DRUG & ALCOHOL RECOVERY SERVICE: CONTRACT NOVATION AND MONITORING

Transcription

1 Reprt t: SINGLE COMMISSIONING BOARD Date: 22 June 2017 Officer f Single Cmmissining Bard Subject: Reprt Summary: Recmmendatins: Angela Hardman, Executive Directr - Public Health, Business Intelligence and Perfrmance DRUG & ALCOHOL RECOVERY SERVICE: CONTRACT NOVATION AND MONITORING At its meeting in May 2017 SCB adpted a recmmendatin t transfer the cntract fr the lcal Drug and Alchl Recvery Service frm Lifeline t CGL (Change, Grw, Live) frm 1 June The terms f the nvated cntract are the same as that agreed with Lifeline in 2015, and runs until July Finance cmments n the prpsal included: Hwever, it is critical that cntinual and regular reviews f the rganisatin s financial stability shuld be implemented within the nging cntract mnitring arrangements t ensure there is a sufficient perid available fr alternative arrangements t be implemented in the eventuality f rganisatinal failure in the future. In view f these cmments, the shrt ntice f the change, the limited lcal knwledge f the new prvider and the absence f a tender prcess, SCB requested a prpsal fr enhanced financial and perfrmance mnitring t supprt assurance and cnsideratin f whether a re-tender is necessary. This reprt utlines prpsed prcess that builds n the existing prcess and includes these elements: current cntract mnitring prcess f: mnthly Steering Grup quarterly prvider reprts regular Gvernance Meetings fcused n clinical audits and untward events annual prvider reprts annual cmmissiner perfrmance audit checks and review TMBC Internal Audit and CQG reviews in July 2017 additinal financial mnitring and rganisatinal intelligence enhanced mnitring measures identified by cmmissiner Clinical Lead natinally published statistics Single Cmmissining Bard are recmmended t: 1. Endrse this prpsed mnitring framewrk which incrprates paragraphs 2.2 t 2.8 f the reprt what is currently included in the current cntract. Paragraphs 2.9 t 2.20 summarise the additinal elements.

2 2. Receive a cntract mnitring reprt in Octber Financial Implicatins: (Authrised by the statutry Sectin 151 Officer & Chief Finance Officer) Budget Allcatin (if Investment Decisin) CCG r TMBC Budget Allcatin Integrated Cmmissining Fund Sectin S75, Aligned, In-Cllabratin 2017/ millin TMBC Sectin 75 Decisin Bdy SCB, Executive Cabinet, CCG Gverning Bdy Single Bard Cmmissining Value Fr Mney Implicatins e.g. Savings Deliverable, Expenditure Avidance, Benchmark Cmparisns Avidance f health service demand related expenditure Additinal Cmments The additinal details stated within sectin 2.12 f the reprt shuld enhance the financial intelligence available t the Single Cmmissining Bard. This shuld supprt awareness f any ptential rganisatinal failure at an early stage. Legal Implicatins: (Authrised by the Brugh Slicitr) Hw d prpsals align with Health & Wellbeing Strategy? Hw d prpsals align with Lcality Plan? Hw d prpsals align with the Cmmissining Strategy? Recmmendatins / views f the Prfessinal Reference Grup: The key time t negtiate changes t the abve cntract was prir t the nvatin f the cntract as the nvatin itself culd have been cnditinal upn the acceptance f the prpsed changes. Whilst there is n reasn t believe that the prvider will nt accept the prpsed mnitring framewrk the ptin remains fr the Cuncil t cnsider the exercise f the n fault terminatin prvisin within the cntract which requires 12 mnths ntice f terminatin and undertake a prcurement exercise fr a replacement prvider. Reducing harmful drug and alchl use is identified as a pririty within the Health and Wellbeing Strategy. Reducing harmful drug and alchl use is imprtant t reduce premature mrtality, hspital admissins and lng term cnditins, and cntribute t ur ambitin t increase healthy life expectancy. Reducing harmful drug and alchl use will cntribute t reducing premature mrtality, hspital admissins and lng term cnditins. The paper has nt been reviewed by PRG in view f the timescale requirement fr it t be prepared between SCB meetings

