The Committee considered a report of the Director of Adults and Communities which provided an update and recommendation for the re-procurement of home care services, post November 2020. A copy of the report marked ‘Agenda Item 9’ is filed with these minutes.
In his introduction to the report, the Director explained there had been some revisions made to the milestones tabled in paragraph 44 of the report; additional flexibility had been built into the procurement and implementation dates to ensure that preparations were fully robust and tested. There had also been changes to the NHS CCGs (Clinical Commissioning Groups) governance, which had now been factored in.
A revised table of milestones would be circulated to members of the Committee after the meeting for information.
The Cabinet Lead Member for Adults and Communities, Mr. R. Blunt CC, confirmed his support for the service proposals and said that due to the nature of the service, there would always be a significant level of risk. However, it was pleasing to see that every effort was being made to learn from past experiences and find pragmatic solutions to design a new and improved service. He was hopeful that the future service would be successful.
Arising from discussion and questions, the following points arose:
i) The Committee was pleased to note that consideration was being given to carers receiving the appropriate remuneration for non-contact time such as travel. Discussions would be held with providers to determine sustainability in this regard. The Department was in consultation with the Council’s Internal Audit Team to determine how the remuneration could be effectively measured and monitored.
ii) It was anticipated that a level of stabilisation would be required between each phase of the implementation period. The actual phasing and level of stabilisation required would be determined following the procurement, using a risk-based approach dependent on the number of existing providers bidding successfully for the new contract or exiting the market. The Committee supported the phased approach to implementation.
iii) Members welcomed the introduction of four pricing levels (urban, fringe, rural and isolated) for the new service, which had been developed following a comprehensive benchmarking analysis. The Department had brought in an independent consultancy company called Care Analytics, which specialised in cost and pricing models for care and support services and had undertaken the same exercise in several areas of the Country. A substantial amount of work with existing providers had been completed as part of the benchmarking process.
iv) The new Home Care Service contract would provide for the joint commissioning of services between the Council and the NHS, which was expected to align better future costs for core home care services where there had previously been disparity. However, there would still be elements of provision, such as the development or establishment of specialist services, which may need to be separately undertaken.
v) Provider performance would continue to be managed under existing processes. The Department’s Quality Improvement Team monitored and worked closely with providers especially where there were performance issues. Flexibility had been built in to the new service agreement so that other providers could be brought in to meet capacity requirements if a provider contract could no longer be sustained, for example due to consistent underperformance. Providers could move between “prime” or “supplementary” status depending on the quality of their service.
vi) It was expected that all providers would have the ability to take on “high dependency” service users as required. Support and training would continue to be available to providers from the Council wherever necessary.
vii) Members felt assured that lessons learnt from the previous procurement were being used to strengthen and shape future plans and practices. The Committee commended officers on what it felt was an excellent report and confirmed its support for the service proposals.
That a revised timetable of milestones be
circulated to Committee members for information;
That the update on the Home Care service
proposals be noted as part of the forthcoming re-procurement;
c) That the Committee’s comments on the Home Care service proposals be submitted to the Cabinet for consideration.