Hywel Dda Third Sector Commissioning Code of Practice for Health and Social Care and Action Plan

Transcription

1 Hywel Dda Third Sector Commissioning Code of Practice for Health and Social Care and Action Plan

2 Hywel Dda Third Sector Commissioning Code of Practice for Health and Social Care and Action Plan Introduction The Third Sector Commissioning Code of Practice for Health and Social Care and Action Plan aim to take forward the joint work on commissioning services from the third sector outlined in A Co-Designed Future: The Third Sector Role in Health and Social Care in Hywel Dda A Co-Designed Future is the work of the Third Sector Co-Design Steering Group for Hywel Dda. This group was established so that the Hywel Dda Health Board (HDHB), the three Local Authorities and the third sector County Voluntary Councils (CVCs) could work in partnership to design the future delivery of health and social care services for the area. As it states in A Co-Designed Future, the group aims to make best use of resources, open up opportunities for organisations to enter into robust contractual arrangements, and align their business planning processes to fit with the strategic direction for future health and social care provision. The Third Sector Commissioning Code of Practice and Action Plan have been produced by the Commissioning Co-Design Group, a sub-group of the Third Sector Co-Design Steering Group which comprises representatives from all partner organisations. They are intended to address the Recommendations for Commissioning contained in A Co-Designed Future, which are: 1. To develop commissioning policies and procedures in the form of a Commissioning Code of Practice (CCOP) which will complement those codes of practice developed as part of local Compact arrangements. 2. To work within each county s Health Social Care and Wellbeing framework, to understand how planning and needs analysis informs the commissioning of the third sector in each locality. 3. To take forward a three counties approach to strategic commissioning supported by local arrangements for local people and adopt the Fulfilled Lives, Supportive Communities Commissioning Framework and Guidance 2010 across Hywel Dda, linking to regional and national networks to implement the standards. It has been agreed that it also makes good sense to address the Recommendations for Charitable Funds contained in A Co-Designed Future in the Third Sector Commissioning Code of Practice and Action Plan. 1 All policy documents mentioned in this Code of Practice are referenced in Appendix 1: Drivers and Influences 2

3 Aims The aims of the Hywel Dda Third Sector Commissioning Code of Practice for Health and Social Care are to: 1. Strengthen the involvement of the third sector in commissioning processes in the Hywel Dda Health Board area at every stage of the Commissioning Cycle (See page 25 of A Co-Designed Future for details of the Commissioning Cycle). 2. Reduce barriers to third sector involvement in commissioning and procurement processes. 3. Ensure equitable access to commissioning arrangements by third sector organisations. 4. Strengthen and standardise contracting and grant agreement arrangements with third sector organisations. 5. Support and promote the establishment of a general fund, under the Hywel Dda Health Board s Charitable Funds, for the purposes of enabling third sector led, collaborative, community healthcare improvement projects. 3

4 Drivers and Influences There are a number of national and local strategic drivers which set out the direction for the third sector and identify ways in which the third sector can work with statutory organisations to influence and positively impact on outcomes for individuals. There are other national and local strategies that may not be specifically about the third sector but that nevertheless have an influence on partnership working and the third sector s role in service delivery. National and European Legislation also apply. Given the dynamic nature of this environment, drivers and influences comprise emerging as well as existing policy. The proposed Social Services (Wales) Bill 2012 is a significant example of the former. Key local and national documents are listed in Appendix 1. Principles for Commissioning Third Sector Services The principles that this Code of Practice subscribes to are based on those laid out in the Third Sector Scheme and Funding Code of Practice 2009 between the Welsh Government and the third sector. Some of these principles relate to grant funding and others to procurement exercises. 1. Delivery of strategic policy objectives acknowledgement of the role the sector can play in delivering these. 2. Respect for the sector s independence recognition that the sector can often reach groups that government agencies cannot and provides innovation. 3. Early and constructive dialogue opportunities to discuss proposals well in advance of the formal application deadline and early in the budget planning cycle. 4. Timely decisions notification of funding approvals for each financial year by 31 December of the preceding year and written confirmation following budget setting. In exceptional circumstances, where this is not possible, notice should be given of an alternative timescale. 5. Security of funding longer term commitments, subject to performance to support a sustainable approach to funding: up to 3-5 years for strategic core funding and commitment for the life of any specific projects which are funded, providing firm year one funding and clear baselines for subsequent years. 6. Fair funding levels levels of funding for the sector should be determined no differently than for other sectors. 7. Full Cost Recovery levels of funding will be based on and reflect the principles of Full Cost Recovery (See Commissioning and Procurement Processes). 4

