1. Martin Kennard Leeds Community Equipment and Telecare Services Manager

2. The Leeds Community Equipment Service: Planning for the Future

3. Session content  LCES now  Assessing our options: why  Assessing our options: how  The options appraisal: service requirements  The options appraisal: the service delivery options  Making the “decision”  The preferred option  Next steps…

4. LCES Statement of Purpose  “The aim of the Leeds Community Equipment Service is to provide the right equipment quickly to enable people to live independent inclusive lives”

5. LCES now: budgets 2008 - 2009  Expenditure on equipment: £1,875,075  Running costs: £1,000.167  As new value of equipment on loan: £10,409,326

6. LCES now: activity 2008 - 2009  No. of items issued: 71,592  No. of items collected: 50,244  No. of adults: 16,089  No. of children: 705

7. LCES now: ways of working  Most community equipment in Leeds for non self funders is provided by Local Authority / Health integrated service directly via main or peripheral stores.  However, certain number of items being provided via direct payments and prescription for the last two years.

8. LCES now: assessing our options - why  TCES agenda  Personalisation  Ageing population  Need to support all equipment and other assistive technology (AT) users  Desire to embrace all aspects of AT, particularly new developments related to Telecare and Telehealth

9. LCES now: assessing our options - how  Conducted a formal option appraisal using project management methodology  “Decision” making process devised and led by Leeds Metropolitan University  Wide stakeholder involvement to validate requirements and to ensure credibility  Use of experts to lead work packages to investigate effect on area of expertise of different service delivery options

10. LCES now: the options appraisal - service requirements  Via stakeholder meetings came up with 15 service requirements for a future service:  The PO has clear, transparent, auditable and effective management, governance and regulatory arrangements  The PO complies with relevant major mandatory national policies

11. LCES now: the options appraisal - service requirements  The PO is based on a sound economic rationale  The PO caters to the requirements of service users/customers  The PO aligns with major strategies of LCC and Leeds PCT

12. The options appraisal: service requirements  The PO serves all population groups  The PO is an integrated service delivered by as few providers as possible  The PO is deliverable within the current versions of LCC/LCES capacity and implementation plans  The PO retains a social responsibility towards LCES staff and any new starters

13. The options appraisal: service requirements  The PO retains a public service ethos  The PO has in place the relevant commercial and partnership arrangements  The PO is supported by appropriate information/ICT requirements  The PO complies with TCES agenda

14. The options appraisal: service options

15. Option 1: A local store, managed in house + a non-CSED retail component LCES Community Equipment Shop Limited prescription service via direct payments Local LCC/LPCT managed CES Store (for all equipment) Existing local CE retailers Leeds Community Equipment Service

16. Option 2: A local store contracted out to a third party + a non-CSED retail component Community Equipment Shop Local CES Store (for all equipment) contracted out Limited prescription service via direct payments Existing local CE retailers LCES PLC Leeds Community Equipment Service PLC

17. Option 3: A local store managed in house for complex items of equipment + a CSED retail component Community Equipment Shop + Local LCC/LPCT managed CES Store (for Complex equipment only) Full CSED Prescription service Existing local CE retailers + new entrants (for ‘Aids to Daily Living’) National Catalogue and Tariff National Equipment Store Accreditation Body LCES Complex Leeds Complex Community Equipment Service

18. Option 4: A local store contracted out to a third party for complex items of equipment + a CSED retail component Community Equipment Shop + Local CES Store (for Complex equipment only) contracted out Full CSED Prescription service Existing local CE retailers + new entrants (for ‘Aids to Daily Living’) National Catalogue and Tariff National Equipment Store Accreditation Body Leeds Complex Community Equipment Service PLC LCES Complex PLC

19. Option 5: A regional store managed in house for complex items of equipment + a CSED retail component Community Equipment Shop + Regional LCC/LPCT managed CES Store (for Complex equipment only) Full CSED Prescription service Existing local CE retailers + new entrants (for ‘Aids to Daily Living’) National Catalogue and Tariff National Equipment Store Accreditation Body WYCES Complex West Yorkshire Complex Community Equipment Service

20. Option 6: A regional store contracted out to a third party for complex items of equipment + a CSED retail component Community Equipment Shop + Regional CES Store (for Complex equipment only) contracted out Full CSED Prescription service Existing local CE retailers + new entrants (for ‘Aids to Daily Living’) National Catalogue and Tariff National Equipment Store Accreditation Body WYCES Complex PLC West Yorkshire Complex Community Equipment Service PLC  Making the “decision”

21. Making the “decision”  Structured day with project board and other stakeholder delegates scoring the recommendations against the options based on the presentations of their findings by work package leads.  After all scoring complete the weightings applied to give final decision

22. Making the “decision”  Factors around costs, need for change?, performance of test sites, need for clear and open governance, lack of data re. regional options, need to meet national and local policy expectations etc. were critical in decisions making

23. The recommendation  Always clear that decision could only be recommendations for consideration by PCT and LA decision makers  Agreed that the recommendations would take account of the vote but also the narrative which emerged via stakeholder sessions, managers meeting, project board meetings etc.

24. The recommendations  Retain in-house joint service purchasing and providing much of equipment over £?  Put systems in place to provide cash and prescriptions to people using IBs  Work with retailers to develop local market to enable above and take prescriptions for some items £? and under

25. The recommendations  Explore option for in-house / social enterprise arm of main service to offer retail sales and hire service to ensure continuity and expertise

26. The recommendations  Ensure that all AT users are supported – including self funders  Focus on the further development and coordination of all AT services in Leeds  Forge new partnerships between all AT providers (statutory, private and voluntary sectors)  Further develop use of Telecare and related technologies

27. Next steps…  Implementation of the preferred option for community equipment provision is part of a wider project to develop our assistive technology offer

28. Definition of AT  “AT can be defined as any item, piece of equipment, product or system that is used to increase maintain or improve the functional capabilities and independence of people with cognitive physical or communication difficulties”.  Audit Commission 2004

29. Developing our Assistive Technology (AT) Services  Work has started in Leeds to develop some of our existing AT services and better coordinate AT services across the city  For LCES, this means implementing our preferred option  For Telecare, it broadly means service expansion

30. Assistive Technology (AT) Services in Leeds  We also plan to develop an Assistive Technology Hub  The AT Hub will operate as a single point of contact for all service users, enabling us to:  Provide a universal AT offer, including for self-funders  Provide straightforward access to all AT provision  Promote greater understanding of what various AT can do via information, advice and training  Provide personalised AT; integral to overall care packages