Date 24/01/12. Date 24/01/12. Date 24/01/12. Date. Date. Date 30 January Date 24/01/12. Date 24/01/12. Kate Kennally. Date 6/02/12.

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1 DELEGATED POWERS REPORT NO. SUBJECT: Care Pathway Modelling and Invest to Save Intervention Design across Health and Social Care Services Dementia Care and Stroke Discharge Control sheet All reports 1. Governance Service receive draft report Name of GSO Chidilim Agada 2. Governance Service cleared draft report as being constitutionally appropriate 3. Finance clearance obtained (report author to complete) 4. Staff and other resources issues clearance obtained (report author to complete) 5. Trade Union response received (Staffing issues only) 6. Legal clearance obtained from (report author to complete) 7. Policy & Partnerships clearance obtained (report author to complete) 8. Equalities & Diversity clearance obtained (report author to complete) 9. The above process has been checked and verified by Director, Head of Service or Deputy (report author to complete) 10. Signed & dated report, scanned or hard copy received by Governance Services for publishing Name of GSO Chidilim Agada Name of Fin. officer Kerry Ann-Smith Name of Res. officer Date Name of TU rep. Date Name of Legal officer Not applicable Not applicable Steven Krempel Date 30 January 2011 Name of P&P officer Andrew Nathan Name of officer Julie Pal Name Kate Kennally Date 6/02/12 Name of GSO Date 7/11/12 Chidilim Agada 11. Report published by Gov Services to website Name of GSO Chidilim Agada Officer reports: 12. Head of Service informed report is published and can be implemented. Date 7/11/12 Name of GSO Date 1536 Chidilim Agada 7/11/12 Cabinet Member reports: 13. Expiry of call-in period Date Not applicable 14. Report circulated for call-in purposes to COSC Name of GSO Not applicable members & copied to Cabinet & Head of Service Date 1

2 ACTION TAKEN BY CABINET MEMBER(S) UNDER DELEGATED POWERS (EXECUTIVE FUNCTION) Subject Cabinet Member(s) Care Pathway Modelling and Invest to Save Intervention Design across Health and Social Care Services Dementia Care and Stroke Discharge Cabinet Member for Adults Date of decision 6 February 2012 Date decision comes into effect Summary Officer Contributors Status (public or exempt) Wards affected Enclosures Reason for exemption from call-in (if appropriate) 6 February 2012 This report recommends contract award following a competitive process for specialist consultancy to model the dementia and stroke discharge care pathways across health and social care in Barnet to support integration and efficiency targets. Eryl Davies: Head of Strategic Commissioning and Supply Management Public (with separate exempt report) All None Not Applicable Contact for further information: Ceri Jacob Associate Joint Director for Commissioning Ceri.jacobs@barnet.gov.uk Serial No:

3 1. RELEVANT PREVIOUS DECISIONS 1.1 Cabinet Resources Committee, 2 March 2011 (Decision item 7) approved criteria for the allocation of funds pursuant to Section 256 of the NHS Act On 24 August 2011 the Cabinet Member for Adults approved under delegated powers (DPR 1403) the procurement of specialist consultancy in connection with Care Pathway Modelling and Invest to Save Intervention Design Dementia Care and Stroke Discharge for a period of up to 6 months through the Buying Solutions Framework Agreement, to commence as soon as possible. 2. CORPORATE PRIORITIES AND POLICY CONSIDERATIONS 2.1 This project supports the corporate plan priority of Better Services with Less Money - integrating health and social care to promote better outcomes, increase independence and reduce bureaucracy. The specialist consultancy resource will be deployed to meet the requirements of the invest-to-save business case for change which supports the development of integration between health and social care which in turn supports the achievement of system wide efficiencies. 2.2 The product to be achieved through this procurement will help to deliver the Council s corporate objective to work seamlessly with partners, which will require us to better coordinate our work and exploit the efficiencies and benefits of joint working. 3. RISK MANAGEMENT ISSUES 3.1 There is a risk that the business case will not be achieved and approved in time to support a joined up investment plan for the areas of stroke and dementia and an associated loss of funds from the Section 256 funding envelope for 2012/13. This will be mitigated by robust project controls and contract management within Adult Social Care and Health which ensures delivery of final product. 3.2 There is a risk that if the joined up investment plan for stroke and dementia is not achieved the Council Medium Term Financial Strategy and the NHS North Central London Cluster (NCL) Barnet s Quality, Innovation, Prevention and Productivity (QIPP) plans will not achieve the savings anticipated as part of this investment. This will be mitigated through management of the risk identified in point EQUALITIES AND DIVERSITY ISSUES 4.1 The contract for the new services will include explicit requirements fully covering the council s duties under the Equality Act 2010 and requiring the contractor to comply with this legislation. 3