5 8. Fair procurement third sector organisations should be allowed the freedom to determine their own price in competition (although they also need to be aware of the risks of not submitting a price based on Full Cost) 2. 9 Payment in advance provision for advance payment of funding, where a clear financial need is established. 10. Fair and reasonable treatment - prior discussion and reasonable notice before any policy changes or decisions which would lead to withdrawal or significant reduction of funding. 11. Joint approach to monitoring and evaluation - the simplest procedures consistent with ensuring proper use of public funds. 12. Who does what best commitment to identifying where the third sector might take the lead in or contribute to the implementation of new policies, and ensuring that the appropriate funding mechanisms are in place. The Commissioning Co-Design Group is committed to implementing the standards contained in Fulfilled Lives, Supportive Communities Commissioning Framework and Guidance 2010 across Hywel Dda. It is worth noting in particular: Standard 4 Commissioning Plans have been developed with partners and have involved all key stakeholders including users, carers, citizens and service providers in the statutory, private and third sectors. Standard 10 Commissioners have understood the costs of directly provided and contracted social care services and have acted in a way to promote service sustainability. It is also worth highlighting the overarching three counties Compact developed through the recommendations of A Co-Designed Future, along with the additional or more explicit principles found within the local Carmarthenshire Funding Code of Practice, namely: Consistency and coordination we are committed to seeking to join up and/or standardise funding arrangements as far as possible to minimise the burden on the third sector and ensure a focus on delivery. Transparency and accountability our relationship will be open and honest allowing informed decisions about spending priorities ensuring all sectors are involved and learn from previous work and best practice. Focus on outcomes we will ensure the achievement of outcomes is used as a key indicator of the success of a project or service as a direct result of funding. 2 Procurement and the Third Sector: Guidance for the Public Sector in Wales 2008, Value Wales 5

6 Empathy we will endeavour to understand each other s needs and requirements which should help to avoid problems and help achieve outcomes. In addition, we recognise the importance of, and need to resource, a local third sector infrastructure to underpin the third sector s co-ordinated involvement in commissioning, i.e. the CVCs All of these principles and standards are reflected in the Third Sector Commissioning Code of Practice for Health and Social Care Action Plan to follow in this document. Background to the Hywel Dda Commissioning Code of Practice for Health and Social Care Action Plan Overall outcome The overall outcome of the Hywel Dda Third Sector Commissioning Code of Practice for Health and Social Care is the commissioning of high quality third sector services that contribute to meeting citizens needs. Where we are now Consultation on the Hywel Dda Third Sector Code of Practice for Health and Social Care Three engagement events were organised by the Third Sector Health and Wellbeing Forums early in 2012 in order to identify priorities for improving local commissioning arrangements. The events were well attended by representatives from both public and third sector organisations. Exercises, based on the Commissioning Cycle stages of Analyse, Plan, Secure Services and Review 3, were undertaken and the top priorities for the whole area were identified. The results are reflected in the Third Sector Commissioning Code of Practice Action Plan below

