‘Money too complex to mention!’
Joint Commissioning:
Models of Current Partnership Practice
NIUSE/IASE Joint Conference
Letterkenny 18th November 2004
Dr Donal McAnaney
Rehab Group
Holistic Approach
Environment
Health
Social/
Emotional
Physical/
Functional
PERSON
Education
Finance/
Economics
Cognitive
Occupational
Multiple Commissioners – Individual Needs
Local Authority
Community Health
Mental Health Services
Physical & Sensory
Services
Education
Learning Disability
Services
Social Welfare
Labour Market Services
Factors Associated with Social Exclusion
Unemployment
Job Loss
Criminal
Record
Abuse
Personal
History
Fiancial
Problems
Low Income
Poverty T rap
Lack of
M obility
Poor Housing
Social
Attitudes
Low or No
Qualifications
Early School
Leaving
Health
Suspicion of
the System
Disability
Family
Instability
Peer Culture
Nonconforming
Behaviour
Low Selfesteem
Discrimination
Lack of
Practical
Opportunities
Economic
Situation
Dependence
Institutionalisation
Responses to Social Exclusion
Job Creation
Intermediate
Labour M arket
Early
Intervention
Economic
Development
Social Policy
Extra Supports
Community
Integration
Prevention
Flexible
T raining
Opportunities
Public
Awareness
Raising
Health
Education
New
Approaches to
Education
Independent
Living
Access to
Qualifications
Family
Supports
Outreach
Personal Skills
Development
Discrimination
Legislation
Community
Development
T ransition
Supported
Recruitment/
Employment
M ainstreaming
Who needs Joint Commissioning?
• People in transition
• People who wish to progress
• People with a dual diagnosis
• People with complex needs
• People who are inappropriately placed
• People who need early intervention
• Most people in fact
What’s so good about Joint Commissioning?
• Contributes to cost effectiveness
• Eliminates gaps & redundancies
• Facillitates a higher utilisation & sharing of resources
• Achieves system synergies
• Supports integrated services design
• Crosscuts administrative ‘silos’
• Promotes inter-agency working
• Achieves customised, person centred solutions
What’s stopping effective Joint Commissioning?
• Fear of Double Funding
• ‘Silo’ policy making & funding mechanisms
• Complexity of arrangements
• Incompatibility in goal & outcome specification
• Lack of leadership
• Categorical models of disability
• Absence of ‘joined up’ working in the sector
• Ambiguous responsibilities
Approaches to Joint Commissioning?
• Funding partnerships
• Provider partnerships
• Dual registration
• Multiple purchasers
• Case management/Rehab Counselling
• Service brokerage
• Single shared assessment/Individual action planning
• Personal budgets/Direct payments/Micro Boards
Multiple Commissioners – Single Provider
Private
Insurers
Direct
Payment
Health
Boards
Local
Authority
Social Work
Departments
Job Centre
Plus
Employment
Service
DWP
Momentum Brain Injury Vocational Service
Assessment
Cognitive Rehabilitation
IT Skills
Personal Skills
Job Tasters
Supported Employment
Client
Purchaser
Service
Users
Scottish
Enterprise
ESF Obj 3
Co-funder
Multiple Contracts – Holistic Service
Job Centre
Plus
Dept. of
Work &
Pensions
Service Provider
Primary Care
Trusts
Local
Authorities
Work Prep
Health
Hours
Component
Hours
Service Provider
Job
Coaching
Supported
Employment
Hours
Individual Plan
Qualifications Hours
Additional Learning Support Hours
Service Provider
Learning
Skills
Council
Lawyers
Private
Insurers
Service
Users
Clients
Multiple Commissioners – Programme Provider
Dept of
Employment
& Learning
Disablement
Advisor
Service
Local NHS
Trusts
ESF Obj 3
Co-Funding
Funding Partners
Voc. Rehabilitation
Cedar
Foundation
Programme
Provider
Person
Centred
Planning
Case Management
Multiple Commissioners – Spot Purchase
Community
Care
Social Work
Learning
Disabilities
Partnership
Care Plan
Independent
Living Fund
Home Support
PI Care
Broker
Individual
Respite
Befriender
Lead Commissioner – Mediating Agency
Supporting
People
Lead
Commissioner
Income
Support
Social
Development
Housing
Health &
Social Care
Independent
Living
Provision
Housing
Support
Cedar
Foundation
Mediating
Agency
People with
Complex
Needs
Multiple Commissioners – Provider Partnership
New
Opportinities
Fund (UK
Lottery
Drumchapel
Social
Inclusion
Partnership
Drumbarton
Road
Corridor
Social
Inclusion
Partnership
The
Robertson
Trust
Greater
Glasgow City
Council/
Health Board
The
European
Social Fund
(Obj. 3)
Funding Agencies
STAR Partnership Consortium
Drumchapel
Opportunities
Local
Economic
Development
Drumchapel
Adventure
Group
Glasgow
Volunteer
Centre
Momentum
Scotland
Community
Addiction
Team
LEAD AGENCY
Individual & Community Action Planning
Unemployed
Residents who
misusing or have
misused drugs or
alcohol
Glasgow
Council on
Alcohol
Supported
Employee
Supported
Employment
Partnerships
Service Provider
FAS
Education
Health
Boards
Vocational
Training
Individual
Plan
Service User
Joint
Commissioning
– Irish Style
Adult &
Basic
Education
Vocational
Rehab
Shelter
Occupational
Services
Individual
Plan
Service User
Sheltered
Worker
?
SCFA
ETE
DOH
E&
LR
ED
STATUTORY & SEMI STATE AGENCIES
NOT FOR PROFIT PROVIDERS
PRIVATE SECTOR PROVIDERS
AREA PARTNERSHIPS
UMBRELLA BODIES
REPRESENTATIVE ORGANISATIONS
Figure 2
NFPs
Partial Map of Current Vocational Education, Training and Employment Provision in Ireland
DOE&S
DOH
VECs
HBs
Voc.Ed.
Providers
NFPs
Cert. &
Standards
HB
Services
VT
Services
2
Employers
DETE
DSCFA
FAS
Comhairle
Community
Training
Employment
Services
ESOs
External
Providers
VT
Centres
Employment
Supports
NFPs
Comm.
Workshops