DIRECT PAYMENTS AND THE MARKET IMPACT

1
DIRECT PAYMENTS AND THE MARKET IMPACT
2
What are Direct Payments?

• Direct Payments are cash payments instead of
  social care services or carers services.

3
ESSEX CONTEXT

• 11 PCTs
• Joint commissioning for MH services
• Lead commissioning for LD services
• This is going to change!

4
Essex Position at Jan 2006

• Essex has the largest DP scheme in the country
  2000 users
• Just hit band 5 in the C51 indicator
• 50 increase this year
• PSI (18-64ish 57 of external domiciliary care
  spend 30 of service users)
• Over 20 Million projected spend on DPs for 05/06
  
• It must and will grow significantly and quickly

5
Existing Social Care Process
6
IB Pilot Process
7
MUST DOS FOR DPs

• Have good network of support for DP users
• Educate staff
• Make it equally easy for our customers and staff
  information, pricing/costings, processes,
  contracts
• Set long term stretch target for DP uptake
• Remember DP users fish in the same shallow pools

8
IMPLICATIONS RE BUDGET MANAGEMENT

• Resources tied up in in-house services
• Budget plan needed to shift resource (over
  several years) and create capacity for DPs

9
IMPLICATIONS FOR PROCUREMENT EXERCISES

• Block contracting encourages fewer providers
• Tendered prices ?varying rates for service type
• Must avoid post code lottery for DP users

10
(No Transcript)
11
FURTHER IMPLICATIONS FOR PROCUREMENT EXCERCISES

• Sudden growth in DPs may destabilise markets or
  contracts
• DP rates must be reviewed to stay fair when
  declared rate contracts let
• Flat DP rate /- geography allowance?winners/loser
  s
• Remember everything people might want e.g.
  help with parenting for disabled parents

12
WHY CONTRACTS/SPECIFICATIONS MUST REFER TO DIRECT
PAYMENTS

• As our direct influence over markets decreases,
  cant leave to chance overall market
  stability/supply for all the services we fund
• We dont want to compete with DP users to secure
  supply
• DP users need same priority as non DP ECC service
  users, at least equal quality/competence
• Suppliers need clarity re roles and
  responsibilities re DP users and ECC whos in
  charge, who negotiates price increases, service
  levels and fees

13
SO THE KEY QUESTIONS TO BE CONSIDERED ARE

• Will DP users want to buy this service?
• Will DP users be affected by stability in this
  market place?
• What type of procurement exercise would safeguard
  the take up of Direct Payments for this service
  type?
• How do we want contracted providers to respond to
  DP users?

14
SO THE KEY QUESTIONS TO BE CONSIDERED ARE

• What level of responsibility does ECC still have
  for influencing market as proportion of directly
  purchased services decreases and DPs increase?
• Suppliers need clarity re roles and
  responsibilities re DP users and ECC whos in
  charge, who negotiates price increases, service
  levels and fees