7 Role of Third Sector Forums in Commissioning It is recognised how important the local Health and Wellbeing Forums and Networks, run by the Health and Wellbeing Facilitators on behalf of the County Voluntary Councils, are to engaging the third sector in commissioning processes. Their role as a conduit to service users, carers and communities is also highly valued. There are three Forums, one for each Local Authority area, with a total membership of around 600 groups and organisations with an interest in the health and wellbeing agenda. Each Forum meets three times per year and come together once a year as the Hywel Dda Third Sector Health and Social Care Network. Although the third sector Health and Wellbeing Forums have good links with public sector organisations, it is recognised that there is potential for stronger links between the Forums and commissioners. This is in particular the case at the earlier stages of commissioning involving needs analysis and service design. Planned and consistent input from commissioners to the Forums is seen by third sector organisations as the single most significant element for strengthening commissioning relationships between statutory organisations and the third sector. There are also specialist third sector networks and forums, for example the Carmarthenshire Carers Third Sector Providers Forum, the Ceredigion Carers Alliance and the Mental Health Forum facilitated by the West Wales Action for Mental Health. In addition, it is planned in the near future to develop electronic third sector focus groups in each county that will align with the emerging Clinical Programme Groups. Developing a clear picture of all the health and social care third sector networks and forums in the area and their relationship to planning structures is included in the Third Sector Commissioning Code of Practice Action Plan. Service Level Agreement (SLA) and Contract Review As highlighted in A Co-Designed Future, a review was undertaken in 2011 of contracts and SLAs between local statutory organisations and the third sector. Although it is acknowledged that the review may not have been complete, it was identified that: HDHB currently commissions 38 third sector services from 21 organisations for adults and older people at an annual cost of around 1.5 million. The three Local Authorities commission a range of third sector services for the same groups at an annual cost of approximately 1.2 million. 7

8 HDHB and the Local Authorities commission adult mental health services from the third sector across the three counties amounting to almost 1.5 million, including statutory and joint funding drawn from the Welsh Government such as the Local Mental Health Grant Scheme. The HDHB has stated its intention to increase the number of services that it commissions from the third sector. Commissioning and Procurement Processes One of the aims of the Commissioning Co-Design Group is to standardise commissioning and procurement processes and documentation across different authorities and different areas of commissioning in line with the standards contained in Fulfilled Lives-Supportive Communities Commissioning Framework and Guidance This will lead to greater efficiency as well as making commissioning processes more accessible. Although this work has begun, it is agreed that there is still much to do. The need for greater consistency, openness and transparency in commissioning arrangements was a key message from the consultation undertaken with the third sector at the beginning of the year, as was the need for more third sector friendly/aware processes. HDHB aims to work with Local Authority partners to clarify and update the governance requirements in its contracts with third sector organisations in order to reflect legislative and policy developments. These include: Standards for Health Services in Wales 2010 and the "How to Guide" for Third Sector Organisations. Public Sector bodies in Wales will work with the Health and Wellbeing Facilitators to clarify the level of adoption required and to promote the standards to the third sector. Welsh Language Scheme Third Sector providers are required and supported to provide a service for patients/customers in the language of choice in accordance with the Welsh Language Scheme. Public Sector bodies are obliged under Section 14 of the Welsh Language Act 1993 to prepare and implement a Welsh Language Scheme, which sets out how the Public Sector bodies will deliver its services bilingually. Good bilingual practice is an essential part of quality care and clinical safety It is therefore important to ensure that due regard is given to the linguistic needs of Welsh speakers, and provide patients/customers with a service in the language of their choice as far as is practicable. Equality and Diversity We will work with relevant third sector bodies towards achieving our stated Equality, Diversity and Human Rights Objectives. 8

9 Safeguarding We will work with Third Sector organisations in conjunction with local Safeguarding arrangements to support awareness of and compliance with safeguarding policies and procedures. Putting Things Right in the NHS relating to issues and complaints. These arrangements came into force in April 2011 and describe the consistent process and approach applicable for all Health Boards in the Country. They apply to any agency with whom the Health Board has a contract to provide a service, it re-emphasises and relies upon the importance of Being Open in the relationship with clients and staff. There will also be a need to adhere to respective Local Authority procedures where joint contracts are in place. Full Cost Recovery In line with the Compact Code of Practice on Funding, that when third sector organisations apply for grant funding they can include appropriate and relevant overheads. In the case of Charities, and as advised by the Charity Commission 4, they should plan to recover their costs in full where a public authority is purchasing a service from them, unless the charity has good reasons for deciding to forego the full cost of recovery. Charitable Funds Support for Life Based on the recommendations on HDHB Charitable Funds contained in A Co- Designed Future, considerable progress has been made to establish a Small Grants Scheme under the Charitable Funds brand of Support for Life. Its aim is to support strategic objectives to design services that encourage more self-care, provide anticipatory care and shift the balance from secondary care to more locally based care. The grant scheme is open to voluntary, community and socially oriented organisations including social enterprises that will support initiatives which can deliver on one or more of the key themes of: Care Closer to Home, Investing in Prevention Reducing Lifestyle Related Illnesses Sustainability, innovation and the degree to which grant funded projects might be scaled up form part of the criterion for support. It is envisaged that the County Voluntary Councils will act in a grant administration capacity and that the Local Health and Social Care boards will score applications and make recommendation for grant support or not to Hywel Dda Charitable Funds Committee. A draft application form for potential applicants is attached as Appendix 2. 4 Charities and Public Service Delivery Charity Commission 9

