Request to Speak at PQT – County Council 17th February 2016
The Future of the Learning Disability Provider Service (LDPS)
I am here today to express my concern about the lack of risk transfer in the contract for the commissioning of our Learning Disabilities Provider Service.
I believe that lack of risk transfer could potentially result in serious issues arising for service users, parents, carers, taxpayers, staff and the reputation of this Council and the elected administration.
This week, we heard that the Cambridgeshire and Peterborough Clinical Commissioning Group and UnitingCare are to end their five-year, £800m health services contract, after just eight months, with a cost of at least £1m, with a lack of “financial sustainability” given as the reason for this very early partnership failure. (http://www.bbc.co.uk/news/uk-england-cambridgeshire-35000421)
It is vitally important that we model our contracts for change, problems and even failure.
I have attended a number of consultations for the commissioning of the LDPS and I remain very concerned that the contract will be signed with significant issues around risk transfer unresolved.
If we had the worst case scenario of Winterbourne View, who would bear the cost of service recovery, fines and compensation?
I believe that those costs and risks would fall upon this Council and not on the Social Enterprise which is trading as a private Limited Company and could simply wind up and walk away. Apart from the risk of harm for service users and un-budgeted costs falling upon taxpayers, the reputation of this Council and the elected administration would also be damaged. (http://www.bbc.co.uk/news/uk-england-bristol-20084254)
If the contracted out Learning Disabilities Provider Service was rated “Inadequate” then where would final responsibility lie for service recovery and improvement?
I believe that this Council (/CCG) and local taxpayers would remain responsible. It has been quite a long and expensive struggle to recover the Children’s Service under our full operational control as an in-house service. How would this Council compel the limited company social enterprise to improve from an Inadequate rating without any operational control whatsoever?
I am also concerned about the significant loss of democratic oversight and public scrutiny once Learning Disabilities is contracted out to a private Limited Company. Right now, our elected Councillors can openly scrutinise the LDPS and the public can attend those meetings and ask questions or seek representation from their elected Councillor and, in the last resort, make a Freedom of Information request. Most of that democratic oversight and public access will, in my view, now be lost.
We have a very short window to ensure that the risk transfer concerns I am raising publicly today are addressed – To protect not just service users, parents, carers, taxpayers and staff, but potentially the reputation of this Council and the elected administration.
UNITE Branch Sec at Somerset County Council
I am writing to respond to the points you raised at Full Council on 17 February.
I would like to remind you that we are considering the creation of a Social Enterprise for Learning Disability services in order to set up services that are fit for the future — services that are able to offer personal budgets, and individualised services in line with the requirements of the Care Act 2014. The rationale for this was set out in the Full Council report of February 2014
I can reassure you that the sustainability of the new business is a central element of the evaluation and selection process for choosing an organisation to establish a Social Enterprise for Learning Disability Services in Somerset. For any bidder to meet minimum criteria for selection it will have to be able to show it has a robust and sustainable business plan that offers good value for money. Of course I cannot prejudge what will come out of the evaluation process, when this matter is considered by Scrutiny Committee and Cabinet in April.
You raised the issue of ultimate responsibility for service delivery and the risk of poor service quality. Ultimate responsibility clearly still sits with the County Council, but this does not mean it has to directly deliver those services. Good quality services are commissioned by the Council across all other areas of Adult Social Care and successfully managed through effective contract management. Our approach would bring learning disability services in line with the way the majority of Adult Social Care services are commissioned both locally and nationally.
You raised the issue of democratic oversight. We have specified for a social enterprise that has people with learning disabilities and their carers sitting on the board of governance. Making services directly accountable to those who benefit from them gives the right kind of oversight and supports the principles of the Care Act.
Cabinet Member — Adult Social Care