Commissioning to address complex needs – Plymouth City Council

• Lead Member Plymouth City Council
• Categories Finance

Background

Traditionally contracts have been commissioned in separate silos, often resulting in duplication, inefficiencies and poor outcomes for the person using multiple services.

Twenty five contracts spanning substance misuse and homelessness were aligned whilst a new single system was co-produced and procured using a competitive negotiated procedure.

New system

During the last four years Plymouth City Council, in conjunction with partners and people who use services, co-designed the new complex needs system as one which will enable people to be supported flexibly, receiving the right care, at the right time, in the right place.

Using an Alliance model, the focus is on creating systemic change: changes to culture, funding structures, commissioning and policy that will support a new way of working. Together we have created a contractual environment where suppliers share responsibility for achieving outcomes and are mutually supportive, making decisions based on the best outcome for the service user.

The new contract went live on the 1^st April 2019 and is being delivered by The Plymouth Alliance, which has eight member organisations. The contract has been issued initially for 5 years but may be extended until 2029. The contract is worth £7.7 million for the first year.

 Key changes

Key changes will include:

• A no wrong door approach, where someone can present at multiple points into the system and still receive the same high quality, consistent offer
• A system of complex needs workers who deliver support wrapped around the person.
• A reduction in duplication and inefficiency
• System decisions being made collectively about resources using a ‘best for people using services’ principle and the ability to respond flexibly to need

System priorities

The Plymouth Alliance is currently in its implementation phase but has identified a number of priorities for the coming months:

• The development of an integrated accommodation hub, providing information and advice, assessments and allocations
• The implementation of a shared referral database, enabling a single record to be held
• An Accommodation and Homelessness Prevention Strategy including plans to increase independent accommodation, reducing the use of emergency placements and rough sleeping whilst exploring a Housing First Approach to accommodate our most complex clients
• An Asset Management Strategy to consider the best use of existing premises across the system and reflect identified priorities.

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