2. SCP CONSULT Alice needs Nursing care …….please assess! Alice needs Day Cay……please assess! Alice needs Sheltered Housing ……please assess! Alice needs Extra Care ……please assess! Commissioning An outcome based assessment done within the framework of an Outcome focused joint commissioning framework…… I think not…… However for many Older People….prescriptive referrals or prescriptive assessments are the norm…will a new style of commissioning improve this ….doubtful

3. SCP CONSULT The need to develop a strategic commissioning framework across all partners, to ensure the right balance between prevention, meeting low-level needs and providing intensive care and support for those with high-level complex needs is very clear Local partners will need to work together to promote and ensure a strategic balance of investment in local services for: the general population, aimed at promoting health and social inclusion; ● people with emerging needs, to provide support to enable them to maintain their independence; and ● those with high-level complex needs, to provide intensive care and support. Local partners will need to recognise the diversity of their local population and ensure that there is a range of services, which meet the needs of all members of the local community.

4. SCP CONSULT What are the possible benefits of integrated commissioning Workforce Development Demand Forecasting High Cost- Low Volume work Developing better commissioning practice skills Better use of existing resources

5. SCP CONSULT The Role of The Commissioner Has to be Active!!! Understand the market Create a viable market Make the most of what is there

6. SCP CONSULT Issues for consideration 1./Changes in Commissioning 2./ Local Area Agreements 3./ Changing Role of Community Hospitals/Extra Care Schemes/day Centres 4./ Changing Market

7. SCP CONSULT Issues for consideration 1./ Changes in Commissioning Introduction by P.C.T.s of Practice Based Commissioning Changing Role of P.C.T. Move to regional commissioning Issues of Choice, how will Direct Payments/Individual Budgets impact on Commissioning Well being agenda… Local Authorities trying to reconcile this with FACs criteria Continued development of joint commissioning arrangements?? Continued development of Extra Care Impact of Telecare Solutions

8. SCP CONSULT Issues for consideration 1./ Changes in Commissioning 2./ Local Area Agreements The LAA Prospectus, published in July 2004, sets out the Government's LAA key objectives: improving central/local relations improving service delivery improving efficiency improving partnership working enable Local Authorities to provide better leadership. LAAs will be structured around four themes: Children and young people Safer and stronger communities Healthier communities and older people Economic development and enterprise

9. SCP CONSULT Issues for consideration 1./ Changes in Commissioning 2./ Local Area Agreements 3./ Changing Role of Community Hospitals/Extra Care Schemes/day Centres A feature of the White Paper is the development of ‘service hubs ’ – Health & Social Care Campuses- Existing centres that can be re- defined and developed to play a greater role in supporting the local community Linking these ‘Hubs’ to new technology as well as existing services to provide tele-care solutions for the local communities

10. SCP CONSULT Issues for consideration 1./ Changes in Commissioning 2./ Local Area Agreements 3./ Changing Role of Community Hospitals/Extra Care Schemes/day Centres 4./ Changes in the Market Consolidation of Residential & Nursing care sector by large multi- national organisations Smaller organisations will increasingly need to specialise to be able to stay in market Impact of ‘Choice’ –direct payments/individual budgets Impact of Telecare Solutions Health & Social Care will need to develop much higher commissioning skills to ensure they are able to manage the growing complexity of the market. Changing demographics and expectations To cope with some commissioning issues, e.g. high cost- low volume it may be more effective to do so on a regional basis

11. SCP CONSULT Any Questions or Contributions?