Meeting:	Executive
Meeting Date:	14^th September 2023
Report of:	Jamaila Hussain Corporate Director Adults and Integration
Portfolio of:	Cllr Jo Coles

Decision Report:  All Age Commissioning Strategy

1. This report provides an overview of the All-Age Commissioning Strategy.  This Strategy forms part of a range of strategies that will support our population providers and stakeholders to understand the direction of travel of the local authority and how we envisage care and support is provided in the future. The Commissioning Strategy (Appendix 1) highlights the focus on supporting people to remain at home independently for longer, supporting young people preparing for adulthood to have access to services that are personalised to their needs as well as reducing the reliance on crisis care.

The Strategy builds on our community development model across all age groups, focussing on community assets and individual strengths that support the promotion of self-care, reducing inequalities of access to services for those who require care and support intervention.

Across York we are committed to commission with providers who demonstrate that they can provide good quality safe services that are cost effective and support council funded and self-funding individuals thus making the market accessible and affordable for all.

The document also outlines clear principles of commissioning moving much more towards outcome and how services improve the health and wellbeing of people who use our services. The key principles are set out below:

· Commission Quality Services that meet high national and local standards, which will be measured through benchmarking

· Prevent, delay, or reduce the need for people to access social care by providing advice, information and services that support people to be as independent as possible

· For individuals who require support provide ongoing care in the individual’s own home (home first) rather than in a residential care facility whenever possible

· Ensure services are commissioned based on need and evidence of effectiveness.

· Ensure value for money and costs benefits are maximised

· Deliver positive outcomes for service users by holding providers to account and ensuring outcomes are captured and measured

· Ensure and encourage an open culture around safeguarding, working in partnership with providers to confirm the best outcome that are in keeping with national safeguarding policy and best practice

· Co-production is a key principle to inform commissioning models of care and support, service redesign and maximising independence through strength-based approaches

· We will commission using an evidence-based approach that supports innovation and achieves the best outcomes.

· Develop robust strategies for market growth and sustainability

· An outcome focused approach that continues to decommission services that are considered less effective or not delivering excellent value for money.

Based on the above principle the Strategy sets out our ambition to move away from transactional commission to more innovative personalised approaches to care delivery. The strategy covers a two-year period and during this time we will continue to review, consult and build on the strategy.

Benefits and Challenges

2. Ensuring the publication of a clear Commissioning Strategy alongside a Market Position Statement is essential part of the delivery of market development and sustainability under the Care Act 2014 as well as the Children’s Act 2004 which states the need of ensuring needs are the population are met through continuing to improve services.

There will be some challenges to existing providers through the more towards outcome-based service provision and the support towards maintain independence.  The more away from crisis care to home first approach will require a change in the current models of care. Commissioners are committed to work external providers across the city to ensure smooth transition in care services.

Policy Basis for Decision

3. The Strategy clearly aligns across several current council strategies particularly the core values and principles of:

Affordability: Ensuring we have an affordable care that is easily accessible across the city that include people who self-fund their own care.

Environment: Through the contract management process we will continue to support providers to adhere to our carbon reduction polices.

Equalities and Human Rights: The strategy clearly sets out the duty of the local authority to provide services that are accessible, flexible, and meet the diverse needs of our population. The views and experiences of people who use services their carers and families have formed part of the development of the strategy and our outcome-based approaches to delivery.

Health Inequalities: The Strategy is based on achieving social care and health outcomes. Using population health data commissioners are able to identify specific areas across the city that requires specific support options. The strategy focusses on the key principle of the health and wellbeing strategy promoting the generation of good physical and mental health through the emphasis on prevention and early intervention.

Financial Strategy Implications

4. The Strategy supports the Local Authority’s approach to ensuring value for money, good quality services for all.  Moving away from expensive crisis care that can result in poor outcomes to more preventative options supporting people within the communities they live in.

Recommendation and Reasons

5. Approve the all age commissioning strategy and delegate any changes to the strategy to Executive Member for Health, Wellbeing and Adult Social Care and the Corporate Director of Adult services and Integration (DASS). The Commissioning Strategy form part of the core requirements under the Care Act 2014 and the Children’s Act 2004. This Strategy underpins the current Market Position Statement as well as conforming to the expectations of the CQC assurance framework.

Background

6. This Commissioning Strategy is being presented to Executive as it covers a wide range of service areas as well as care delivery. The Strategy aligns with the council ambitions and current policies as well as the ICS System Strategy.  

Consultation Analysis

7. The Strategy has been developed through the feedback from people using services, carers, and families as well as key reports from Healthwatch. The strategy is also underpinned by population health data and the joint needs assessment and includes feedback from all council departments in-particular housing, public health communities and finance.

The Strategy is a working document and will be reviewed as key changes in national and local polices arise. 

Options Analysis and Evidential Basis

8. The Strategy is a key requirement of the Care Act and forms a key part of the themes outlined in the CQC assurance framework. The strategy outlines the ambition of the council pertaining to the commission of care and support services. 

Organisational Impact and Implications

9. The Strategy has been taken through various DMTs and CMT for consideration and agreement

Risks and Mitigations

10. The Strategy supports the care act duty to market sustainability and ensure the population has access to a diverse range of care options. As well as support the clear principles of various legal statutes regarding prevention, early intervention, reducing inequalities in health and ensuring equality in access to services.

Wards Impacted

11. This Strategy is city wide and covers all wards across York.

Contact Details

Author

Name:	Jamaila Hussain
Job Title:	Corporate Director of Adults and Integration
Service Area:	All Age Commissioning, Contracts and Quality
Telephone:	07718995696
Report approved:	11/09/23
Date:	23/08/2023

Co-author

Name:	Abid Mumtaz
Job Title:	Head of All Age Strategic Commissioning, Contracts and Quality
Service Area:	All Age Commissioning, Contracts and Quality
Telephone:
Report approved:	11.09.23
Date:	23/08/2023

Annexes

All annexes to the Decision Report must be listed.

· Background paper: Commissioning Strategy (Attached)