Joint Strategic Commissioning is at the heart of the Public Bodies (Joint Working) Bill. JIT has recently issued guidance on what Partnerships need to do in order to develop Strategic Plans that incorporate a Financial Plan, relating to all integrated resources, by April 2015. This session provides an opportunity to further explore the scale and scope of what partnerships are required to do to deliver on the opportunities and ambitions of integrated health and social care. Contributed by: Joint Improvement Team

1. Joint Strategic Commissioning
Raising the Bar
Tony Homer, Joint Strategic Commissioning Lead,
Joint Improvement Team
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JIT is a strategic improvement partnership between the Scottish Government, NHS Scotland, CoSLA, the Third
Sector, the Independent Sector and the Housing Sector

2. Content
 About the JIT
 Context –The Challenge, Key drivers, Legislation
 Public Bodies (Joint Working) Scotland Bill 2014
 Implications for Joint Strategic Commissioning (JSC)
 Challenges for Partnerships

3. About the Joint Improvement Team (JIT)
 JIT is a strategic improvement partnership between the
Scottish Government, NHS Scotland, COSLA and the Third,
Independent and Housing Sectors
 We work with partnerships to create the conditions for
improvement, to implement national strategies and to deliver
better outcomes in health, social care and housing services,
including through:
 Building capacity and developing skills
 Sharing knowledge
 Improving outcomes through joint strategic commissioning processes
which include effective analysis and needs assessment.
 Constructive challenge
 Strategic Planning (Joint Strategic Commissioning) Advice
Note
 Learning and Development Framework

4. Context
The Challenge
“public service providers must be required to work much more
closely in partnership, to integrate service provision and thus
improve the outcomes they achieve”.
Statutory powers and duties focussed on improving outcomes.
Embedding community participation in the design and delivery of
services.
Developing joined-up services, backed by funding arrangements
requiring integrated provision.
Applying commissioning and procurement standards consistently
and transparently.
Public Services (Christie) Commission (2011)

5. Why?
Key Drivers for Change
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6. Key Legislative Drivers
Public Bodies (Joint Working) (Scotland ) Bill
2013
Social Care (Self-directed Support) Act 2013
& wider framework
Community Empowerment (Scotland) Bill
Human Rights (SNAP)
Community Planning & SOAs
Reshaping Care for Older People
National Legislation & Strategies inc Criminal

7. The Public Bodies (Joint Working)
(Scotland) Bill

8. Integration- The Vision
People are supported to live well at home or in the
community for as much time as they can
They have a positive experience of health and

9. The Purpose of the Public Bodies (Joint Working)
(Scotland) Bill
•To improve the quality and consistency of services for patients,
carers, service users and their families;
•To provide seamless, joined up quality health and social care
services in order to care for people in their homes or a homely
setting where it safe to do so;
•To ensure resources are used effectively and efficiently to
deliver services that meet the increasing number of people with
longer term and often complex needs, many of whom are older.”

10. Public Bodies (Joint Working) (Scotland) Bill (2014)
Defines…
Principles for integrated health and social care
Nationally agreed outcomes for health and wellbeing
Integrated governance arrangements for health and social care:
delegation to a body corporate or lead agency

11. Joint Strategic Commissioning
“Strategic commissioning is the term used for all the activities
involved in assessing and forecasting needs, links investment to
all agreed desired outcomes, considering options, planning the
nature, range and quality of future services and working in
partnership to put these in place.”
“Joint commissioning is where these actions are undertaken by
two or more agencies working together, typically health and local
government, and often from a pooled or aligned budget.”
Public Bodies ( Joint Working) (Scotland ) Bill 28.05.13 – Policy Memorandum para 117
Adopted from the National Steering Group definition

12. The Public Bodies (Joint Working)
(Scotland) Bill - legislative requirements
• Strategic Plans to be developed for all adult care groups,
(Joint Strategic Commissioning Plans) to include specified
functions and a Financial plan by April 2015
• Strategic Planning Group to be established by
Partnerships for the purpose of preparing a Strategic Plan
• Localities - Partnerships will establish at least 2
localities to undertake locality planning and inform the
strategic plan

13. Good Strategic Plans (Joint Strategic
Commissioning plans) should:
• Identify the total resources available across health and
social care for each client group and relate this information
to the needs of local populations;
• Agree desired outcomes and link investment to them;
• Assure sound clinical and care governance is embedded;
• Use a coherent approach to selecting and prioritising
investment and disinvestment decisions; and
• Reflect closely the needs and plans articulated at locality
level.
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14. Strategic Planning Group
• Purpose is to prepare a Strategic Plan and to maintain an ongoing role in
reviewing and improving the Strategic Plan
• Membership will include:
– People who use services and unpaid carers
– Third and independent sector providers, representative organisations and
advocacy groups
– Local authority and Health Board nominees
– Social work and social care professionals
– GPs, clinicians, nurses, AHPs and other professional groups
– Housing representatives
– A representative from each locality planning group
– Staff side and/or trade union representatives

15. The Role of Localities
 To feed into the strategic commissioning process a
collective view on what needs to be made available
in respect of their locality
 On an on-going basis decide on proposals from local
professionals, users and communities on ways to
improve the delivery of services for the locality.
 In time, greater responsibility over financial & service
planning, changes and decision making.

