Presentation on theme: "NDIS & LEARNING FROM THE UK EXPERIENCE OF PERSONALISATION:"— Presentation transcript:
1 NDIS & LEARNING FROM THE UK EXPERIENCE OF PERSONALISATION: A PROVIDER PERSPECTIVEPeter Gianfrancesco
2 Overview About me The UK & ‘Personalisation’ How we prepared What we didInsights arising from our experienceLessons for NDIS providersMy emphasis is on the long term view of market engagementA provider emphasis and focus
3 Personal & Organisational RESPONSES Emotional (Fear, Apprehension, Excitement)Cognitive (what does this mean for me / us)Attitudinal (am I/we for or against, do I need to defend)Cultural (how do I/we need to be different, barriers)Strategic (how does this fit with everything else)Operational (how do I/we do it)Reflective (how are we doing, should I/we sustain the effort, change)
4 The International Picture Providing care through a model of regulated brokerage and personal purchasing is not new:Examples can be found in ENGLAND, USA, BELGIUM, SCOTLAND and may or may not be limited to disability care. The private insurance and/or managed care model also fits into this contextThe best current comparator is the UK Personalisation Model as it has a uniquely disability focus and is national in its scope
5 In ALL OF THE models, it is the provider response and not the regulation that will determine the success of the model
6 The greatest risk to ALL models is if providers withdraw from or fail in supply OR if the provider market changes too quickly
7 The Evolution of a Model RegulatorProviderConsumerPhase 1: ImplementationHelpfulStimulates Provider MarketSupports existing providersOptimal inclusivenessOptimal generosity re TariffSeparation of FundingAnxiousShort Term FocusCollaborativeRe-engineers existing servicesProducts emerge from existing capabilityWorkforce modificationConfusedWants more of the sameChooses familiar supplierPhase 2:EmbeddingLess Market InvolvementSupport for struggling providersIntegration of FundingLess inclusiveSees a way to make it workLoss of other funding sourcesStarts to subsidise careMore competitionEmerging product innovationNew PartnershipsEmerging new providersEmerging new workforceReassuredStarts to exercise influenceProvider swappingStill choosing traditional carePhase 3:Market MaturationLess HelpfulMarket DrivenTariff adjustment as budgetary controlModel has shaped provider cultureIncreasingly innovative productsCompetitive MarketNon MH providersProviders compete on added valueNew workforceDiscerningMore recovery orientatedExpects more
9 PERSONALISATION – THE ENGLISH EXPERIENCE A national policy approach with strong political supportImplementation devolved to 250+ UnitaryAuthoritiesIntroduced on a national scale 5 years agoTariffs and products (regulation) determined locally (with some exceptions) or by providerConsumers ‘hold’ the budget (reality is different) or get a ‘notional’ budgetBrilliant when it is allowed to be used creatively (the Lathe example)It has not worked that well in mental healthBeing used to drive price down and eligibility upImplemented at a time of great financial austerity and loss of contracted care
11 CURRENT NDIS THEMES QUESTIONS ABOUT PACE OF IMPLEMENTATION QUESTIONS ABOUT AFFORDABILITYSUGGESTIONS ABOUT DE-REGULATIONCHANGES IN CONTRACT FUNDINGWORKFORCE INDUSTRIAL ISSUESTENSIONS BETWEEN NDIS & RECOVERY MODEL
12 What we know is that the smaller providers demonstrated faster market entry and greater innovation and responsiveness but the larger providers outlasted them in the market because of their infrastructure, capacity and lower unit price - In this scenario everyone loses because localism and innovation disappear
13 DESPITE THE CHAOS PERCIEVED BY PROVIDERS, MANY CUSTOMERS REPORTED: - BETTER SATISFACTION - BETTER ENGAGEMENT - IMPROVED QUALITY OF LIFE
14 WHAT WOULD HAVE HELPED CLEAR NATIONAL TARRIFFS SUPPORT FOR PROVIDERS SUPPORT FOR CUSTOMERSINDEPENDENT CARE PLANNINGMORE GRADUAL REDUCTION IN CONTRACTSBETTER PLANNING AND LESS CHAOSMORE STRATEGIC AND LESS REACTIVE SUPPLYTIME TO UNDERSTAND WHAT WE WERE DOING
16 WE SURVIVED AND THRIVED SO WHAT DID WE DO? WHY US?
17 Cultural confidence and readiness Customer service and focus THE 5 C’SCultural confidence and readinessCustomer service and focusCapability was understoodCapacity was identifiedCosts were known (eventually!)
18 CULTURAL CONFIDENCE & READINESS Who are we here for?Is the whole organisation on board?What are the cultural barriers?What values must we preserve?What can we move on from?
19 CUSTOMER SERVICE & FOCUS Who are our customers?How do we provide GREAT customer experience?What do our customers tell us about our effort?What more can we do to add value?
20 What is it we ACTUALLY do? What is it that makes a difference? CAPABILITYWhat is it we ACTUALLY do?What is it that makes a difference?What else are we good at?Who else might benefit?How can we develop to match REAL customer needs?
21 How productive do we need to be? How can we be more efficient? CAPACITYHow much can we provide?How productive do we need to be?How can we be more efficient?What new partnerships emerge?What are the markets we are seeking to appeal to?What else do we need and how will we pay for it?
