Work collaboratively with community partners

Work collaboratively with community partners to commission services that optimise health gains and reductions in health inequalities.

This competency focuses on developing partnership agreements and sharing strategic information to support commissioning decisions on services that optimise health gains and reductions in health inequalities.

Working together for well-being: from vision to reality (Local Government Association 2007)

This is one of several papers from the Inter Agency Group on Adult Social Care that together develop the case for a partnership approach based on two fundamental principles.

• Health and social care commissioning should be firmly located in a wider community well-being programme to ensure decisions about care and treatment are taken within a framework that promotes health improvements, independent living, inclusive communities and reducing inequalities.
• Delivery of this agenda should be the responsibility of partnership arrangements that are focused through local area agreements and reinforce public engagement as well as accountability.

The report explores how systems and services could be designed to achieve the outcomes endorsed by the White Paper Our health, our care, our say, using examples of work going on in a range of settings. It looks at current readiness to respond to this strategic vision, which includes the shift of commissioning processes from separate services to outcomes focused around individuals and community well-being.

This paper outlines what is involved in the 'local building blocks' of outcomes, commissioning and service models, and identifies specific issues such as a lack of shared definition of commissioning, and both the lack and duplication of information required for needs analysis.

Building capacity and partnerships in care (Department of Health 2001)

This agreement was developed by representatives of central and local government, the NHS and independent sector as a yardstick for productive working relationships to guide the future development of services, and encourage a more strategic, inclusive and consistent approach to capacity planning at a local level, based on a whole system approach across health, social care and housing. But it points out that care markets don't follow administrative boundaries and while accountability may be at local level, strategic planning has to span traditional boundaries.

Commissioners need to explore where provisions exists but is under-used or unpopular, and points out that both commissioners and providers must be prepared to be challenged on their assumptions about what people want. Assessments of need should be based on local evidence and reflect user aspirations. Related housing need must form part of any overall assessment. Commissioners will need knowledge of regional and national service providers to commission specialist services.

The agreement points out that information should be shared both ways. To understand the local market commissioners require a thorough knowledge of all potential providers locally and the services they are able to provide. Some providers would have the capacity to provide a wider range of services if they were clearer about the need and financial support for those services. Providers have access to important and helpful information - for example, on service delivery, user preferences and the running of services - that needs to be incorporated into commissioners' overall understanding when planning future services.

There are action checklists for both commissioners and providers, with practical suggestions in key areas, such as ways to support joint working and improve communication.

Implementing building capacity and partnerships in care (Association of Directors of Social Services 2003)

This discussion document is the result of regular meetings between the statutory and independent sector to develop ongoing dialogue on key issues from different perspectives and model an open and transparent negotiating process between commissioners and providers that could be replicated at local level. It offers a range of practice examples illustrating key points made in the original Building capacity and partnerships in care agreement.

An engaging process (Change Agent Team 2003)

The Building capacity and partnership in care agreement highlighted concerns about indifferent relationships between statutory and private sectors, with arguments about fees getting in the way of discussions around development, partnership and new ways of working. This report is based on a survey of local authorities, independent sector (private, voluntary and not-for-profit) providers and PCTs in London and the South East to identify common themes and pointers for improvement.

Key findings were that relationships were improving overall but from a low base, with lack of trust between the sectors cited as the main obstacle to progress. Typically local authorities met with independent sector providers formally every three to six months but smaller authorities tended to have more frequent and less formal relationships, which seemed to improve their knowledge of the providers. Meetings with domiciliary care and residential care providers were usually conducted separately and, while there were sound reasons for this, it was perceived to be a possible barrier to better strategic commissioning. Independent providers felt as though they were only consulted after decisions had been made, and communication generally was a problem that needed to be addressed.

Building bridges (Change Agent Team 2005)

This report explores the lessons learned from two pilot schemes set up to help develop relationships between commissioners and independent providers and tackle the issues raised in the 2003 study An engaging process. The one-year pilots aimed to fund a full-time brokerage post to improve overall commissioning practice between all members of the economy.

The report explains the care sector context of each pilot area - Surrey and East Sussex - and explains how they established the broker role, including specific approaches to recruitment and funding. It outlines the work done during the pilot period, such as:

• development of communications plan and mechanisms such as newsletters and dedicated websites for sharing information between commissioners and providers
• supporting independent providers through partnerships with business advice and development bodies and access to training
• creating an independent provider forum to focus on wider development rather than discussing fees.

A companion workbook goes into more detail on the benefits and aims of appointing a paid professional specifically to develop better relationships with the independent sector. It looks at what worked in the pilot schemes and offers ideas for initiatives like change seminars, plus templates of job and person specifications.

