Weekly updates and essential insight into the NHS in the South West, by Will Hazell

Northern Devon enters the home care market

Northern Devon Healthcare Trust this week announced it was entering the home care market, in what is believed to be an NHS first.

The trust has won a bid to be “prime contractor” for domiciliary care services in Northern and Mid Devon, in a contract let by Northern, Eastern and Western Devon Clinical Commissioning Group, South Devon and Torbay CCG, and Devon County Council. Northern Devon picked up three of the eight contract lots available. 

As prime contractor for “Devon Cares”, Northern Devon will not directly deliver the services, but will manage providers who will.

It’s a bold move by Northern Devon, with obvious potential benefits – if the trust has oversight of the local domiciliary care market, it can hopefully manage the services to prevent avoidable hospital admissions.

Northern Devon has come under fire in the recent past for closing beds at its community hospitals. Taking a more active approach to home care will give it the opportunity to make good on its assurances that those closures were all about shifting more care to people’s homes.

Andy Ibbs, Northern Devon’s director for strategy and transformation, told HSJ that the contract would allow the trust to crack down on delayed transfers of care and “reduce the number of people going through the front door to see a [home care] client”.

While the quality of home care in Devon is “generally… very high”, Mr Ibbs said the sector was facing staffing shortages. He said Northern Devon would improve care workers’ pay and conditions to “try and improve the recruitment and retention of staff” in the county.

Northern Devon’s move is not without risks – social care is not an area famed for plentiful funding, and finances are even tighter with the introduction of the national living wage at the beginning of this month.

The trust will have to make sure its providers get enough money to make a margin – even with higher wage costs – while also carving out sufficient funding to pay for a high quality prime contractor function. The contract is expected to be worth £70m-£80m over its five year duration.

Mr Ibbs said the trust had been required by commissioners to submit separate prices for these different elements, and was “absolutely confident that what we bid was affordable”. Northern Devon worked with 40-50 providers to get its costs right, he said.

The contract is expected to go live in July, and Northern Devon will shortly begin a process to select its providers next week. We’ll watch this one with great interest.

Competition rules stop joint commissioning in Somerset

Somerset is a bit of a test bed for innovation at the moment, as I’ve reported in previous editions of Deep South.

As well as being the home of one of the country’s most high profile vanguards – the South Somerset Symphony Programme – commissioners have ambitious plans to move towards two outcome based, capitated budgets across the whole of the county.

However, the course of health and social care integration never did run smooth. HSJ reported last week that fear of new competition rules had dissuaded Somerset County Council from rolling its social care funding into Somerset CCG’s joint commissioning plans.

While the CCG was seeking to establish two contracts through a non-competitive “most capable provider” route, the council was advised that new EU regulations required it to go to full competition if it wanted to award social care contracts.

There’s an extra sting in the tail for the NHS here. The rules in question – the Public Contract Regulations 2015 – became applicable to the health service from this month, and it is now unclear whether commissioners will be able to use most capable provider.

Are there any other in cases across the South West – or indeed more widely – where the new rules might lead CCGs to rethink their plans? If you can think of any, then please do let me know.

Deep South

Deep South is HSJ’s email briefing on the NHS in the South West of England.

It takes an in-depth weekly look at a region which is one of the NHS’s most innovative, but also highly turbulent. The patch includes the cities of Bristol and Bath, through Wessex and Dorset, and all the way down the peninsular to Lizard Point.

Please get in touch with any suggestions about what you’d like to see covered and any story tips: will.hazell@emap.com