Commissioning%20Children

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Commissioning Childrens Services.Passing the
baton mind the gap!

• Steve Cropper
• Keele University and
• Partners in Paediatrics
• To Social Services Research Group Childrens
  Services
• Birmingham 7th March 2011

Whoops!
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Health and Social Care Bill 2011

• strengthening commissioning of NHS services
• increasing democratic accountability and public
  voice
• liberating provision of NHS services
• strengthening public health services
• reforming health and care arms-length bodies.

Transition will occur through a carefully
designed and managed process, phased over the
next four years to allow for rapid adoption,
system-wide learning, and effective risk
management.
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Leadership Performance timeline Oct 2010 Mar
2012
2012
2011
Oct10 Jan 11
Apr11 Jul 11
Oct11 Jan 12
Apr12
LG/DH Transition group provide assurance on LA
engagement
Local Government/ Health Wellbeing Bodies
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3 SCENARIOS

• Revolt or Abdication/Denial
• Collective response -political action (or perhaps
  widespread inertia and apathy)

Responsible Public Servants Gradual engagement
through GP leaders, representatives. Rules of the
new game worked through small scale,
incremental changes some system shocks in
context of broader strategy
Melt-down pace and extent of change not
achievable national board and local leadership
at loggerheads inertia thwarts radical action
GP consortia fail, merge, change cases of
break-up of providers
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primarily about a cultural change to
genuinely collaborate throughout the
commissioning process.
Local Strategic Partnership Childrens Trust
LSCB CYPP
GP Commissioning ?knowledge and experience of
paediatrics ?awareness of services GPs training
should be reviewed to include the ECM agenda as
statutory
Other hurdles, shocks and wild cards Deep
financial cuts and effects Personalisation Thoroug
hgoing marketisation ..
Public health transfer to LAs

• Statutory Health and Wellbeing Board and ?.
• local authorities to coordinate the
  commissioning of
• local NHS services, social care and health
  improvement
• The Health and Social Care Bill will
  significantly strengthen
• collaborative and integrated working (Govt
  response Jan11)

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Issues HWB Early Implementers

• How do we set a new direction while ensuring
  current programmes through the transition?
• Relationships and knowledge
• Accountability and transparency
• Boundaries and levels
• a. Joint Strategic Needs Assessment
• b. Working with elected members

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Types of Friendly Relations
Easier

• Networking Exchanging information for mutual
  benefit
• Coordination Exchanging information and altering
  activities to achieve mutual benefits and a
  common purpose
• Cooperation Exchanging information, altering
  activities sharing resources to achieve mutual
  benefits and a common purpose
• Collaboration Exchanging information, altering
  activities, sharing resources and enhancing the
  capacity of another to achieve mutual benefits
  and a common purpose
• Arthur Turovh Himmelman Communities Working
  Collaboratively for a Change, 1991
• And in Chris Huxham (Ed) (1996) Creating
  Collaborative Advantage. Sage.

Harder to develop and sustain
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Collaborative leadershipWhat to do, now?

• Develop GP Comm. understanding capacity (SHAs,
  PCT clusters LAs leading process)
• Ease of linkage as essential - organisational
  maps whos who?
• Jointness and transparency as principles no
  surprises, linked/shared info sites, briefings,
  news.
• Set out authorisation/governance processes
• Commissioning maps, agendas and infrastructure
• Best info re childrens program budget
• What commissioning support capacity is required
• Strategic
• Joint
• Support functions
• Pragmatism where to hold initial steady state
  and where to change
• Reasoned advocacy on childrens needs services
  Kennedy JSNA, existing strategies, etc.
• What does the Local Authority currently
  commission with PCTs?
• What works well? What should continue and be
  built upon?
• What else is needed?
• Priorities
• Population groups and services eg CAMHS,
  Safeguarding, Complex/continuing care, Cared for
  Children
• Commissioning capacity eg linking sector
  commissioners, community consultation

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Hold collective purpose and nerve.
Baton fumbled but scooped up here, here and here