Continuing the commissioning journey… | adam HTT

In 2013 a member-led Cardiff council taskforce was created to review their Domiciliary Care commissioning process.

They concluded that their existing framework and process was not only restricting them from delivering a sustainable quality service to individuals but also presented a risk to supply and being able to deliver services effectively and compliantly. Following the decision to change, adam was brought on-board to implement the digital commissioning platform. The outcome was an increased size and level of activity through the provider base, implementing new quality measurements resulting in measurably better quality services being delivered. In short, the council were commissioning more effectively for the individual and able to demonstrate the results.

Fast forward four years and it was time for the contract to be reviewed. The result was an options paper which was submitted to, among others, the IPC (Institute of Public Care) for review. The IPC response to their approach was positive and confirmed Cardiff’s belief that digital commissioning was the right path.

So how does Tom Narbrough, Project Manager for Cardiff, sum up adam?

“The benefit of adam is that they deliver a bespoke service. They give a level of functionality that is not available with any other technology that we are aware of, and it is a platform that delivers not just for us, but also for our providers.

We reviewed all of our potential options in terms of commissioning; returning to a closed framework was seen as logistically very resource intensive and also an unpopular choice with providers. The project concluded that although there were merits to moving to a hybrid or a zoned model a straight DPS would continue to deliver more effectively; to that end, the adamplatform remained the best bet. Using the platform has also freed up a lot of resources. So much so that even the thought of trying to bring some of those modules back internally is unpalatable. The other thing is the MI and data we can get out of the system. When it came to getting sign off to continue using adam, the data proving what we were achieving made it a much more straightforward process”

Has there been any challenges in those four years?
Well, in 2016 Cardiff had concerns over the health and stability of their provider market along with the rates being paid for care. The council had the impression that the market was not growing and was potentially stagnating. This perception was partially rooted in the fact that two providers elected not to take on business through the DPS in 2014, and a further two struggled to retain their business and handed back packages during the first two years. Having to move quickly, the council had to retender to accommodate those contracts with other providers in a very tight timescale.

Following a review, it was concluded that whilst using a DPS there needed to be better market engagement in order to work with the market and head off such risks. Quarterly provider forums were established which were attended by representatives from the Council, local providers and adam. It was here that Cardiff found that providers were adamant that the adamplatform was working and more communication was needed.

Having all three parties in a room regularly has resulted in better engagement and ultimately more offers on packages. This has enabled Cardiff to maintain their focus on selecting the most appropriate, quality providers.

Regular contact with providers is vital. Tom concludes:
“I’m not sure having a healthy provider base can be achieved without it. In fact, through the adam platform, we have be able to monitor the spikes in offers following each event”.

About Tom: Tom is a Project Manager working within the Council’s Capital Ambition Delivery team, contracted to Social Services with a focus on Adults. Since late 2016, Tom has been coordinating the work of the project team dedicated to implementing the model for procuring domiciliary care.

Results in Cardiff for Home Support:

  • Average above 3 offers per package
  • Increased their provider base by 22%
  • 11% savings which equates to around 80,000 hours of home care

Results in general for councils working with adam:

  • On average, we increase a client’s provider base by 30%
  • We improve process efficiencies resulting in 33% time saving for brokerage and finance staff

Midlands and Lancashire CSU:

  • The time it has taken to place a patient out of hospital (DTOC) has halved
  • We enable clients to commission packages which are 6-9% better in their quality rating than they previously did

Across Social Care:

  • our clients generate an average of 3 offers per package
  • Isle of Wight: By integrating with their Case Management System, the council has been able to increase the level of service managed by their brokerage team by 40% without increasing headcount.


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