22 How much does it cost us to supply? COSTSHow much does it cost us to supply?Can we supply within the market tolerances?Do we ‘loss lead’?Do we subsidise care?What assumptions do we make about our supply model?What are the cost pressures we must respond to?
23 KEY QUESTIONS WE CONTINUALLY ASKED…. Why are we considering entering this market?What are our ambitions as a provider?Do we have a duty to supply?What happens if we choose not to?How does it fit with our organisational purpose?Can we afford to do it?Do our values limit our market?What hidden capability is there?What would we do with the profit?How would we manage revenue loss?
26 IN NORFOLK, ENGLAND… Population of 1 million people In any given year:*120,000 people experience a mental health problem requiring help65,000 see a GP ONLY and/or use public or NGO mental health services55,000 people need help, get nothing or have no eligibility but many have a capacity and desire to purchaseWhat are the market opportunities here?
27 Developing a Product Range Dis-aggregating current supply into productsAssessing current product range against the market opportunityTesting the offer and refining itIdentify new product opportunitiesAssess the supply issues and challengesDefining the story associated with the product offerDevelop marketing, perhaps JUST for the productLaunch and supply
28 LIFEHELP Part of Norwich Mind (A$5M) New brand and product range developedOffered universally600+ customers first two years25% clients hold a personal budgets40% have care purchased for them (notional budget)25% self fund10% freeProfit is used to provide free care to 10% of the clients who would otherwise receive nothingGrowth is projected at 20% pa
29 UniversalityThe 2011 Australian Census indicated that the incidence of a mental health problem could be as high as 1 in 3Why would we not want to include the whole population as potential customers for our purchasable care products?The larger the market, the larger the potential revenue, the more mixed a customer base is, the less stigma is attributed to any customerIt IS possible to broaden your market and retain (and enhance) your offer to your core beneficiaries
30 Advantages of Universal Supply Larger MarketLess StigmaLess RegulationGreater Public Benefit & Impact & ReachCustomer Expectations HigherBetter Organisational ProfileFewer people excluded from available careLarger profit, greater potential to subsidise
31 WE SUCCEEDED IN SUPPLYING BUT, MORE IMPORTANTLY, WE BECAME A MUCH BETTER ORGANISATION ALONG THE WAY
32 LIFEHELP – MAIN LESSONS Staff are much more productiveStaff are more flexible and multi-skilledStaff have become innovators and promotersThe workforce is more diverse and more casualisedVolume matters as does a broad customer baseMixed economy of purchasers is criticalMAXIMISING market size is keyFinancial planning and management is very complexClient retention is goodClients say the service works and they welcome the choiceStaff are satisfiedThe number of NGOs providing has halved.
33 10 insights that are relevant here Our offer is 90% RELATIONAL and 10% technicalThere is very little product differentiation on the provider side in mental health (it’s the people and their lives that represent difference)Market the relational promise (the employee profile and story)Celebrate and communicate success through stories – real people, real photos, real narrativeKeep your values and history at the heart of your messageContinually ask what makes us differentEmphasise localism and cultural relevanceAdd delight and value at every opportunityProvide GREAT customer serviceContinually innovate (because your competitors will copy you)
34 Our Evidence on Customer Priorities System defaulted to traditional suppliers at start up (seems to be same in some NDIS launch sites)Peer support over-rated by providers (not a factor in initial purchase but a factor in re-purchase)Customers value:ResponsivenessGreat customer serviceFamiliarity / low risk / continuityHelp that works (from the customers perspective)FlexibilityValuePleasant surprisesPeople that they like and who like them
35 SUPPLY CHALLENGES – WHAT WE HAVE LEARNED IN THE UK Our workforce had to increase productivity by 20%‘Standing’ liability needs to be minimisedCustomers demand different qualities to those that organisations often hold dear….eg:Less qualified but experienced in lifeFlexible and responsiveRelationally competentA new paradigm of staff deploymentMove away from traditional structural model (teams)Multi-skilled staff covering full range of client needs are more efficientBig increase in infrastructure demandsRequires a different understanding of outcomeWorkforce has become more casual and/or self employed and generally operating at a lower level of qualification but with new sought after attributesOrganisational complexity increasesCreativity needed to continually add valueGreater reliance on technology to support distant deliveryVery hard to supply remotely unless additional investment (by provider, regulator or co-purchasing)
36 Measuring SuccessRewarding staff who are BOTH effective and productive – how would we do that?The Loved One TestMarket CaptureCustomer Loyalty (a good thing?)Health and other client outcomes (QOL, Goals etc)Testing value for moneyFinancial monitoring – efficiency monitoringPractice governancePublic ratings (Patient Opinion, Whitecoat)Matching the promise to reality - stories
37 Summary of Key Points It’s bloody hard! NDIS offers great opportunity The implementation approach seems soundProviders need to think differentlyIn terms of who they supply toIn terms of brand and marketingIn terms of supply and productivityEarly to market is importantCompetition is inevitable (particularly in urban settings)Funding will be more complex and chaoticCustomers will benefit if suppliers adaptPreparating for supply will improve your organisation