3 Public and Patient Implicatins: Quality Implicatins: Hw d the prpsals help t reduce health inequalities? What are the Equality and Diversity implicatins? What are the safeguarding implicatins? What are the Infrmatin Gvernance implicatins? Has a privacy impact assessment been cnducted? Risk Management: Access t Infrmatin : Nvatin f the cntract will ensure cntinuity f service prvisin. The new service has attracted new clients, particularly alchl users and yung peple. CGL passed all sectins f the Organisatinal Questinnaire dcument which included elements n rganisatinal infrmatin, financial details, insurance, equal pprtunities, health & safety, clinical safety and gvernance, business cntingency and safeguarding. Harmful drug and alchl use is assciated with scial deprivatin. The service aims t supprt recvery enable independence, and stability f husing, relatinships and emplyment. The service is available t self-referral frm anyne with a cncern abut their use f drugs r alchl. Service users and their families may be vulnerable as result f harmful drug use. The current service was reviewed by CQC in December 2106, and n cncerns abut safeguarding were identified. Safeguarding was included in the Organisatinal Questinnaire fr CGL, and sme plicy issues fr fllw up were identified. Infrmatin Gvernance was included in the Organisatinal Questinnaire and cnsidered satisfactry. This was cncluded within the tender in Infrmatin Gvernance was included in the Organisatinal Questinnaire and cnsidered satisfactry. The backgrund papers relating t this reprt can be inspected by cntacting Giden Smith, Cnsultant Public Health: Telephne: giden.smith@tameside.gv.uk

4 1.0 BACKGROUND 1.1 At its meeting n 25 May 2017 the Single Cmmissining Bard adpted a recmmendatin t transfer the cntract fr the lcal Drug and Alchl Recvery Service frm Lifeline t CGL (Change, Grw, Live) frm 1 June This was prmpted by a request frm Lifeline and CGL based n an agreement that had been reached between them fllwing changes in the financial circumstances f Lifeline. 1.3 In rder t be assured f the capability and cmpetence f CGL as an rganisatin and their ability t achieve and deliver the cntractual bligatins, a full rganisatinal questinnaire was submitted by CGL, identical t the dcument prvided by tendering rganisatins during the riginal service tender in CGL passed all sectins f the dcument which includes elements n rganisatinal infrmatin, financial details, insurance, equal pprtunities, health & safety, clinical safety and gvernance, business cntingency and safeguarding. Each sectin was been evaluated by lead fficers. 1.4 The terms f the nvated cntract are the same as that agreed with Lifeline in 2015, and runs until July Finance cmments n the prpsal included: Single Cmmissining Bard members shuld be satisfied that the nvatin f the cntract t the new prvider n 31 May 2017 will ensure cntinuity f an essential service t the health and scial care ecnmy. It is imprtant t nte that the new rganisatin is currently cnsidered t be financially stable based n the details prvided within the rganisatin questinnaire referenced in Appendix 1. Hwever, it is critical that cntinual and regular reviews f the rganisatin s financial stability shuld be implemented within the nging cntract mnitring arrangements t ensure there is a sufficient perid available fr alternative arrangements t be implemented in the eventuality f rganisatinal failure in the future. 1.6 In view f these cmments, the shrt ntice f the change, the limited lcal knwledge f the new prvider and the absence f a tender prcess, the Single Cmmissining Bard requested a prpsal fr enhanced financial and perfrmance mnitring t supprt assurance and cnsideratin f whether a re-tender is necessary. 2.0 OUTLINE OF PROPOSED ENHANCED FINANCE AND PERFORMANCE MONITORING PROCESS 2.1 The prpsed prcess builds n existing prcesses and includes these elements: current cntract mnitring prcess f: mnthly Steering Grup quarterly prvider reprts regular Gvernance Meetings fcused n clinical audits and untward events annual prvider reprts annual cmmissiner perfrmance audit checks and review TMBC Internal Audit and CQG reviews in July 2017 additinal financial mnitring and rganisatinal intelligence enhanced mnitring measures identified by cmmissiner Clinical Lead natinally published statistics

