Clarifying CCG and SCC requirements for LDPS
This extract from SCC Accounts 2015/16 states:
The Authority is currently investigating the following options for service delivery models:
Note; Trade Union questions are in italics below each bullet point
The Authority and Clinical Commissioning Group believe that a social enterprise partnership would be the best way to ensure that:
- Customers and carers are at the heart of decision-making
Q1. This aim can be delivered within an In-House service and is largely delivery model dependent. The Trade Unions have raised a number of governance issues where the use of a Limited Company vehicle (for an externally delivered service) and an exemption from the Freedom of Information Act would reduce current levels of accountability, transparency and information access from the democratically accountable existing in-house provider service. Additionally, access to information and intervention by local Councillors (on behalf of a service user or carer) would be diminished by an externally delivered service and this also applies to Scrutiny Committee effectiveness in holding an externally-delivered service to account. How will that “democratic deficit” be addressed?
- Services are value based
Q2. Please provide a list of values that form the requirements used for LDPS commissioning? How will those required values be measured and monitored for real world delivery (at an acceptable quality level) in any contract-based externally delivered service? How will any contract for an externally delivered service flex for new or modified values?
- Profit should not be made from the delivery of services
Q3. This is confusing as there are repeated references to reinvesting “profit”(“not for private profit” and “surplus” are terms that have also been used (?)) from the commissioning team. This has raised issues over the definition of net profit and how this authority would monitor net profit to ensure that the accounting remained open and didn’t support any artificial means of lowering net profit (e.g. through inter-company trading). Will the contact allow for profit or will the CCG published requirements be honoured?
- Change for customers and carers should be minimised
Q4. Clearly an in-house service driven by an agreed Service Improvement and Innovation Plan (SIIP) and effectively managed (with appropriate investment) will meet the criteria with the least risk of disruption. The service take-on, risk management and contract exit requirements for an externally delivered service will not be required. Disruptions from a new management and staffing changes will be avoided. All of these change risks are therefore avoided with the added benefit of continuity from an in-house service and therefore service users and carers will benefit.
- Services should be accountable to the people who use them and their carers and relatives
Concerns raised in Q1 above also apply here. An externally delivered service will create a “democratic deficit” and reduce accountability compared to the current in-house service. How will that “democratic deficit” be addressed?
In addition, this should ensure sustainability and the continuation of the things that customers and carers have told us that the Learning Disabilities Provider Service is already doing well.
Q5. UNISON are proposing to engage APSE to help produce a Service Improvement and Innovation Plan (SIIP). The SIIP will give the Council a Plan B in case the commissioning to a single provider (now without the element of competition) fails to meet all requirements, mitigates the High-Risk nature of this service and/or fails to meet affordability requirements. The Trade Unions would like a copy of the “things that the LDPS is already doing well” to inform the SIIP. These will have been part of the requirements issued to external providers bidding for the external delivery of the LDPS (to ensure that these qualities are respected and maintained).
In addition and for completeness, the Trade Unions would like to sight published requirements where Opportunities and Improvements are specified. Please note that the published requirements documentation has been requested by the Trade Unions a number of times and has not been forthcoming. In order to have a “level playing field” for the In-house LDPS service and the creation of a SIIP then the requirements information requested is both a reasonable ask and necessary.
Unite Branch Secretary