National Commissioning

1

• National Commissioning Contracting Training
  Conference
• The Challenges and Solutions in Commissioning and
  Contracting for Outcomes for childrens services.
  
• Thursday 13th September 2007

2
Workshop Objectives.

• Review how the reality of commissioning and
  purchasing for outcomes and efficiency is
  developing by looking at the subject from the
  perspective of Oxfordshire County Council.
• Examine the potential for more uniform and
  consistent approaches and tools, with a
  particular focus on an outcomes tool developed by
  Revolution and CACI.
• Discuss the potential application and further
  development of outcomes based approaches.

3
Oxfordshire starting point

• No Leaving Care service
• Huge Budget pressures
• Disaffected /frightened users
• Poor outcomes
• Lack Of Choice of placements
• Difficulties in providing respite
• High Nos in Residential care
• Fire fighting
• Wanting to listen and work with CYPF

4
Oxfordshire -What We Knew about keeping CYP safe

• Secure attachments and relationships
• Good care
• High warmth, low-criticism parenting
• Support when and where needed
• Consistent relationships between professionals
  and families

5
Oxfordshire

• Since 2003 Oxfordshire has moved from a 1 Star to
  a 4 Star Authority
• The number of children looked after has decreased
  from 520 to 410.
• The number of new admissions has reduced from 204
  to 150
• The number of children placed in residential care
  has reduced from 63 to 43.
• The number of children placed in out of authority
  residential care has reduced, but is unstable
• The number of children placed in IFAs has
  increased from 14 to 43
• From 2003 to 2007 there were 2 fostering agencies
  based in Oxfordshire, with another couple
  offering some placements.
• Until 2005 there was 1 private residential home
  and 3 private special schools
• From 2005, 2 new homes have opened

6
Oxfordshire

• Aware that outcomes for children placed out of
  county worse than in house
• Strategies to improve outcomes were being
  undermined by individual placements, e.g. around
  the management of offending, completing course
  work
• Shared with providers our aspirations for our yp
  through provider forums
• Aimed to develop better understanding of the
  needs of Oxfordshire from providers of care and
  difficulties faced by providers in delivering the
  care we wanted
• Worked closely with main providers of care to
  develop relational contracts which reflect these
• Aim to emphasize outcomes for children and a
  greater understanding from providers about the
  need to produce outcome data

7
Oxfordshire
QUALITY ASSURANCE OUTCOME MEASUREMENTS FOR LOOKED
AFTER CHILDREN
8
Oxfordshire
9
Oxfordshire
10
Oxfordshire

• Issues
• We have noticed that there is a difference in
  response from discussions with Directors/Senior
  Managers and the staff doing the day to day care
• Feedback to commissioners is via social worker
  and not on the format requested directly from
  provider
• This means that as a commissioner we also have to
  chase providers for information about our
  children
• To understand the ability of providers to meet
  the needs of children placed now and in the
  future is difficult if the information is not
  received.
• To give meaningful information to Councillors and
  Senior Managers requires more work

11
Outcomes perspectives

• Oxfordshire an individual authority approach.
• What does it look like as a provider?How does a
  multi-site care organsiation monitor its own
  quality?CSCI/OfSTED reportsReg 33 in Childrens
  HomesOUTCOMES?
• Commissioning Processes PQQ, tenders.Ask
  forInsurance details, HS policy, HR policies,
  CP Procedures, DDA.Dont ask forStability of
  children placed in last 3 years with your
  organisation, Education results of those
  children, frequency of incidents involving use of
  restraint

12
Outcomes measurement tool

• Start with measurable and absolute facts.
• Start with 3 simple but important foundation
  measures.
• E.g. Date of placement move. Hours of education
  attended this week. Date of last statutory
  medical with GP.
• Importance of relativity.
• Importance of context.
• Aiming for consistency and comparability.

13
CACI/Revolution Tool
14
Children's Outcome Management System

• Kevin Sparks
• Director
• CACI

15
About CACI

• Significant IT Solutions Company
• Over 350 staff in the UK
• Strategic focus on Children's Services
• Both commissioners and providers
• 40 local authority childrens services customers
• Unified solutions covering education, social
  care, fostering adoption, mental health etc
• Strategic Partners
• Revolution Consulting
• CfBT Education Trust
• Hedra plc

16
About the System

• Objective is to better inform the commissioning
  process
• Allows providers to record key foundation
  performance areas, such as
• Placement stability
• Educational attendance
• Health related events

17
Key Features

• Its inclusive
• Web technologies reduces barriers to involvement
• No software required by users, just a browser
• Its flexible
• Based on a user-definable and extended database

18
Key Features

• Its easy to use
• All input forms, reports, and dashboards are
  available from a simple user interface
• No menu structures to navigate around
• Its powerful
• Advanced analytics are available to advanced
  users

19
Demonstration of Proof of Concept
20
Business Analytics
21
Balanced Scorecards
22
Imagine a placement or commissioning decision
based on this information?
23
Where next?

• Childrens Homes, Fostering care settings,
  residential special schools.
• Relative data from local authority ICSs.E.g.
  Ave length of placement prior to latest
  placement.Education attendance.Target Real
  Value Added measurement and showing which
  providers work best for which pre-existing
  profiles.And preserve ability to upload data
  back to ICS.
• Providers early adopters help shape direction
  and evidence outcomes.
• Commissioners Insist on common measurement and
  tools in commissioning and contracting.
• Local Authority provision use same evidencing.
• Regulators audit the integrity of the
  information.
• Researchers More robust data to work with.

24
Discussion/Questions

• Is the development of outcome monitoring and
  commissioning for outcomes only achievable where
  there are substantial contractual arrangements
  between purchaser and provider?
• Is a common and consistent approach achievable?
• Is a common approach applicable to all 3
  sectors?
• Are there other examples of good practice that
  you would like to share?
• Are there sufficient forums to share development
  of best practice in this area?
• Would you be interested in joining such a forum?

25
Contact

• www.Revolution-Consulting.org
• 01225 869198
• 07773 343715
• contact_at_revolution-consulting.org
• andrew_at_rome.eclipse.co.uk
• Ollie Watson CACI Ltd
• 0208 893 9039
• owatson_at_caci.co.uk
• Fran Fonseca Oxfordshire