5 Paragraphs 2.2 t 2.8 belw summarise what is included in the current cntract, and 2.9 t 2.20 summarise the prpsed additinal elements. 2.2 Current Cntract Mnitring 2.3 Outcmes The cntract includes the fllwing key utcmes that the Prvider will be required t achieve: 1) T increase the number f peple accessing treatment and the number f peple wh mve nt lng-term sustained recvery; 2) T reduce Alchl-related harm and Drug-related harm; 3) T maximise the pprtunities fr integratin and cllabratin in adpting a whle system apprach t Drug and Alchl treatment; 4) T cntribute t a whle system apprach which reduces the demand fr Specialist and Targeted services thrugh enhanced Early Interventin and Preventin; 5) T becme a natinal exemplar f best practice. 2.4 Mnthly Steering Grup Meeting f prvider service manager, cmmissining fficer and strategic lead cvering current issues and prgress summarised in wrking actin plan. 2.5 Quarterly Prvider Reprt As set ut in service cntract: - Prvide 3 case studies per quarter which ver the year detail cases invlving all types f drugs and alchl and plyuse. - Cnsult Service Users, and thers helped by the Service n their views f the Service and evidence this invlvement e.g. by Service User Survey, Review Prcesses, and planned exits frm the Service. - Engage and prvide evidence f where Service Users and Stakehlders have influenced and assisted in the develpment the Service, detailing hw and where changes have been made as a result f their invlvement. - Cnsult Stakehlders n their views f the Service and evidence respnses e.g. respnse times, access, plicies, prcedures etc. and any changes in practice. The reprting f Quarterly statistical infrmatin required will be agreed between the Purchaser and Prvider but will include as a minimum: - New cases; Ttal number f cases accepted & refused reasn/signpsting; - Accumulative active caselad figures with length f time in the Service; - Cmpletins; bth successful and treatment cmplete but nt Drug/Alchl free. Brken dwn by the fllwing: Age / D.O.B.; Gender; Ethnicity; Disability; Residential Area; Religin;

6 LGBT / Sexual rientatin; Children in Husehlds; Pregnancies; Number and Surce f referrals; Drug / Alchl Type(s) being treated and nature f use; Injecting status; BBV status including if treatment ffered, accepted and accessed; Other Health pathways identified (i.e. Chrnic Obstructive Pulmnary Disease) and fllw up referral/access assistance; Number f representatins, reasns and previus interventins accessed; Number f clients signpsted t additinal/alternative services and destinatins; Key issues related t Service User needs such as Husing, Educatin, Emplyment, Health Cncerns and active service engagement with ther agencies. This will prvide nt nly useful intelligence but als the prvider s management f cmplex dependencies; Number f referrals t Safeguarding Adults Team, Children s Scial Care/Safeguarding and Plice, regarding welfare f a child; Perfrmance against Payment fr Change Prjects. The Prvider shall nte that infrmatin btained thrugh cntract management f the Service will be shared with relevant stakehlders as identified and apprved by the Purchaser. The Prvider will cntinually evaluate the Service and reprt t the Purchaser as required. Such evaluatin shall include any gaps in prvisin suggested by the ther agencies f Tameside. The Prvider will ensure that a clinical audit prgramme is develped with the Purchaser which will be applied in practice annually and/r as required. 2.6 Annual Prvider Reprt As set ut in service cntract: The Prvider will prvide a review f the Service, in the frm f an Annual Reprt perfrmance review and imprvement plan, which will include: A review f the perfrmance and delivery f the Service against the 5 utcmes in Sectin 5 during the perid f the previus 12 mnths f the Cntract; Frm year 3 nwards, a review f perfrmance ver the previus 3 year time span. Where apprpriate, prpsals t imprve the perfrmance and delivery f the Service during the frthcming year, a summary f the business plan and assciated actins, in the frm f an imprvement plan; An verview Staffing Structure and an FTE emplyee headcunt; Full year independently audited Financial Accunts, in respect f this Service nly, including details f any shift in expenditure and any underspend; A Risk Register with mitigating actins and clear wners; The Annual Reprt shuld clearly identify where the service has psitively cntributed t the Public Health Outcmes Framewrk, NHS Outcmes Framewrk, Scial Return n Investment and Adult Scial Care Outcmes Framewrk.

