Decision details

To consider the report of the Cabinet Member for Health and Adult Social Care seeking approval to proceed with the implementation of an Integrated Commissioning unit between the People Directorate and Southampton City Clinical Commissioning Group (CCG).

The two organisations have identified commissioning priorities to work on jointly to improve outcomes for residents in a more cost effective way. The priorities are based on the Health and wellbeing Strategy and informed by the Joint Strategic Needs assessment and relevant national outcomes frameworks. There is a joint accountability structure to oversee achievement of the work , although final approval for decisions remains with Cabinet and the CCG governing Body

The proposal is to develop a joint team with appropriately skilled staff who will deliver the shared strategy and achieve quality outcomes and savings through more focused, integrated work. Staff have been consulted on a proposed model. Staff will remain employed by their current employer, with their existing terms and conditions, but work as part of a combined unit.

(i)  To consider the consultation feedback on the establishment of an Integrated Commissioning Unit.

(ii)  To approve the establishment of an Integrated Commissioning Unit.

(iii)  To note that there will be an additional cost to the Council due to the establishment of the Integrated Commissioning Unit of £90,800 from 2014/15 onwards which will be addressed as part of the development of the budget. 

(iv)  To approve as a last resort a draw from the General Fund Revenue Budget contingency for the in year pressure in 2013/14 which cannot be managed within existing resources or from the savings to be delivered, as set out in paragraph 28.

(v)  To delegate authority to the Head of Legal, HR and Democratic Services, following consultation with the Director of People, to agree and execute the Memorandum of Understanding.

1.  Redesigning and commissioning integrated services will improve quality and outcomes and result in more effective use of resources and cost avoidance and as a consequence release savings.

2.  It has been identified that some investment will be required to attract the skill set needed into some of the more senior posts to ensure the leadership, experience and rigour necessary to achieve the change required at scale and pace.

1.  A range of approaches were considered including no change to current aligned commissioning or a compromise that would have a shared strategy but continuing with separate commissioning functions. This was rejected as would maintain inconsistencies in commissioning leading to disjointed pathways and provision, duplications and inefficiencies and limited use of outcome based commissioning.

2.   Alternative models were considered in developing an Integrated Unit including use of Section 75 agreements with pooled budget that either of the organisations could be the lead for or the development of a Joint Venture company. These would all have supported the benefits of integrated commissioning such as pooling  capabilities and purchasing power across the Council and CCG; realigning spend to outcomes required; influencing the market on a grander scale; commissioning more joined-up services so everything “works together and achieving value for money.

3.  However the decision was taken to develop the model outlined in this document as this achieves the benefits of integrating commissioning whilst being less disruptive to staff as no TUPE implications, retaining accountability and governance for each organisation and allowing period to trial and evaluate the approach first.