No excuses. Embrace partnership now. Step towards change (Department of Health 2006)

This report from the Third Sector Commissioning Task Force, set up to promote a sound commercial relationship between health and social care commissioners and third sector providers, highlights critical barriers to cost-effective commissioning, explaining where they occur in the planning, purchasing and monitoring stages of the process. The report sets out commitments by the task force to tackle these.

The report points out that it is not just the responsibility of commissioners to drive the transformational change required for new models of provision to become a mainstream option. Third sector organisations also need to demonstrate to commissioners their potential to deliver services, and communicate their unique selling points in the context of more flexible and responsive provision. It concludes that culture and behavioural change are the biggest challenges and must be recognised and embraced as critical and integral to the success of ongoing reform.

Report of the Third Sector Commissioning Task Force - Part II Outputs and implementation (Department of Health 2006)

The outputs of the task force working groups are based on the commitments made in the complementary report No excuses. Embrace partnership now. Step towards change, and intended as practical tools for anyone involved in commissioning health and social services from the third sector. The report incorporates a guide on commissioning from the third sector, which covers practical aspects such as mechanisms for communication and encouraging creativity from providers, and tackling issues of viability and business support. The report also includes principles of good regulation and a model contract and guidelines.

Developing effective joint commissioning for adult services: Lessons from history and future prospects (Commissioning eBook 2006)

This paper explores why mechanisms for promoting joint commissioning have previously not been effective, and looks at the factors that help or hinder the process.

Compact

Compact aims to improve partnership working between statutory and voluntary organisations at national, regional and local level. On the website are codes of good practice that cover rights and responsibilities which government, local public bodies and the voluntary and community sector should reflect in their relationships to make them work

www.thecompact.org.uk

Improvement & Development Agency (IDeA)

IDeA is managing the national programme for third sector commissioning, which aims to develop specialist guidance and support on commissioning services from the third sector, increased understanding of the third sector among commissioning and procurement officers and improved third sector bidding capacity, particularly among smaller organisations

www.idea.gov.uk

Creating trust and confidence: Governance and partnership behaviours benchmark and health check (IDeA 2008)

This is a tool for reviewing the culture, values and behaviours of organisations to ensure they effectively underpin the implementation of processes and working practices developed through cross-sector partnership. This will open up discussion and improve the way they work together to deliver local area agreement priorities. The toolkit explains how to carry out a review of key principles for partnership behaviour, including engagement for public accountability, a focus on community outcomes, clearly defined functions, transparent decision-making and risk management, and developing partnership capability and capacity. A behaviour benchmark checklist sets out positive indicators that demonstrate effective partnership and negative indicators that suggest areas for improvement.

Supporting People for better health: A guide to partnership working (Department of Communities and Local Government 2006)

This guide draws on six Supporting People pilot schemes to illustrate good practice in partnership working and identify issues to consider when setting up services designed to cross organisational boundaries. It explores the need for buy-in to the partnership approach, effective governance arrangements and agreeing outputs and outcomes at an early stage. The guide highlights sharing information and professional differences as common obstacles to joint working. It is important to be realistic about timescales for joint commissioning and the funding and capacity required to manage the partnership working. All partners need to see the benefits of a joint commissioning approach and be clear about what data is required for monitoring.

Key contents for a joint commissioning strategy (CSIP 2004)

This briefing outlines what should be included in a joint commissioning strategy and how the contents should be structured. It explains what detailed information should be in each section. The hub of the strategy should be the section on changing the focus of services, which identifies outcomes to be achieved through joint commissioning and appraises the service options available.

Connecting housing to the health and social care agenda (CSIP 2007)

This paper looks at approaches to practical collaboration between housing services and health and social care delivery that have an impact on people's health and well-being and can form part of the care pathway. It looks at the impact of the built environment on three 'domains'. Firstly, housing services can help to achieve people's aspirations, such as encouraging people with physical disabilities, sensory impairment, mental health problems or learning disabilities to learn new skills. Their home can also be the place people receive treatment, such as self-management of long-term conditions, or receive care, like rehabilitation services.

The second domain is property, the impact of housing quality, particularly on underlying causes of ill health. Eco homes can reduce illness such as asthma, while lifetime homes are adapted to provide ongoing support, after a stroke for instance. The third domain is about the neighbourhood's impact on health through providing social networks, crisis support and safe areas to encourage physical exercise. The paper also summarises the policy context, showing how housing affects the health of target groups such as offenders, homeless people and people with mental health problems.

• Working together for well-being
• Building capacity and partnership in care
• Implementing building capacity and partnerships in care
• An engaging process
• Building Bridges
• No excuses embrace partnership now
• Report of 3rd sector task force part 2
• Catalyst for Change II
• IDeA Creating trust and confidence
• Supporting people for better health
• Key contents joint commissioning strategy
• Connecting housing to the health and social care agenda