10 Trends and future considerations Community Care Future forecasts suggest that statutory services will have to look increasingly to noninstitutional ways of working to prevent people from being admitted to hospital and to supporting them in their own home. An example of this is the virtual ward being taken forward in the Hywel Dda area by the Locality Teams. Key to its success are stronger links between Locality Teams and third sector organisations and a greater understanding of the role third sector organisations can play in preventing hospital admission and maintaining people in the community. Consideration will therefore need to be given to extending the role of third sector brokers, currently available in Pembrokeshire, in order to strengthen the links between statutory services and the third sector and identify where there are gaps in service provision. Regional working The need for greater regional working is high on the agenda of the Welsh Public sector. Consideration will therefore have to be given to the implications for commissioning more third sector services on a regional basis. Third sector collaboration There has been a growing interest in collaborative working among third sector organisations in recent years, in addition to advice and guidance. 5. This trend is driven both by increased pressure to achieve value for money and efficiency and by the belief that shared working can achieve more effective or joined up services. This is an agenda that commissioners could help to influence where it felt that more integrated third sector delivery was the best way of achieving outcomes for citizens. Tendering and Support for local third sector organisations Some third sector organisations are already well placed to deliver public sector contracts and have done so for many years. Other organisations will need greater support in order to be a in a position to tender for service contracts. The role of the local County Voluntary Councils in providing a range of capacity and development building services will be key to preparing more third sector organisations for tendering

11 Co-production There is also a growing debate about the principles of co-production, which was one of the work streams taken forward by Fulfilled Lives-Supportive Communities in The co-production model recognises that service users and communities can work in partnership with professionals, to redesign services so that they are more responsive to needs or even reshape the relationship between public bodies, citizens and communities. It also understands the added value that third sector organisations can bring to service delivery. This includes specialist knowledge and expertise; a not for dividend ethos that allows it to invest any profit into the organisation; the ability to mobilise citizens and communities; and to recruit large numbers of volunteers. If statutory organisations wish to identify and find the best solutions to local issues, they will have to increasingly consider how to enlist citizens, communities and third sector organisations as co-producers. Social Investment Bonds Wales Council for Voluntary Action has set up a Social Investment Bonds initiative (Welsh Wellbeing Bonds), to provide statutory organisations with low risk opportunities to invest in third sector services based on the achievement of better outcomes for citizens. The Co-Design Commissioning group and the CVCs will explore the relevance of Welsh Wellbeing Bonds to Hywel Dda together. Partners Strong partnership working has been achieved in relation to this agenda through the Co-Design Commissioning Group. Members include: Hywel Dda Health Board Carmarthenshire, Ceredigion and Pembrokshire Local Authorities Carmarthenshire, Ceredigion and Pembrokeshire County Voluntary Councils It is recognised that there is a need to identify any gaps in membership in order to achieve a more integrated partnership approach to commissioning health and social care third sector services. It is also intended that more commissioners will make use of the Co-Design Commissioning Group and the Third Sector Commissioning Code of Practice as reference points for live commissioning processes. This in turn will help to embed consistent practice across organisations. 11

