Follow VODG Blog EditorNational Market Development Forum: VODG sets out its stall
Market development: two words unlikely to raise much interest if you’re a frontline social care worker, and even less, one imagines, if you’re a service user or carer.
Social care is in fact a market; local authorities purchase care and support services from provider organizations, which are in effect in competition with each other. The same is true even for people who use their direct payments or personal budgets. Competitive markets are said to keep costs down and drive up quality and choice but this is often not the experience of the people being supported. Add to this the facts that public funding is being cut and that more people need support there is a big and increasing problem to solve.
Central to the issue of how the social care market will be successful in finding solutions over the next few years is the dynamic between commissioners, providers and those cared for. The National Market Development Forum (NMDF) a group set up to promote progress in social care, is therefore of much greater and wider significance than its title initially suggests.
As the managing director of a provider organisation I meet with commissions, individuals and families frequently so have direct experience of the issues on the ground. Recently I have been asked to chair the NMDF, a key part of the Think Local, Act Personal partnership. The partnership is made up of around 40 national and umbrella organisations representing a broad interest in personalisation and community-based support. The partnership takes over from Putting People First, the government programme that championed personalisation and which ended on in March this year.
Given the fact the NMDF group concerns relations between commissioners, providers and people, relations that are fundamental to the personalisation agenda, it is clear that the success of Think Local, Act Personal will in large part be measured by what the forum does. The involvement of the VODG in this national body speaks volumes of our reputation for adopting a progressive approach and reflects the way we aim to influence the sector rather than simply operate as a trade association.
A personalised approach allows individuals to follow their interests (film: MacIntyre)
In a nutshell, the forum is the place where the thorny operational issues that rattle social care professionals are aired and – hopefully - grasped: the nitty gritty of resources, consultation, contracting and procurement. We have to be constantly mindful of the triangular relationship of commissioner, provider and service user (in terms of co-production) and the VODG is particularly assertive about this and we know this is great in theory, harder to make a reality.
Among the biggest challenges will be to influence local behaviours, many of which are ingrained and include tricky issues such as a lack of trust and transparency between provider and commissioner or the fact the service user is a passive recipient of care, rather than a collaborative partner.
The issues covered by the forum so far include the future shape of the social care market which will be affected by, for example, an increasing demand but dwindling local government spending. This will radically shift the social care landscape in coming years.
Developing market intelligence is another area for the forum, so that councils, care organisations and users understand more about how markets operate and councils can move from being simply purchasers of care to facilitating that care. The impact of personalisation on procurement will also affect relations between care commissioners, providers and individuals.
Currently, three “task and finish” groups are looking into different areas and will report back periodically over the next nine months to the steering group that I chair:
- procurement - what is good practice, how to increase choice, how to encourage investment, and how are councils moving away from their traditional role as primary purchaser of care and giving real choice and control to individuals?
- quality assurance and improvement – how do you provide more for less without standards falling and ensure the public are the final arbiters?
- personalisation – is there a way to bring existing good practice to all models of provision including registered homes and home care services? How do we ensure all interactions between professionals and individuals and their families are respectful and empowering? What skills do the workforce need to ensure people’s independence is enhanced and their place in the local community is protected?
The NMDF’s work complements existing efforts by the VODG on personalisation. The online assessment tool, Getting Personal, for example, was developed by the VODG and SCIE (Social Care Institute of Excellent) to measure providers’ progress on personalisation. In addition, the VODG report, Gain Without Pain (PDF 2.5Mb), demonstrates how to put people at the heart of their own care in a cost-effective, innovative way.
I am determined to ensure the NMDF isn’t just another talking shop, but a chance for real action and high level progress that will filter down to the frontline and therefore - most importantly - to service users.
It’s obvious why the VODG is throwing its weight behind this agenda – without it we risk being left with a fragmented marketplace, a stance of protectionism and all the inequality and stagnation that this would create.
Comments ...
Comment by: Donald Delmohamed (works for MacIntyre in admin)Hi, just read the blog, wow interesting, but this has been going on for years since councils introduced direct payment of which I am very passionate about no only because I am getting it but because some of the people who get it as well can't speak up for themselves unlike me who can, and if their care is not to their liking because of the funding is their carer going to support them to complain about them or the poor service of the care providers.
My experience of it is that the providers i.e the companies that do the care are often understaffed at times like early mornings and at night. Most of the staff who are working are mothers who need time off to take thier kids to school and can't work before 9am leaving the ones who work to be over worked, plus there is very little travelling time between clients sometime only 15 mins so some are often late or which means the client who receives his/her care doesn't always get their full time allowed.
Plus the pay which carer are paid is always low and that's because of funding and some care providers have to pay for their own staff training which is not always a priority.
But hey say we have the right to chose our own care but to me they're all the same.
But what I hate is in the news they always talk about care for the elderly and how they can save for it. But remember this most disabled or sick people who are young and in need of care never get the chance to have savings.
But because some can't speak up its out of sight out of mind.
Comment by: Bill MumfordThanks for your comments Donald, as a fellow colleague I always find your insight challenging. Similarly I like the challenge you have given the Market Development Forum: "......but to me they're all the same". It is quite right that people should expect support which is both flexible and appropriate to their needs while also affordable. Is the problem people face due to a lack of funding or a lack of imagination- or both?
Comment by: Alex FoxGlad to see you leading the Forum, Bill. MacIntyre strikes me as a big organisation with the ability to think small and personalised, and that combination of the very big and the very small will be vital if people are to have real choice as a result of the moves towards personal budgets.
I think that some of the most exciting developments will come when budget holders are enabled to work together to pool their resources and to share ownership of their providers. I would like to see this on a very small scale, as happens when service users form or share ownership of our micro-enterprise members, but I'd also like to see the individuals and families using the largest providers getting together and flexing their muscles. Would Southern Cross have behaved in the same way had its users/ their families formed a user group, or even better, a co-op? What else could they have bought with their £500m a year?
Alex Fox, NAAPS UK (Alex Fox's Blog - NAAPS: sharing lives)
Comment by: Bill MumfordHi Alex and thanks for your interesting thoughts. Philip Blond from Respublica addressed the VODG on Friday and through out some challenges which support your idea. He talked about the "capitalisation of personal budgets"- pooled from all sources for each individual and then as a small local group. He asserted that such self-directed cooperatives need to create assets; "the path out of poverty is through ownership and trading".
With respect to larger organisations, specifically charities, the assets of course are already locked in and are held in trust. Unlike Southern Cross et al they can not be sold on to the benefit of any individual or group of individuals other than the beneficiaries of the charity. The history of most organisations within the VODG is that they were set up by families of people with disabilities and continue to have significant representation of families on governing boards. That said I think we still are a long way from from collective ownership by the people who indirectly or directly buy into our services.
I think the short term answer lies partially in good person centred service delivery on a local level but within a full understanding about the power of good co-production. That is a challenge for all of us, big or small.
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