16. Localities – securing real added value
 Not just a talking shop....
 From care groups to assets, multi morbidities and real lives
 Community empowerment and understanding people’s
priorities
 Making space for ‘individual commissioners’ to be heard and
to share their thinking
 Empowering clinicians, users and carers all to play their part
 Where service changes can have a real and quick impact on
outcomes

17. Critical success factors...

18. Group Discussion

19. • Do the key themes and legislative drivers reflect your
experience of the current landscape?
• Pace of change – what’s the reality?
• How easy is it to put together and ‘good’ strategic plan- what
helps/hinders?
• What is your expectation of the future commissioning role in
a world where ‘Individuals become commissioners’?
• Outcomes- is commissioning sufficiently linked to outcomes?
• Is ‘co-production’ achievable with ALL players at Strategic
Planning Group and locality level?

20. • Joint Improvement Team http://www.jitscotland.org.uk/
• Scottish Government and COSLA (November 2010) Self-directed Support: A
National Strategy for Scotland – section 5 “The Shift” http://
www.scotland.gov.uk/Publications/2010/11/05120810/0
• Public Bodies(Joint Working) (Scotland) Bill, Delegated Powers, and Policy
Memoranda and Explanatory notes, 28.05.13
http://www.scottish.parliament.uk/help/63845.aspx
• SWIA Commissioning Guide for self evaluation www.swia.gov.uk
• Procurement Scotland www.scotland.gov.uk/Topics/Governement/Procurement
• Age, Home and Community 2012; A Strategy For Housing For Scotland's Older
People: 2012 - 2021 http://
www.scotland.gov.uk/Publications/2011/12/16091323/0
• Scottish National Action Plan for Human Rights
http://www.scottishhumanrights.com/application/resources/documents/SNAP/
SNAPpdfWeb.pdf
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21. Additional Slides for reference

22. Social Care (Self-directed Support) Act
2013

23. Social Care
(Self-directed Support) Act 2013
• Comes into force in 2014. Replaces the previous
legislation on Direct Payments & Self-Directed
Support (SDS).
• Requires a step change in how we view
individuals – as commissioners of their own
support regardless of their chosen option
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“Individuals will
have greater
choice and
control over the
services they
use through
self-directed
support for
social care and
person-centred
healthcare.”

24. Potential Implications for future commissioning
Points for consideration
• Shift in Culture – using the SPG and locality planning as a means for the
voice of the ‘individual commissioner’ to be heard; making a reality of
‘prevention’ and ‘upstream options’ in the Strategic Plan
• Financial flexibility – ensuring that good quality, value for money services
are available for people who decline self-directed support, or for users who
choose not to become employers
• Clear individual pricing mechanisms required in house and externally
• Workforce – workforce planning essential to ensure sufficient numbers of
Personal Assistants to address potential demand.
• Commissioners as facilitators- Strategic Planning includes facilitating
markets and building community infrastructure links, between existing
assets.

25. • Provider diversification- Providers may find the transition to self-
directed support challenging. Market facilitation and re-visiting the
in-house / external position will be key
• Independent advisors/advocacy- enabling individuals to make
choices- change existing support
• Care Management System - greater emphasis on providing
information about choices and facilitating decision making
• Add in shifting procurement parameters..

26. Procurement

27. Procurement Changes
• ‘Person centred services’ will be subject to a lighter- regime for the
procurement of certain social, health and education services with a
higher threshold of €750,000 applying
• Public bodies may take into account the need to ensure quality,
continuity, accessibility, affordability, availability and
comprehensiveness of the services, the specific needs of different
categories of users, including disadvantaged and vulnerable groups,
the involvement and empowerment of users and innovation
• The Procurement Reform (Scotland) Bill, 2013 focuses on
sustainable public procurement that supports economic growth by
delivering social and environmental benefits including community
benefits, supporting innovation and promoting public procurement
processes and systems which are transparent,
streamlined, standardised, proportionate, fair and business-friendly
•
http://www.scottish.parliament.uk/parliamentarybusiness/Bills/68170.as
px

28. Human Rights

29. Approach for Change
• Human rights – PANEL Approach
– Participation
– Accountability
– Non discrimination
– Empowerment
– Legality

30. Joint Strategic Commissioning Cycle

31. The Commissioning Cycle
31 Developed by the Institute of Public Care, Oxford Brookes University

32. 32
• All four elements of the cycle are sequential and equally
important.
• The commissioning and purchasing/procurement cycles are linked.
• The commissioning process must be equitable and transparent,
and open to influence – a co-productive approach.
• Have a written joined up commissioning plan, focusing on how to
meet needs, improve outcomes and standards, to be met by all
public service providers, with a clear financial plan
Key principles of the model

33. A Tool for….
 Understanding long term demand giving a common perception
of the world.
 Understanding the best approaches and methods for meeting
that demand.
 Improving and modernising supports and services to achieve
better outcomes.
 Encouraging innovative solutions by ALL providers.
 Achieving best value by better configuration of delivery and
greater efficiencies.
 Managing and facilitating the market in a climate of changing
independent and third sector providers.
 Working across boundaries

34. Levels of commissioning;
National
Regional
Sub-regional
Area or strategic
Locality
Individual
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