12 Priorities to achieve the overall outcome On the basis of the partnership working and progress that has been made to date and the results of the consultation exercise undertaken by the Forums in February 2012, the priority themes that will be addressed in the Action Plan are: 1. A stronger role for the Third Sector Health and Wellbeing Forums in relation to commissioning 2. Improved commissioning and procurement processes, including more simplification, streamlining and standardisation across the board 3. The implementation of the Charitable Funds Small Grants Scheme, Support for Life 4. A better understanding by the public sector of third sector services and their potential to deliver services The Action Plan is structured around the key stages of the Commissioning Cycle (Analyse, Plan, Secure Services and Review), and the priority themes. How we will know if the action plan is working The overarching indicator will be the percentage of service users and communities that are satisfied with services commissioned from the third sector. Other indicators might include: The amount/proportion of services the third sector is commissioned to deliver will increase % third sector networks and forums attended by commissioners will increase (Data Development Agenda ) The number of Commissioning plans the third sector is consulted on will increase (Data Development Agenda ) % third sector organisations that report positive experience of commissioning will increase (Data Development Agenda ) Baselines Baselines will have to be established for most of the indicators, as denoted by Data Development Agenda above. This will take place within year one by identified leads. 12

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14 Hywel Dda Third Sector Commissioning Code of Practice for Health and Social Care Action Plan Key: CDCG=Co-Design Commissioning Group; HWF= Health and Wellbeing Facilitators; CCOP=Commissioning Code of Practice; CVCs= County Voluntary Councils; WCVA=Wales Council for Voluntary Action; HDHB=Hywel Dda Health Board ANALYSE STAGE including: managing the commissioning process, service mapping and resource analysis, needs analysis, service design Actions - In order to deliver the overall outcome, the following actions will be taken: Lead Deadline Re-emphasise and formalise the need to make the CVCs the point of access to the local third sector, CDCG 2012 e.g. to seek representation for strategic working and consult on policy and strategy Make consistent use of the Health and Wellbeing Forums to consult on needs analyses and service design and to ensure that the voice of service users is heard CDCG 2012 programme Map all local third sector networks and forums and their relationships to planning structures HWFs 2012 Assess whether there are any gaps in the membership of the CDCG and address as required CDCG 2012 Produce a commissioning schedule to share in advance with third sector Forums CDCG 2012 Produce a programme of Forum and Network meetings to share with commissioners in order to schedule their contributions in advance and increase their involvement in the Forums HWFs 2012 programme Gather together Expressions of Interest from third sector organisations on which services they might be interested in delivering in the future for identified priorities. Use this information to help to inform future planning including the promotion of collaborative working Raise profile of NHS Direct with local third sector and encourage as many to update entries as possible Promote the use of NHS Direct within HDHB as a means of accessing information on third sector services Map third sector provision to the emerging Clinical Service Programme Groups and ensure third sector involvement in the Groups PL 2012 with HWFs HWFs 2012 PL 2012 PL HWFs

15 Establish third sector brokers in each area to ensure links between public and third sectors PL? Clarify the process or mechanism whereby the opportunities for the third sector to deliver more NHS CDCG 2012 services will be consistently identified, e.g., through Strategic Planning Groups Identify an opportunity to pilot a collaboration amongst third sector organisations, which would be promoted and supported through the Health and Wellbeing Forums CDCG/ HWFs 2012 Explore the potential application of Wellbeing Bonds in Hwyel Dda with WCVA CDCG/HWFs? Make use of an outcomes based framework such as Results Based Accountability CDCG PLAN STAGE including: producing a commissioning plan, producing a procurement plan, service specifications Actions - In order to deliver the overall outcome, the following actions will be taken: Lead Deadline Make consistent use of the Health and Wellbeing Forums to consult on commissioning plans Support third sector organisations to explore collaborative working HWFs Produce outcomes based service specification that include consideration of community benefits the third sector can offer, such as volunteering CDCG SECURE SERVICES STAGE including: advertising, pre-qualification, tender/application process, contract agreement and payment terms, evaluation and clarification of tenders and applications, award of contract or agreement, market development and capacity building Actions - In order to deliver the overall outcome, the following actions will be taken: Lead Deadline Consolidate and implement the Charitable Funds Small Grants Scheme, Support for Life, based on HDHB 2012 good practice in small grant management Clarify and develop the role of the Health and Wellbeing Forums/HWFs in relation to publicising and HWFs promoting funding and contract opportunities Provide as much notice as possible of forthcoming funding and contracting opportunities and publish CDCG the timetable for each opportunity before the formal process begins Make use of standardised and consistent documentation, including: CDCG

