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THE COMMON GOOD THE PUBLIC AND THE PRIVATE SECTOR IN CARE.
Some thoughts on how the public and private sector might hate each other less and work together effectively.
Paul Simic, CEO, Lancashire Care Association and Director, GM Independent Care Sector (GMICS) Network
LaingBuisson Conference
5 December, 2018
INDEPENDENT
SECTOR
REPRESENTATION
& PARTNERSHIP
IN LANCASHIRE
& GM
Some background on Lancashire Care Association and the LancsHealth and Social Care Partnership
The GM Independent Care Sector Network and the GM HSCP
Independent sector…
- Alignment
- Engagement
- Governance
- Voice and message
- Programme and priorities
- Influence and contribution
www.lancashirecare.org.uk
www.gmicsn.org.uk
THE “TIPPING POINT”
“We cannot continue to
support people in the same
way as existing models of
care will simply not be
sustainable…
transformational
change…is required to
create a sustainable and
vibrant market.”
NW ADASS market sustainability and
oversight report (2018)
Social Care
|5
➢ Social care is critical to the …achievement of clinical and financial sustainability
➢ ADD HOW MUCH WE SPEND the country’s local authorities are facing significant budget pressures. Within GM, the funding gap has been calculated as £70m in 2017/18 rising to £113m by 2020/21
➢ Increasing demands on the social care system, which include demographic pressure and increased costs to implement the National Living Wage, are a contributory factor to:
➢ Significant increase in delayed discharges
➢ Unprecedented pressure on the urgent and emergency care system
➢ Significant market challenges in both domiciliary care and residential home provision.
Slide with permission from TG’s CE pres, November 2017
Greater Manchester Independent Care Sector Network
|6
➢ Effective engagement with the independent sector is crucial to effective service design
➢ Engagement needed a different spatial levels
➢ Independent sector needs to generate sector leadership
➢ Commissioner/provider dialogue has to change
➢ GM is setting up an effective representative body to support partnership working led by Paul Simic and Mark Cunningham.
Slide with permission from TG’s CE pres, November 2017
CARE HOMES,
FOR…
The private residential care sector
is at the heart of Britain’s health
and care system. It is where we
house and care for some of our
most vulnerable citizens …It is
already home to over 425,000
people and to 1/6 people >85.
The need for this vital part of our
health and care infrastructure will
only increase …between 2010
and 2035, the number of people
aged over 85 will more than
double, from 1.4 million to
3.5million. Res Publica 2016
CARE HOMES,
AGAINST…
“I hope all care homes
have shut within 50
years.” “The
combination of team-
working, technology
and better social
support, I hope means
that they go the same
way [as TB beds] over
time.” Simon Stevens, 2014
GM ‘SUMMIT’
2017:
“..TO GO
BOLDLY…”
Mayor Andy Burnham:
…”early intervention…” …”NHS
which promotes not just illness
model…” …”radical, forward-
thinking…set aside some of our
old loyalties…”
Jon Rouse, COO, GMHSCP:
…”audacious…counter-
cultural…paradigm-
shifting…extraordinary scale…it is
now going to get tougher…walk
in the other party’s shoes
…extending trust…believe the
best of each other…collective
ownership…”
THE CARE
NARRATIVE –
PRIVATE
SECTOR
“…it is time for social care to come fully within the public national health service…if you want one example of where outsourcing really has [seen] the worst kind of capitalism it is in social care where older people have seen services utterly slashed and there has been profiteering on the back of the most vulnerable people in our society.” Andy Burnham, Question Time, 2018
‘SYSTEMS
LEADERSHIP’
Question. How to deal with tribal
identities, complex systems and
unpalatable (“brutal”) truths?
Answer = strong systems
leadership.
Question = who can deliver
systems leadership? Who is able
to? Who is empowered to?
Answer = There is a role for
strategic intermediary structures
(provider associations and
partnership bodies) working on a
joint programme.
IMPROVING
NUMERACY
AND LITERACY
Numeracy:
Understanding
the costs of care and EBITDA
commissioning
profit and surplus
the role of markets
the ‘mixed economy’
Literacy: “when did we become the enemy”.
SUMMARY:
SOLUTIONS
KEY POINTS 1
Independent sector needs to shape up in terms of strategic engagement
But it also needs to be allowed to and supported to succeed
Relationships across organisational and sectoral fault lines crucial
“There are no beautiful surfaces without a terrible depth.” Nietzsche.
SUMMARY:
SOLUTIONS
KEY POINTS 2
Dealing with ‘Brutal truths’
Reflections on authority & power:
‘avoidership’ & leadership
Creating an intermediary space
between worlds
Making progress through projects
(eg joint MPS) and ‘learning
together’ processes.
Creating a culture of nurture
rather than fear.
Are ‘we’, collectively, up to the
task?
SUMMARY:
SOLUTIONS
KEY POINTS 3
Cohesion
Continuity
Coherence
LCA: engagement strategy for
the independent sector and
the Lancs and Sth Cumbria ICS
SUMMARY:
SOLUTIONS
KEY POINTS 4
- ‘sleeping with the enemy’ & systems
leadership
- relationships: allow myths and
stereotypes to be challenged
- clear messaging from the top
- transparency in process
- formalised partnership
- mutual respect
- working on projects together: e.g,
‘MPS’ as a joint project
- ‘Gunning principles’ re consult:
genuine dialogue at a formative
stage making a difference
RETHINK
We need to rethink the
process of dialogue and
engagement between
the public sector and
private sector.
Transparency and
honesty are key. Leave
the playground behind.
Audit
IMPROVING
NUMERACY
AND LITERACY
A deeper and more layered understanding of
- Costs (eg Which?)
- Markets, their role
- The mixed economy of care
- Adult to adult conversation
CONTACT
Paul Simic, paul.simic@gmicsn.org.uk
paul.simic@lancashirecare.org.uk
Sarah Luton, Administrator, sarah.luton@gmicsn.org.uk
sarah.luton@lancashirecare.org.uk
01772 455574
www.gmicsn.org.uk
Mark Cunningham, CEO, The Fed, GMICSN Chair
Ken Nolan, Chair, Springhill Group, LCA Chair
www.lancashirecare.org.uk
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