Dealing with Contractor Market Volatility Topic Group Day Two - PowerPoint PPT Presentation

Dealing with Contractor Market Volatility Topic Group – Day Two www.hertfordshire.gov.uk www.hertfordshire.gov.uk

Overview of dealing with supplier instability in HCC Paul Drake www.hertfordshire.gov.uk

Questions to be addressed 1. How effective is Hertfordshire County Council’s due diligence activities? 2. How does the council practise good quality contract management to identify potentially serious issues early? 3. What happens when a supplier fails or becomes increasingly unstable? www.hertfordshire.gov.uk

A typical procurement cycle Pre- procurement market engagement Re-procure or Procurement decommission process Contract management www.hertfordshire.gov.uk

How often? www.hertfordshire.gov.uk

HCC’s response to contractor volatility • Not one size fits all • Routine actions such as: • Contacting sector colleagues to share knowledge • Contacting regulatory bodies • Close monitoring of ‘industry’ media and financial media • Understanding what the alternatives might be in the market • Understanding what alternatives council resources might provide • Considered and proportionate response aimed at protecting service users and continuity of service • Whole organisation involvement • Lessons learnt www.hertfordshire.gov.uk

Case study features • Vulnerable client group or specialist service • Hard to replace contractors • Market disruption • Urgent response required • Not “Carillion” instant failure • Creative solutions needed • Longer term plans to be put in place following initial urgent response www.hertfordshire.gov.uk

Allied Healthcare: A Case Study of Contractor Volatility www.hertfordshire.gov.uk www.hertfordshire.gov.uk

Purpose of this session • To understand Allied Healthcare performance prior to its collapse. • To identify the key actions taken by HCC to successfully manage the provider failure. • To consider lessons learnt for how HCC could prevent a similar provider failure in the future. www.hertfordshire.gov.uk

Homecare, a Fragile Market National Vacancy Rate: Care Care Sector Turnover Rate Sector 45.00% 38.70% 12.00% 40.00% 10.00% 33.90% 35.00% 10.00% 8.90% 30.70% 8.00% 30.00% 8.00% 25.00% 5.30% 6.00% 20.00% 4.00% 15.00% 2.00% 10.00% 0.00% 5.00% Homecare Care Home Care Home All Care 0.00% Services with Services Services Hertfordshire Eastern Region England Nursing without Nursing 4,000 social care vacancies in Hertfordshire www.hertfordshire.gov.uk

Homecare Provider Handbacks: November 2017—March 2019 No. of HCC Homecare Service Users No. of Service Users Handed Back Per Affected by Provider Handbacks Provider Springwell 600 560 8 5 Cuffley Care Carewatch 500 85 FIRST 400 Special Seven 69 HeavenScent 262 300 47 Real Care Caremark Chiltern 200 47 487 Bluebird St Albans 100 26 1 AC Homecare 5 Allied Healthcare 0 8 Haven Homecare 2017 2018 2019 10 8 13 providers handed 801 HCC back some Service Users or all of their HCC affected Service Users www.hertfordshire.gov.uk

Contracts Terminated / Handed Back Homecare Provider Handbacks: contd. Provider Date Date of Reason for Contract area No of New informed transfer handback / closure Service provider Users Caremark 13/03/2018 13/06/2018 Provider unable to Dacorum 8 Caremark Chiltern continue to provide Dacorum service out of franchise area Bluebird St 24/04/2018 27/07/2018 Provider chose not to St Albans 10 Various Albans extend contract or bid for framework AC 14/08/2018 17/08/2018 Care workers found to Welwyn Hatfield 8 Caremark Homecare be working without DBS WelHat & or training Destiny Special 05/09/2018 22/10/2018 Handback following St Albans & 20 Various spot Seven ongoing quality Dacorum providers and concerns T24 Allied 05/11/2018 06/12/2018 Council took back Lead – Hertsmere, 487 Abbots, Alina, Healthcare contracts due to North Herts, St Anchusa, concern over financial Albans, 3 Rivers Helpers & failure Spot – Stevenage Herts at Home Flexicare = Hertsmere, N Herts www.hertfordshire.gov.uk

PAMMS Monitoring Performance Monitoring • 8 PAMMS assessments published during Q3. • 5 Good rating, 3 were Excellent. • 3 of these were first time PAMMS assessments. • Of the 5 providers that had been assessed during 2017-18, 2 had previously been rated as Requires Improvement. www.hertfordshire.gov.uk

Delayed Transfer of Care – bed days lost waiting for Homecare 10,525 8,346 7,296 4,997 4,933 4,160 2013-14 2014-15 2015-16 2016-17 2017-18 2018-19 Apr - Dec www.hertfordshire.gov.uk