16 - A simplified pre-qualification questionnaire - Ensuring documentation is clear with a minimum of jargon Have clear and straightforward payment terms; and be prepared to provide payments in advance to third sector organisations in recognition of the pressure that retrospective payments put on their cash flow Provide feedback to organisations on request on their funding applications and bids CDCG Encourage third sector organisations to register on sell2wales HWFs Each newsletter and e-bulletin Clarify and develop the role of the Health and Wellbeing Forums/HWFs in relation to increasing the HWFs knowledge and skills of third sector organisations to undertake tendering and manage contracts Establish an annual service-focussed event to minimise duplication and promote collaboration HWF/ CDCG 1 in 2012 amongst local third sector organisations Encourage third sector organisations to share their business plans (including proposed funding bids) HWFs/CDCG with statutory partners in order to support a shared strategic direction Work with the HWFs to arrange Meet the Buyer events through the Forums (and possibly in partnership with the Supplier Development Service) CDCG/HWFs? REVIEW STAGE including: contract and performance monitoring, evaluation and review Actions - In order to deliver the overall outcome, the following actions will be taken: Lead Deadline Update contract and performance management arrangements in line with policy requirements CDCG 2012 Make use of the Forums to prepare third sector organisations for new SLA/contracting requirements, HWFs including use of the Standards for Health Have monitoring that is proportionate to the level of funding and the risk involved CDCG Ensure that service user and carer feedback is included in service evaluation CDCG Make consistent use of the Health and Wellbeing Forums to undertake strategic review of services CDCG 16

17 Financial implications of the Action Plan Most of the Plan will be delivered on the basis of current capacity. However, given the strengthened role of the Third Sector Forums that is proposed and greater alignment with commissioning processes, it will be necessary to identify additional funding for Forum events. This would also provide consistency in funding across the County Voluntary Councils. Monitoring and Review Progress against the Action Plan and performance measures will be overseen by the Commissioning Co-Design Group and reported to the Third Sector Co-Design Steering Group. Reports will also be made via the local Compact arrangements as required. 17

18 Appendix 1: Drivers and Influences Key local drivers and influences A Co-Designed Future: The Third Sector Role in Health and Social Care in Hywel Dda 2011, including the Commissioning Co-Design Group and the Review of Third Sector SLAs and contracts with Hwyel Dda Health Board and Local Authorities. Carmarthenshire Tri-Partite Compact and Carmarthenshire Compact Funding Code of Practice Overarching Third Sector Compact (draft) Hywel Dda Health Board Clinical Services Strategy Health Social Care and Wellbeing Strategies Carmarthenshire Integrated Community Strategy tegy pdf Bywyd Da Health, Social Care and Wellbeing Strategy for Ceredigion Health Challenge Pembrokeshire Health_Social_Care_and_Well_Being_Strategy_% pdf Hywel Dda Health Board Welsh Language Scheme Key national drivers and Influences include: 18

19 Designed to Add Value a third dimension for one Wales 2008 Welsh Government rqttddpbq9b1jrjvmz7hl1lhvjcvfx! ?lang=en Procurement and the Third Sector: Guidance for the Public Sector in Wales Fulfilled Lives, Supportive Communities Commissioning Framework and Guidance Bridging the Gap: addressing the gap to fully utilise the third sector contribution in the management of complex care 2011 National Continuing NHS Healthcare Programme Third Sector Scheme and Funding Code of Practice 2009 Welsh Government Helping you to use "Doing Well Doing Better, the Standards for Health Services in Wales 2010": a "How to Guide" for Third Sector Organisations The Welsh Government s Legislative Programme including consideration of a Statutory Third Sector Compacts Bill. Sustainable Social Services for Wales: a Framework for Action zj2sr2wtp22lk2zly2bvwqyj! ?lang=en Shared purpose, Shared Delivery 2012 Welsh Government consultation on new statutory guidance which is intended to integrate local service planning, streamline partnership working, and strengthen the strategic role and accountability of the Local Service Board. Social Services (Wales) Bill, the consultation for which ended on zj2sr2wtp22lk2zly2bvwqyj! ?lang=en 19