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Social Care Procurement Scottish Procurement Directorate Joint Improvement Team

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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  1. Social Care Procurement Scottish Procurement DirectorateJoint Improvement Team

  2. Social Care Procurement Guidance Framework

  3. 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

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

  5. Commissioning Cycle Analyse Plan Review Do Procurement

  6. Commissioning Cycle • Procurement • Guidance • Legislation • Policy • Analyse • Plan • Do • Review Analyse Plan Analyse Plan Review Procurement Procurement Cycle Review Do

  7. Social Care Procurement Programme Meetings with Service Users Learning Disability Alliance Learning Disability National Involvement Network

  8. 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 .

  9. 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

  10. 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.

  11. Social Care Procurement Programme Local Meetings Local Authorities and Service Providers

  12. 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

  13. 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

  14. 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.

  15. 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

  16. 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?

  17. 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

  18. 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

  19. 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)

  20. 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

  21. Social Care Procurement Scottish Procurement DirectorateJoint Improvement Team National Survey on Social Care Procurement Local Authority Results

  22. 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

  23. Procurement policy and procedures Analysis and planning Tendering and contracting Review Key issues for improvement Conclusions Survey Sections

  24. 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

  25. 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

  26. 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

  27. 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

  28. 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

  29. Procurement Routes

  30. 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

  31. 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

  32. 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

  33. 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

  34. 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

  35. 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

  36. 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

  37. 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

  38. 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

  39. 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

  40. 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

  41. Key Issues - Discussion

  42. 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

  43. 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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