4 4.2 The contractor will be required to give consideration to the potential impact of any proposals on the protected groups pursuant to the Equality Act This general duty requires public authorities, in the exercise of their functions to have due regard to the need to: (a) eliminate discrimination, harassment, victimisation and any other conduct prohibited by the Act; (b) advance equality of opportunity between different groups; and (c) foster good relations between different groups. Equalities analysis will be completed within the context of the partnership with Health and be addressed through the Health and Well Being Board (HWBB). 5. USE OF RESOURCES IMPLICATIONS (Finance, Procurement, Performance & Value for Money, Staffing, IT, Property, Sustainability) 5.1 The amount allocated for this procurement was up to a maximum of 400,000 funded by the Section 256 money in the Adults Social Care and Health budget and agreed by the HWBB. The project will be delivered through a three stage process with defined results required at each stage leading to the production of an overall business case, design for an ideal care pathway, all associated costings and a route map for implementation. This will be used to create a sound and robust case for any further investment from the Section 256 funds which relates to the improvement of the dementia and stroke care pathways. 5.2 The tender process for this project was conducted through Buying Solutions, operated by the Government Procurement Service, a national procurement partner for all UK public services and part of the Efficiency and Reform Group within the Cabinet Office. The role of Buying Solutions is to maximise the value for money obtained by Government Departments and other public bodies through the procurement and supply of goods and services. This allows public sector organisations to save time and money and enables a solution for consultancy to be procured within a short timescale. 5.3 Framework agreements are referenced under paragraphs to of the Council s Contract Procedure Rules (CPR s), as set out below: Before procuring or entering into a framework agreement, the Commercial Director shall be satisfied that: the term of the arrangement shall be or is for a period of no longer than four years duration; the terms and conditions of the arrangement do not compromise the Council s contractual requirements; the parties to the arrangement are recognised public bodies or providers from the private sector; full, open and proper competition in respect of the creation of the framework agreement has taken or will take place in accordance with the Relevant EU Rules and/or Relevant Contract Procedure Rules Preference should be given to use of any Government Procurement schemes e.g. OGC. 5.4 The Commercial Director has given his consent to undertake the competition within the Buying Solutions framework 4

5 5.5 There are no IT, staffing, property or sustainability issues. 6. LEGAL ISSUES 6.1 The NHS Act 2006 provides a legal framework enabling NHS bodies and local authorities to work together through delegation of functions, grant arrangements and flexibilities such as pooled budgets. 6.2 Section 256 of the NHS Act 2006 is the enabling power for a PCT to make payments to a local authority towards expenditure incurred or to be incurred by the authority on community services. The contract with Pricewaterhouse Cooper LLP is being funded under a Section 256 funding arrangement. The agreement of the transfer of social care allocations from NHS Barnet to the Council is set out in paragraph 9.4 of the Cabinet Resources Committee report dated 2 March Procurement processes must comply with the European procurement rules and the Treaty obligations of transparency, equality of treatment and non discrimination as well as the CPR s. 6.4 A framework is an agreement between a client and a contractor or contractors or consultant or consultants (depending upon the nature of the framework), the purpose of which is to establish the terms governing particular call-off contracts that may be awarded during the term of the framework, in particular with regard to price and quantity. The advantage of establishing framework agreements is that as long as the original framework agreement has been advertised and let in accordance with the EU procurement rules, there is no requirement to advertise any subsequent call-off contracts let under the framework agreement even where those call-off contracts exceed the stipulated financial threshold for works and services. 6.5 As outlined in paragraph 5.3 above, framework agreements are referenced under paragraphs to of the CPR s. 7. CONSTITUTIONAL POWERS 7.1 Paragraph 3.3 of Part 3 of the Constitution (Responsibility for Functions) enables Cabinet Members to discharge the executive functions that fall within their portfolio, and to accept tenders in accordance with the Contract Procedure Rules (CPR s). 7.2 Under the Contract Procedure Rules, Table 5-1, where the contract value is between 156,422 and 499,999, acceptance of a tender or quotation where the tender is the lowest price may be made by Director/Head of Service or by Cabinet Member where the tender represents value for money and is the best available option for the Council. 8 BACKGROUND INFORMATION Context 5

