Agenda item

Report to follow.

Introducing this item, Jon Tomlinson explained that a decision had been taken about a year ago to review the adult social care commissioning function and so the Local Government Association (LGA) had been approached who had suggested taking part in testing out an evaluation tool provided by the Public Services Transformation Academy. Haringey was the first local authority to use this tool and, over the course of three days in Sep/Oct 2022, engaged with teams across the Council, providers, service users and voluntary organisations. The Review which was then produced included eight different dimensions which were scored with areas highlighted where room for growth had been identified in areas such as relationships, co-production and innovation. From a commissioning perspective, Jon Tomlinson said that there was enthusiasm to drive change, challenge the market and achieve a high-quality level. There were therefore some areas of improvement work, including on strategic direction, data, communication with providers/service users and refreshing documentation to help plan the commissioning cycle. The direction of travel was to be user and outcome centred as set out on the ‘progress through the models’ slide.

Jon Tomlinson and Vicky Murphy then responded to questions from the Panel:

• Referring to paragraph 1.8 of the Executive Summary of the report, Cllr Connor noted the statement that there were “foundational resources that are lacking within the Adult Social Service Commissioning team” including an overall commissioning strategy, a clear vision about strategic commissioning, leadership and a contracts register. Vicky Murphy highlighted that the commissioning function was still in recovery from the impact of the Covid pandemic and Jon Tomlinson noted that the priority during the pandemic had been ensuring that residents had access to basic services which impacted on other areas of work, such as the commissioning documentation. In terms of other issues, he said that the churn in senior managers across the services would have caused some disruption, so the aim of the current approach was to establish a ‘foundation block’ and clarity of direction to enable consistency irrespective of who was leading commissioning. Cllr Connor observed that the language of the report suggested a lack of strategy and that there would have been a strategy in place prior to the Covid pandemic. Jon Tomlinson confirmed that there had been a strategy in place but said that it was now quite dated, particularly because commissioning had changed as a result of Covid. Various documents, such as the market position statement, and the overall direction of travel therefore needed to be updated. He added that the report had been quite honest about what the key issues were, which was important to enable these to be tackled.
• Cllr Iyngkaran welcomed the transparency of the report and noted that some of the issues highlighted were familiar ones such as silo mentality and poor communication. Asked by Cllr Iyngkaran about the positive points that could be taken from the report, Jon Tomlinson said that the staff being the strongest asset came out clearly in the report. He added that they were happy to be honest and to share and that they were a generally supportive group of staff which boded well for the future.
• Asked by Cllr Connor how staff were being supported, given the critical nature of the report, Beverley Tarka said that the health and wellbeing of staff was paramount and welcomed the spirit in which this exercise had been approached. She added that a culture of learning and absence of defensiveness was important and was pleased that staff felt able to be open about challenges. Alexandra Domingue, Project Manager in the Commissioning team, explained that she had been involved in the balanced scorecard approach and that the presentation shared with the Panel had also been used as a way of talking to staff about the outcome of their contributions and about what to do next. She added that the largest part of the project plan focused on workforce and there had been collaboration with the Human Resources team on tools to help staff with their experience of the transformation process.
• Cllr O’Donovan asked about the timescales required to implement the commissioning development plan. Jon Tomlinson said that the aim was to have the strategic plan in place within six months and then the action plan would follow from that.
• Cllr Mason queried whether the systems were working properly to support the workforce and the residents and to deliver outputs and outcomes. Vicky Murphy said that she was confident that the right people were in the right roles with the right systems and processes to support the best outcomes. She said that it had been necessary to redesign strategies, policies and process over the past nine months to meet the changes in the service, such as the transition to a new customer interface system and the digitalisation of commissioning strategies. Asked by Cllr Mason how she could have confidence in new systems, Vicky Murphy explained that the new customer interface system was used nationally and would add capabilities for Haringey in terms of payments and financial assessments.
• Cllr Brennan emphasised the need for transparency and outward-facing communication as highlighted in the report. Beverley Tarka said that she fully agreed with this and that this was part of the onward journey.
• Helena Kania expressed the view that the recommendations were not strong enough, particularly in the residents and community area and said that there should be a greater emphasis on consulting and co-producing with the local community. Vicky Murphy agreed to take this comment on board and look to strengthen the approach in that area. (ACTION)
• Referring to scorecard approach on the eight aspects set out on page 82 of the agenda pack, Cllr Connor observed that it was difficult to gauge the scores without being to compare it to other local authorities. She noted that the “user and outcome centred” aspect had scored only 30 out of 100 and that this aligned with feedback that she received from carers’ groups that carers were engaging with the Council but experienced a lack of clarity on what support they should be receiving. Alexandra Domingue clarified that, under the scoring system, anything above 75 would indicate no issues to resolve, 50-74 would be classified as ‘good’ and 25-49 would indicate that action was needed for improvement. She added that the aim on communication and coproduction would be get this right across the whole commissioning cycle, including by understanding the experience of residents after a contract was in place and involving them in the quality assurance. Work was ongoing with Public Voice to work with communities on co-production and commissioning engagement.
• Asked by Cllr Connor about previous examples of co-production, Beverley Tarka said that recent co-production work had included on the Chad Gordon Autism Campus and on Osborne Grove Nursing Home. She explained that each London local authority had scored poorly across the co-production strand in the recent round of peer reviews. She acknowledged that there were mountains to climb to reach genuine co-production and that, while Haringey was able to evidence some good examples, this needed to be embedded across a range of areas including by developing personalised outcomes by shifting the power dynamic between the professional and the person with lived experience. Co-production was not just about engagement but about shifting the power dynamics to give over some of that control, though this wouldn’t happen overnight.
• Cllr Mason commented that few people fully understood co-production and that Councillors would also be part of a learning process as this work progressed. She added that some residents did want professionals to take the lead and provide guidance in some circumstances.
• Cllr Connor asked how the Council’s co-production work could best be supported, including from external people with relevant expertise. Cllr O’Donovan noted that co-production was taking place across the country and asked whether the Council was using the academic research and best practice guidance that was available. Beverley Tarka said that the Council had access to good practice information through ADASS and there were other learning opportunities such as a recent ‘partners in care’ away day which had included an ‘expert by experience’ Panel speaking about what a good life meant for them. She emphasised that this area of work represented a massive cultural shift and so it would be important to take on board all the resources and support available. Vicky Murphy confirmed that there would be further staff consultation in the future.
• Cllr Connor asked about the appropriate timescales for the Panel to receive the next progress update on this area of work. Beverley Tarka said that it was important to include Councillors in the ongoing process of learning, particularly in relation to the localities work as they knew communities best. Vicky Murphy said that the next update to the Panel could potentially be provided in approximately 6-9 months. (ACTION)