7 2.7 Annual Case Audit Detailed review f service activity recrds. 2.8 Year One Cmmissiner Review Submitted t Tameside and Glssp Prfessinal Reference Grup Nvember Tameside MBC Internal Audit and CQC Reviews The service was visited by Tameside MBC Internal Audit in July and the Care Quality Cmmissin in December during 2016, and fllw up reviews are scheduled fr July The Care Quality Cmmissin des nt give ratings fr visits t substance misuse services, but the reprt included areas f gd practice as well as areas fr imprvement fr which prgress n actin has been fllwed up by cmmissiners at the mnthly Steering Grup meetings Financial Mnitring And Organisatinal Intelligence 2.11 Financial mnitring 2.12 The cntract requires annually: Full year independently audited Financial Accunts, in respect f this Service nly, including details f any shift in expenditure and any underspend. The fllwing additinal reprting is prpsed: - Prvisin f annual pre and pst independently audited Financial Accunts fr the rganisatin with supprting ntes t the accunts - Prvisin f quarterly in year financial accunts fr the rganisatin as apprved by the bard f trustees. - Prvisin f medium term rganisatinal financial frecast as revised and apprved by the bard f trustees perid t cver current plus fllwing tw financial years 2.13 Organisatinal intelligence The new prvider will be invited t prvide updates n the prgress f rganisatinal develpments within the full parent cmpany t assist understanding f the future delivery f the lcal service Enhanced Mnitring Measures 2.15 The Single Cmmissining Bard Clinical Lead fr substance misuse has identified alchl cmmunity detx activity as an imprtant indicatr f service quality and perfrmance. Natinal data cllectin des nt currently prvide adequate mnitring data, and the prvider has cmmitted t review recrding The details f the current mnitring framewrk will be reviewed with the Clinical Lead with a view t identifying further aspects f perfrmance that require clser examinatin The details f the current mnitring framewrk will be reviewed with the Single Cmmissin Quality Team with a view t identifying further aspects f perfrmance that require clser examinatin.

8 2.18 Natinal Statistics 2.19 Public Health England Natinal Drugs Treatment Mnitring System (NDTMS) and Diagnstic Outcmes Mnitring Executive Summary (DOMES) The lcal service submits a mnthly dataset that cntributes t a natinal database frm which a wide range f analyses are prepared. Sme analyses are available publicly and thers nly t cmmissiners r prviders. Cmparisns with ther areas can be difficult due t differing cnfiguratin f services and cding practices. Cmparisns ver time can als be difficult due t changes in datasets and prviders. Three publishes key indicatrs are: Treatment cmpletin and nn-representatin (% piate users) Treatment cmpletin and nn-representatin (% nn-piate users) Treatment cmpletin and nn-representatin (% alchl users) 2.20 Public Health Outcmes Framewrk Tw measures frm DOMES are included in the Public Health Outcmes Framewrk: % f alchl users that left drug treatment successfully wh d nt re-present t treatment within 6 mnths. Adults with substance misuse treatment need wh successfully engage in cmmunitybased structure treatment fllwing release frm prisn. 3.0 COMMISSIONING STAFF RESOURCE 3.1 Cntract and perfrmance mnitring fr substance misuse is currently supprted by a dedicated Cmmissining and Perfrmance Officer supprted by a Cntract Perfrmance Officer. 4.0 RECOMMENDATIONS 4.1 As set ut n the frnt page f this reprt.