Representatives of the Croydon Alliance were in attendance to report to the Committee, this included Stephen Warren, Director of Commissioning CCG, Martin Ellis, CCG, Rachel Soni, Head of Adults, Health and Integration, Croydon Council, Barbara Peacock, Executive Director for People, Kate Pierpoint, Age Uk Croydon, Dr John Chan, Clinical Lead, Croydon GP Collaboration and Janice Still, CCG Janice Still, John Goulston CHS had sent his apologies.
The Alliance reported that the Outcome Based Commissioning for Over 65s had been presented at December meeting of the Cabinet. This is the first year of a 10 year running contract, where the financial risk of £223m per annum had been split between CCG, £180m, £44m Adult Social Care and £30m is third party spend, however the bigger risk sits with the Council as the responsible organisation delivering social care. All parties have the belief that this is the right approach to deliver future adult social care.
Members raised concern that the Alliance agreement term of 10 years could have sustainability risks. Officers agreed that there is a risk which is why the contract is split 1 year followed by 9 years. The Committee considered that the two areas nationally that has explored an alliance model had both failed. Officers confirmed that they went "too fast" and that the guidance had been changed following these false starts. Croydon is in a "good place" with the models of care and the multidisciplinary team working, it is a good new story for Croydon.
The Alliance is committed to a long-term contract to ensure that the services transformation can take place. Across the authority, officers are signed up to long term contract.
The Committee asked the Alliance how the Health Scrutiny Sub Committee should scrutinise outcomes, as the contract is complex and recognised that as a committee there is a need for an exercise in how to scrutinise OBC in the future. Some of the areas of performance which could be reviewed are the measurement of progress, evidence of budget management etc.
The Alliance discussed timescales and that overall the OBC has slipped about a year, 23 Dec was a new deadline for the heads of terms to be signed off. A lot of work has been done to complete on the Alliance, with a start date of 1 April 2017.
Officers confirmed that the OBC should achieve 5% savings year on year for the 10 year term. This will be achieved by moving care to a different format, focusing on out of hospital locations, keeping people fit and well, strengthening community services as hospital provision is very expensive, transformation is the key.
The Committee were concerned that if savings are not realised who will happened to the budget. Officers reported that the transformations that are required are very important, as a major plan for all Alliance partners. Realistically it is going to take a few years to deliver.
The Committee concluded that they are more assured by the presentation and that as the Alliance are conducting the reviews that as things develop if these could be brought back to scrutiny.