North East Lincolnshire Care Trust Plus

Allied Health Professionals

On behalf of North East Lincolnshire Care Trust Plus (CTP), Agencia is undertaking a review of commissioning arrangements for the provision of Allied Health Professionals services.  This is in response to strategies for moving more health and social care into community settings.  The Agencia team is working in close collaboration with the CTP commissioning team, partner organisations and the local Allied Health Professionals, including physiotherapists, occupational therapists, dieticians, podiatrists, speech & language therapists, orthotics, and the wheelchair and equipment and adaption services.  We completed an extensive engagement programme with service users and staff, from which a new commissioning framework and service specifications were developed. 

The framework outlined the key requirements and outcomes that need to be delivered as part of the new therapies model and is under-pinned by a re-alignment of the resource to support the delivery of the commissioning framework.  In developing the Commissioning Framework, consideration was given to the Government's Any Qualified Provider (AQP) guidance and explored where this could be utilised to best effect. 

Finally, options for delivery structure were identified and Agencia has subsequently worked with the providers (Northern Lincolnshire and Goole Hospitals NHS Foundation Trust and Care Plus Group) to achieve a signed agreement, confirming their agreement to work together to develop and deliver the new therapies model. 

The Agencia review has been instrumental in informing and determining the best configuration for these important services to meet the needs of everyone in the area.  The development of the new therapies model will help to ensure that services are delivered in the most efficient and effective way possible for the local population. 

Developing QIPP

Agencia was asked to organise and facilitate a one-day workshop to determine North East Lincolnshire Care Trust Plus’ QIPP strategy and programme for the following year. Agencia worked with United Health UK (who are engaged to provide commissioning and analytical support to the CTP) to develop a programme that provided attendees with a clear summary of the analytical work undertaken to identify potential priorities for cost savings, quality improvements and productivity gains.

The event was also attended by the CTP’s partner organisations to enable them to influence the areas to be identified for action and implementation and to ensure “buy-in” to difficult decisions about future priorities. The event was written up and a summary included as evidence within the documents submitted as part of the CTP’s recent World Class Commissioning Assurance review.

GP Out of Hours Service Review

In North East Lincolnshire we reviewed the GP Out of Hours arrangements, including medical support, management arrangements, call handling and nurse triage.  Radical change was needed to achieve sustainable arrangements, and our work has taken us into close negotiation with a wide range of key parties, including the commissioners and the GPs.  A new model has been successfully agreed, together with mechanisms for integration into the strategy for emergency care, intermediate tier services and other out of hours services such as transport and social care.  Agencia supported the detailed design and procurement of a new service, which has recently gone live.

Urgent Care Centres

For North East Lincolnshire Care Trust Plus, the Agencia team was commissioned to provide project support for the development of new arrangements for an Urgent Care Centre, embracing primary, community and secondary care.  The project brought together GP out of hours care, district nursing urgent services as well as the A&E service.  A partnership agreement was drafted by Agencia, as part of a package of support to the project team involving the facilitation of joint working and project planning.

Workforce Development Review

Agencia was commissioned by North East Lincolnshire Care Trust Plus to undertake a review of the Workforce Development functions across the CTP, to assess fitness for purpose and make recommendations for change.  Through review of best practice, document analysis and a series of interviews with key staff, the Agencia team identified a series of recommendations for consideration by the CTP.  These included the role and purpose of the in-house team, decisions about commissioning and delivery of training, the options for integration of workforce strategy with other key organisational strategies for services and finance, and the use of available funds in more innovative ways. 

Safeguarding Vulnerable Adults

For North East Lincolnshire Care Trust Plus, Agencia undertook a short review of arrangements for safeguarding vulnerable adults with complex mental health needs.  The team examined arrangements for care co-ordination and commissioning for patients requiring care whose needs could not be met by local services.  The review centred on arrangements for safeguarding patients’ interests, the relative responsibility of providers, care co-ordinators and commissioners, and the consistency of arrangements with other complex care commissioning arrangements within the Care Trust Plus for both health and social care.  Our report included recommendations on these issues, and proposal for change to the current arrangements.

Interim management support

Agencia continued its long standing relationship with North East Lincolnshire Care Trust Plus by providing interim management support for a range of issues across the CTP's commissioning spectrum.  Among the subject areas supported were:

• Continuing care
• Home care
• Local Development Plan (LDP)
• Procurement Patient prospectus
• Development of a Children’s Trust
• Pathfinder commissioning

Preparing for World Class Commissioning

Agencia was appointed, following competitive tender, to support the CTP Board in its preparation under the World Class Commissioning (WCC) assurance scheme.  Using a variety of approaches, including desk research, data analysis, stakeholder interviews and Board workshops, Agencia helped the CTP to assess its position against the WCC competencies, identify and agree a set of health outcomes and prepare for self-certification under the governance assessment.  The Agencia team also assist in the preparation of the CTPs organisational development plan.

Joint Area Review (JAR)

A major Joint Area Review of Children’s Services (JAR), part of a national roll-out of inspections, was to be undertaken in North East Lincolnshire.  Agencia provided extra capacity to North East Lincolnshire PCT to assist with their preparations for the JAR. This support included undertaking data sourcing and collation, population of self assessment documentation, and awareness raising within the PCT about the JAR process.  Liaison with other JAR partners (other NHS bodies and local authority departments) also assisted in enhancing the quality of the submission to the JAR Implementation Team.  The Agencia team was able to bring a wide range of skills to bear, including data analysis, clinical expertise, project management, report writing and cross-agency working.