Lewisham Passenger Transport - Procurement & Joint Commissioner Q&A

In this interview we speak with Paul Creech, Procurement and Joint Commissioner at Lewisham Borough Council about going live with Passenger Transport and what that means for Procurement and the Care Act.

  1. Thank you for your time today Paul, can you tell me a bit about your role and what you’re doing at Lewisham at the moment in the procurement side of things?

"OK, so I’m actually a Joint Commissioner in a team that covers both Adult Social Care and the Lewisham CCG. As a group of commissioners, we tend to commission services across both Health and Social Care across Lewisham. I tend to do a bit more of a Project Management type of role within the team, so I take on individual projects. Transport was a project I’ve been working on for a number of years in various forms, trying to implement the aspects of the Care Act across Social Care practice in relation to travel assistance and travelling; as well as other things for example statistics, needs assessments, information governance so I cover quite a broad remit really."

  1. What made you want to change Lewisham’s approach to procuring transport services?

"It was identifying that the current system was inefficient more so in terms of the processing of the invoices, once the service has been procured. We were leaving ourselves open because of the audit trail in the way that we were actually procuring the contracts for transport. Obviously, that tied in with the cost-effective delivery of services so we were being penalised for some of those inefficiencies, which was increasing our unit costs to adult social care which was something we wanted to drive down in the current climate as much as possible and also as part of the Care Act it was good to develop the market further than we have in previous years. So, the existing Framework was quite limited in terms of the number of people who were actually able to provide services for us. Where-as this was identified as an opportunity to expand that market, provide a clarity of providers and develop that market segment and that’s something we’re looking to do more and more as time goes on. We rely a lot less on some instances of in-house provision than we did previously. There’s also the rise of Direct Payments and Personal Budgets, it’s a way of looking at procuring things like transport differently than we did previously."

  1. Was there one consideration the decision was based on above others? – you mentioned the Care Act.

"I think from my perspective it was very much about the Care Act but the business case that was proposed about the inefficiencies in the service and the cost effectiveness. I mean we couldn’t say it was nothing to do with money, I think that was the leverage in order to get this through and was to say the current system is ineffective and inefficient, we can deliver this differently, plus free-up time so there will be cost savings and benefits both for Adult Social Care, for Children’s and Young People’s Services as well as for the actual administration team that’s doing the work."

  1. What objectives do you believe this approach will help Lewisham achieve?

"Well I think in terms of corporately and strategically as I said, delivering things more cost effectively but in terms of Adult Social Care the objective of being able to provide more tailored support. One of the arguments we’ve put forward in changing our travel policy, about the fact that the current system doesn’t allow for variations or many options in terms of the travel assistants people receive. Where-as procuring through a system like adam means you’ve got a little bit more flexibility about how you can actually have your needs provided for. So, it works in both of those ways."

  1. What issues do you believe this approach will help Lewisham alleviate?

"I think in terms of the key thing around the business case the processing and the payments, I mean, the issue was that our payments were very very late, which tied up the team’s time in order to process them. Plus, it meant that the relationship with our providers wasn’t as good as it could be. So, I think that in terms of what it’s going to alleviate is number one, that relationship which then will drive and have a direct influence on the costs that we’re accruing for Social Care and it will also mean a more effective procurement system for the actual team that’s doing it."

  1. How (if at all) will this change / improve your role, strategically and day to day?

"Day to day, hardly at all to be honest because my role is more strategic and advisory in terms of what I do to Social Care. What it has helped me do is basically sell the idea of Direct Payments and Personal Budgets to a much broader audience. So, one of the issues we have around this is that people don’t necessarily want to Direct Payment because they don’t want to deal with the administration of having to manage money or employing people directly and everything that entails. So, we have a lot of managed accounts and there was a concern that strategically would we be in a position where we couldn’t manage people’s expectations around this given the teams that we had but, using adam as a procurement platform means that strategically we can do that. So, we can offer a Personal Budget and we can commission using this much more effectively than we could previously."

  1. Was it a question of Framework or DPS or more than that?

"I think initially it probably was just a question of Framework or DPS and I think when you look at the Framework that’s where the recognition of the fact that it was quite limited in its development of the market, people were tied into the framework for five years or four-five years, so if there were changes to people’s needs in the intervening period, if it wasn’t something that we had necessarily thought of five years ago you couldn’t deliver that. So, that’s when we identified the DPS as a much better way of building in more flexibility and therefore providing more personalised services and provisions for people."

  1. What internal obstacles did you have to overcome to make the change?

"To be honest, from my perspective, I didn’t really encounter any I think Stephen may well have had as he drove most of the project around this. But from my perspective, maybe it was the way I couched the proposition, which was we recognise that we had an issue around the cost involved in transport and we knew anecdotally that it was higher if we went through the Framework than if an individual social worker called up a company and got a cab. So, it was playing on that fact that we were paying way above the market rate for the providers that we had made it a much easier sell I think."

  1. Why now for Lewisham?

"I think it was almost like a perfect storm of things so transport is one of those areas where you will probably find that different councils are looking at their provision for transport because it is a very expensive aspect of people’s care and support. You’ve also got the changes of the Care Act which we’re coming to terms with, the personalisation agenda which has been going on for a long while but people are still looking at ways to enhance and develop that. We had the recognition that the Framework wasn’t working in terms of developing the market and we also knew that the team was inefficient so I think it was a case of we were looking at our options and this came around just at the right time."

  1. What is Lewisham trying to achieve in transport?

"More individualised, flexible services for people that meets their actual needs rather than people being siphoned off into something. So, from my perspective it’s much more about recognising people’s own abilities and to be independent and recognising independent travel and what this fulfils is providing an option for people where that’s not currently the case but can still cater for individual’s needs. So, not everybody needs to go on a 17-seater bus, not everybody needs to have a tail-gate, tail-lifted mini-bus, not everybody has to have an escort. So, working with adam means we are able to much more effectively cater for peoples’ individual needs or even groups of individuals’ needs than we have done previously."

  1. What advice or recommendations would you make to other boroughs/councils looking to change, perhaps aren’t looking to change but taking a strategic view of their Borough/Council?

"I think strategically you have to look at the provisions of the Care Act, it’s difficult because it doesn’t really answer some of the questions that come up so what this does is, you can look at this as a way of helping you towards that goal in a way of implementing Care Act compliance services and assessment. Although looking at it strategically, for us it made sense given procuring and the way that we were procuring, but it’s being able to have all of that information accessible to you early on to know whether or not this is going to be a good option. So, for us it was quite clear, after some time and motions studies and system planning to look at where are there hold ups, why are their hold-ups and how can we then develop that. So, it was a whole system approach to looking at what we did in terms of procuring taxis so I’d say undertake that first so you can really see the benefits of this."

Thank you for your time today Paul.

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