1. Developing diversity in the marketplace Andrew Jepps, Assistant Director, Adults and Childrens Commissioning The Challenge of Choice

2. The changes in commissioning Moving from traditional social care commissioning Moving towards: providing market data signalling the market, identifying where we procure, structure and capacity build, where we intervene developing market position statements

3. Capacity to deliver and secure services Monitor Review Improve Decommission Establish priorities Service options Need Supply Resources AnalysePlan DoReview

4. Analysis Joint Strategic Needs Assessment –Population data; comparative information; benchmarking; demography; performance data –Customer and patient information; formal consultations, ongoing feedback, focus groups, etc Other resources –Supply data, market intelligence –Where possible, detailed information on PBs choices

5. Research Research into Self Directed Support – Your Money or Your Life? Lack of research capacity Challenges in consumer research

6. Policy The multiple meanings of choice Consumerist and/or empowering? What do people really want?

7. Practicality Redesigning Resource Allocation System Affordability Ability to plan for the long term

8. Existing commitments Four PFI specialist care centres Transferred residential care homes (PPP) In-house direct services (residential, reablement, specialist dom care, day centres)

9. Local Authority Teckal Company Ambition for April 2012 Challenge in releasing back office costs VAT issues Different spread of risk Potential for ability to reposition services May address some shortfalls in affordable supply

10. Care homes Expected to pay rate challenges The balance of self funding The risks of failure in quality The risks of failure in sustainability –-Urgent closure protocol at SCIE site

11. Voluntary sector Diversity in range of VCS organisations Challenges in aligning compact with procurement advice What is the balance of risk? Reductions in prevention funding and reshaping of services Capacity varies organisation by organisation

12. Campus reprovision Complex and time consuming process ISFs used CHC issues More limited set menu of providers ultimately used Challenges in the ability of threatened providers to enable change

13. Capacity building VCS training on commissioning and procurement National Provider Development project – Think Local Act Personal (SCIE) (e.g. Acquired Brain Injury) Market place events – dream cards etc Getting a Life Project

14. Mixed position PBs 45.5% Nearly 40% of these have direct payments About 4,000 PBs Personal Health Budgets PBs in childrens services Increase in care home places within the county