Allied in Hertfordshire: 2017—2018 12 100 78 80 10 60 60 8 40 22 21 12 10 6 20 3 1 0 4 Extremely Very Quite Neither Fairly Very Extremely Not 2 Satisfied Satisfied Satisfied Satisfied Dissatisfied dissatisfied dissatisfied Recorded* nor 0 Dissatisfied Apr-18 May-18 Jun-18 Jul-18 Aug-18 Sep-18 Quality Monitoring Officer feedback of 207 Allied SUs, Complaints & Safeguardings Herts April—November 2018. Valleys (Blue=Complaints, Red=Safeguardings) 25.0% 4 20.0% 3 15.0% 2 10.0% 1 5.0% 0 0.0% Apr-18 May-18 Jun-18 Jul-18 Aug-18 Sep-18 23/04/18 30/04/18 07/05/18 14/05/18 21/05/18 28/05/18 04/06/18 11/06/18 18/06/18 25/06/18 02/07/18 09/07/18 16/07/18 23/07/18 30/07/18 06/08/18 13/08/18 20/08/18 27/08/18 03/09/18 10/09/18 17/09/18 24/09/18 01/10/18 08/10/18 Complaints & Safeguardings E/N Herts (Blue=Complaints, % of planned versus delivered calls over 1 hour late. Red=Safeguardings) www.hertfordshire.gov.uk

Allied in Hertfordshire: 2017—2018 Contd. 16000 14000 12000 10000 Hertsmere North Herts 8000 St Albans Three Rivers 6000 Total 4000 2000 0 Dec-17 Jan-18 Feb-18 Mar-18 Apr-18 May-18 Jun-18 Jul-18 Aug-18 Sep-18 Allied Mainstream Care: Hours Delivered in Lead Areas December 2017—September 2018. www.hertfordshire.gov.uk

May 2018: Provider Failure Avoided • Allied notifies market it is in financial difficulty. • Narrowly avoids financial collapse by entering into a Company Voluntary Agreement. Immediate Response: • Start to create Herts at Home, aiming to support all service users. Over 600 HCC • RAG rating service users. service users Medium-term Response: receiving care • Reduce Allied placements. from Allied • Continue developing Herts at Home. • Draft a mobilisation plan. • Re-think our future response. www.hertfordshire.gov.uk

Commissioning Action Taken • Weekly/bi-weekly branch visits from April 2018. • May – plan agreed with other major providers to prepare a response in case of Allied failure • Est. 6 weekly strategic meetings with Allied—focus on recruitment and capacity. • Promised a business improvement plan would be launched in October 2018. • November 2018: branch visits less welcoming and a need to help manage the branch manager. www.hertfordshire.gov.uk

Operational Actions Taken • Daily automated report run showing Allied healthcare users and level of care. • RAG rating exercise of all Allied service-users to collate: – Time critical medication. – Dementia. – Unbefriended. – Double-up care. – Increased surveillance of safeguarding. www.hertfordshire.gov.uk

Interventions by CQC & DoH • Early November 2018: CQC officially warns Local Authorities about Allied’s future. • Early to Mid-November 2018: DoHSC trying to hold Local Authorities in line to prevent them precipitating collapse • 16 th November: official notification that Allied are seeking to sell their contracts. www.hertfordshire.gov.uk

Allied in Hertfordshire: Winter 18/19 • November 18: – 489 service users & 200 staff. – 1 branch office (Stevenage) & a hub (Letchworth): head office in Stafford. – 2 flexi-care sites (Letchworth & Borehamwood). – Small number of live-in care packages. – Reduced management structure in the Herts office. www.hertfordshire.gov.uk

CB5 CB6 Timeline of HCC’s Response 16 th Nov onwards: 22 nd & 23 rd Nov: 6 th Dec: 16 th Apr Allied HCC presence at Partial service Phased transfers Informs HCC branch office failure St Albans complete of CVA application 16 th Apr onwards: 16 th Nov: Allied 20 th Nov: 14 th Dec: HCC accelerates 28 th Nov: HCC Terminate End of Allied decides to sell Phased contingency plan Allied payroll transfers start its contracts Contracts including formation of Herts @ Home, identification of additional agencies and planning division of contract areas www.hertfordshire.gov.uk

Slide 22 CB5 Lets add the May CVA notice here, and that we then brought other providers together to hatch a plan and accelerated establishment of Herts at Home at that point Chris Badger, 08/03/19 CB6 Addiin the operational response in MAy as oputlined in slide Chris Badger, 08/03/19

The HCC Response • Agreed contract end date of 6 th December. • Divided up the Allied block between Abbots, Alina, Anchusa, CBU, Helpers & Herts at Home. • Rapid mobilisation of Herts at Home. • Regular meetings on Business Continuity footing www.hertfordshire.gov.uk

Main Outputs • All service users received a new provider and had continuity of care. • Only 3 calls missed out of approx. 40,000 during transition period. • 200 Allied staff subject to TUPE, 95% retained (had expected 70%). www.hertfordshire.gov.uk