Cost and quality ranges and balance in evaluation

    • Involvement of service users and carers

    • Implementation process (including TUPE)

    • Contract monitoring and management

  • Balance between fairness and competition v. stability and continuity

  • Implications of personalisation, self-directed support and better outcomes


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Key Issues 2

  • Differential approach to directly provided/purchased services

  • Partnership working between local authorities and service providers

  • Training and skills development in social care procurement


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