6 8.1.1 To help support the development of integrated care between health and social care, both strategically and in terms of operational change and delivery, central government is making available significant monies for social care through the NHS. For Barnet in , this is an allocation of 3.9million Whilst some of this resource will be used to help offset pressures arising from care closer to home, Adult Social Care and Health is significantly investing in a range of projects to strengthen enablement, rehabilitation and early intervention In February 2011 a high level spending plan against these funds and the separate NHS Enablement allocation was agreed by NHS Barnet and LBB. In May 2011 the HWBB endorsed the decision. Ongoing oversight and direction of this joint working will be provided by the HWBB. Service Purpose The Council and NHS Barnet are seeking to commission a consultancy provider, for a period of six months, with proven actuarial skills and national and international knowledge of stroke and dementia practices, to map the ideal care pathway for people with dementia and the ideal care pathway for stroke discharge patients across both health and social care services in Barnet. The commissioned provider will be required to work with the local Barnet Dementia Steering Group and Barnet Stroke Action Group comprising local clinicians, front line team managers, providers, service users, carers and commissioners in order to develop an ideal dementia care pathway and stroke discharge pathway for Barnet The consultant will be required to identify where changes to the pathways should be made to generate the greatest invest-to-save benefits across health and social care services in Barnet. The consultants financial modelling system will need to anticipate changing demands on these services as a result of Barnet s changing demographic and the impact that this will have on patterns of service use within the borough The provider will be required to provide robust evidence to support the business cases for change including a clear cost/benefit analysis for each of their proposed invest-to-save interventions. They will need to clearly indicate where and when the savings will be achieved both cumulatively and for individual stakeholders. Process The Service Specification and Invitation to Quote documents were uploaded on 22 November 2011 to the Multi-Disciplinary Consultancy Framework Section of the Buying Solutions website and a mini quotation process was undertaken via the Buying Solutions portal. Tender Evaluation: Six tenders were received by the closing date. The six organisations were assessed for quality and price, with weighting attached to each area as shown in the table below. The overall weightings of 80% and 20% for Project 6

7 Approach and Price are those specified by Buying Solutions for procurements from the Multi-Disciplinary Consultancy Framework. A Project Proposal 80% A1-2 Proposed Approach A3 Business Case Development A4 Stakeholder Engagement A5 Data Requirements A6 Implementation Plan 20% 15% 15% 15% 15% B Price 20% The tenderers were required to submit a number of detailed method statements to demonstrate: their approach to mapping, modelling and developing invest-to-save intervention models; their understanding of working with dementia and stroke services; international and national best practise; national policy; their proposed methodology to build a robust business case; their proposed approach to effective stakeholder engagement ; their understanding of data requirements and methodology of using data in mapping and modelling; timescales and details of implementation; and their pricing schedule The tenders were scored by a panel, which was comprised of the core tender group. Following individual marking by each panellist, the Tender Panel had a final meeting to moderate scores and to agree the preferred tenderer. The results of the evaluation were as follows: A B - PWC C D E Project Proposal Total Proposed Approach Business Case Development Stakeholder Engagement Data Requirements Implementation Plan Tenderers were asked to submit a pricing schedule showing their overall price and a break down of the prices for the individual outputs for the following elements a) Mapping the current dementia and stroke discharge pathways b) Development of the ideal dementia and stroke rehabilitation pathways in Barnet c) Cost benefit analysis of potential interventions and the development of business cases for change d) Implementation route map for the development of the ideal future pathways for stroke discharge and dementia Price 7 Total F Possible

8 The total tender prices submitted were as follows: A B (PWC) C D E F Total Price 164, , , , , , Details of Companies A B C D E and F are shown in the exempt report. B, PricewaterhouseCooper (PWC), was significantly more expensive than the lowest priced tender, but scored the highest points by a reasonable margin and their bid is considered to represent best value for money. The panel are aware that B (PWC) are more expensive than the other bids, however the quality of their bid is considerably greater than other quotes, indicated by the company achieving the highest score in four of the five qualitative project proposal areas. PWC were clearly ahead of all the other tenders in the Project Proposal assessment, approximately 22% ahead of the lowest scoring company ( A) and approximately 5% ahead of F, the second highest scoring bid PricewaterhouseCooper s key strengths include: their proposed methodology for re-designing Barnet s stroke and dementia pathways, their strong business case development and their approach to stakeholder engagement. 9. LIST OF BACKGROUND PAPERS 9.1 Tender specification 9.2 Any person wishing to inspect the background papers listed above should telephone, Caroline Chant Joint Commissioner Older Adults, DECISION OF THE CABINET MEMBER(S) I authorise the following action: 10.1 That PricewaterhouseCooper (PWC) be awarded the contract to model the dementia and stroke discharge care pathways across health and social care in Barnet, for a period of six months. Signed Councillor Daniel Thomas Cabinet Member for Resources and Performance (on behalf of Cabinet Member for Adults) Date 6/02/12 8