Commissioning for personalisation in the round

‘Consumerist -. In the first approach the users are patients in need of timely and effective services from the NHS that are personalised to their needs. In the first approach the professionals – medical practitioners – must deploy their knowledge and skills in a timely and effective way to solve a problem for the user. The more that is done in a personalised, considerate and responsive manner the better. Personalisation - the users are co-producers of the good in question. They are active participants in the process – deciding to manage their lives in a different way – rather than dependent users…. the key is to build up the knowledge and confidence of the users to take action themselves, to self- manage their health without turning to the professionals. The professionals deploy their knowledge to help the users devise their own solutions – smoking cessation programmes, exercise regimes – which suit their needs.’ Source: Charles Leadbeater ‘Personalisation through Participation: a new script for public services’, Demos, 2004 From consumerism to personalisation

Outcomes Public sector Contracted Private Sector Voluntary Organisations Commercial services - shops, jobs, finance, housing Adults and children and their Families Communities and Friends ORGANISATIONS SERVICE USERS SOCIAL CAPITAL Coproduction Based on: ‘Coproduction in Children’s Services’, Clive Miller and Sue Stirling, OPM, 2004

Personalisation: the key components Individualised purchasing and coordination of services Integration of non individually purchased services around individuals Based on: ‘Putting People First, the whole story’, DH 2008 Personalisation of public and commercial universal services Building and utilising individual capacity and social capital Whole life commissioning

Individualised purchasing and coordination of services Building and utilising individual capacity and social capital Personalisation of public and commercial universal services Personalisation: the key components Sports clubs pro-actively include Expert patients Personal budgets and self directed support Integration of non individually purchased targeted services around individuals

Individualised purchasing and coordination of services Building and utilising individual capacity and social capital Personalisation of public and commercial universal services Personalisation and social capital Integration of non individually purchased targeted services around individuals

Self care: current role and potential Source: ‘Coproduction in public services: a new partnership with citizens’, Matthew Horne and Tom Shirley, Cabinet Office, March 2009

The role of social capital in everyday life Source: Clive Miller, Social capital, co-production and the delivery of Putting People First: scoping a framework for social capital’, DH August 2009

Individualised purchasing and coordination of services Building and utilising individual capacity and social capital Personalisation of public and commercial universal services Personalisation of universal services Integration of non individually purchased targeted services around individuals

Well-being Care Universal services Targeted services Current use of the universal - targeted services continuum Universal services Targeted services

Well-being Care Universal services Targeted services Potential use of the universal - targeted services continuum Universal services

Personalising universal services Refocusing Non health and social care transformation programmes – make use of wider personalisation or linked initiatives such as Total Place and Respect. Ownership – all public and commercial universal services see people who use social care as integral to their customer base Targeted services – focus on supporting use of universal services rather than creating substitutes Service redesign Coproduction – work with socially excluded people to identify how they can be supported by the universal service to enable more effective coproduction of outcomes. Differentiation – to enable universal services to be directly accessible, affordable and acceptable to a much wider range of people and life styles Collaboration – with other universal and other targeted service providers to enable people to easily find a way of using the service that suits their requirements and abilities. Service organisation Community run – where possible enable local people, including those who are socially excluded, to run part or all of any universal service, including budget devolution Voluntary and community sector – move away from targeted to universal service provision Based on: ‘Service Transformation through Market Reshaping’, Report for Department of Health, OPM July 2009

Individualised purchasing and coordination of services Building and utilising individual capacity and social capital Integration of non individually purchased targeted services around individuals Personalisation of public and commercial universal services Personalisation of non individually purchased targeted services

Personalising preventive, early intervention and re-ablement services Refocusing Whole system access – view prevention and re-ablement as a whole system use of services rather than specific health and social care targeted services Self directed support – apply the principles and devolve funding to individuals wherever possible Service redesign Pathways – analyse the typical pathways that people experience and work with them to reshape services and pathways to enable choice and achieve more effective coproduction of outcomes Individual control – enable the individual to self assess, make choices and secure the supports that meet their own requirements and resources Information – proactively provide information and advice to individuals and carers as soon as possible, and on a continuing basis to enable them to consider support options Service organisation Coordination – ensure the individual rather than a lead professional and the care pathway are at the centre of service coordination. Business case – develop a robust business case and funding process to support a multi sector approach Based on: ‘Service Transformation through Market Reshaping’, Report for Department of Health, OPM July 2009

Individualised purchasing and coordination of services Building and utilising individual capacity and social capital Integration of non individually purchased targeted services around individuals Personalisation of public and commercial universal services Personalisation through individualised purchasing and coordination of services

Framework contracts Service personal- isation Personal budgets Three key components Personalised: PB holders using direct payments or ISFs, and self-funders purchase personalised services within the framework contract, sometimes using person-centred ‘mini tenders’ Source: ‘Contracting for personalised outcomes’, DH 2009

Personalisation and prevention Primary prevention Secondary prevention Tertiary prevention Integrated service pathway Individualised purchasing and coordination of services Building and utilising individual capacity and social capital Personalisation of public and commercial universal services Integration of non individually purchased targeted services around individuals Personalisation of public and commercial universal services Building and utilising individual capacity and social capital Integration of non individually purchased targeted services around individuals

Individual or community ownership and control – designing, managing, delivering, evaluating; decision making; portable budgets Individual capacity and social capital – affordable; ability based; developmental and reciprocal; efficient for all Life centred – whole life; outcomes focused; what ever works; all services and how they are organised and delivered Information – accessible and timely; pro and interactive Choice - type of service, provider, staff; cost and quality; when and intensity; support planning and management support; only constrained by genuine risk and legality Coordinated - with individually relevant services; individually controlled How do we know the service system is personalised? Fully personalised Not personalised Personal budgets in PbBorough