Service continuity and Care Market Review

Hazel Summers:  And welcome, everyone, to the Service Continuity Care Market Review question and answer session today. My name's Hazel Summers, I'm the Care and Health Improvement Advisor for the North West, working for the LGA, but I also have a, a role around commissioning and market, so, so welcome, everybody. I, I have to emphasise, this will not be slides, very many, just a couple at the beginning. This is for you to ask questions really, around, around the review and we will be taking your questions through the chat box. So, could I have the next slide, please? So, as I said, I'm Hazel Summers, I'm the chair today and we have Ian Winter from-, who's the DHSC lead. He'll be talking you through the purpose and be here to answer your questions. We have Phil McCarvill here, who's from ADASS and will be answering questions around the regional work, etc., and Leon Goddard from the LGA and Leon is the senior advisor for commissioning and markets. Just do normal housekeeping stuff. So, please can you stay on mute and keep your camera off because the-, if we don't keep the camera off when there's so many people the, the connections might go down very easily. Please use the chat for your questions and we will take them as they come through and just to let you know that the-, that the webinar is being recorded. So, the structure of today is a bit of an update on the regional role. Some detail on the questions that have already been asked, 'cause I know Ian has been out to many of the regions already, if not all of them, where questions have already been raised and a question and answer for our panel, so, next slide please? So, Ian, I think you're talking through the regional framework, is that correct?

 

Ian Winter:  Yes, I am, Hazel. Thanks very much indeed. Hi to everyone. It's important we get through these slides quite quickly, but obviously to pick up any questions. The, the regional role is really important and significant, alongside the self-assessment from each council. We, we realise and know that, that regions have a key role to play and have been playing that for a long time. So, the first role of the regional support during this period, from now, up until the submission on the 21st, is to support councils to complete their SAQ, pick up any questions, filter any points, give any further advice, if necessary, feed back into LGA ADASS to the advisory group that I chair every week and to make sure it-, it's, it's being kept on track and if there are any difficult issues to, to flag those. The second element, which goes alongside that, is to use the knowledge, experience and skill that already exists in the regions, either because of work that's been done, market intelligence that's been gathered, particular projects and programmes that have been run, to give their regional perspective on the state of the market seen through the lens of the particular issues of COVID-19 and EU transition, but more generally as well. And to give their view of the combined SAQs, self-assessment questionnaires, for their region and to highlight what might be perhaps sub-regional issues, because there'll be some of those that need to come out of that, or key link ups that are particularly relevant between authorities or, more generally, the kind of picture and overview, as we call it, of what's happening in that region.



They may be able to comment, as well, on the (audio cuts out 04.21) perspective, if I can call it that, of key partners, NHS and, and, and so on. So, so that's what we're-, that's what we're seeing in all of that. I think there's another slide, is there? Next? Yeah. Let, let me-, I've, I've done the first bits in a way and you, you can all, all see those, throughout this process LGA ADASS and DHSC are, are keeping in touch with it, supporting it in, in the way that's said there. We track progress every day with, with the group LGA ADASS and DHSC, to keep on top of any queries, that's the important thing, so that things don't go astray, we, we can move things on helpfully and clearly. The frequently asked questions are on the web and they will be updated on a regular basis as well. Let me go to the details, because this is now important. We have shifted this slightly in the last day, as a result of these sessions and others and comments that we've received from particularly regional colleagues, to try and make this really workable, even though it is a tight deadline. Recognise that. So, the deadline for submissions of each-, of each council's SAQ is midnight Wednesday 21st. This should be the complete and full version and then, allowing for the region to receive all the completed SAQs. The changes here. We have said that on the 21st they would be closed as they were submitted into LGA and we've amended that.



We've amended that to be (audio cuts out 06.22) they can be looked at by the region, with the region and local authorities and if there is a requirement for any clarification, any amendments that help to make it make more sense, or a query that says, 'This doesn't fit with anything else that's being said,' which is a perfectly valid question, there may be good reason for it I hasten to add, then that can happen. So, it won't be that regions are looking at a document that's already been submitted and gone and can't be amended. It can be amended, though of course we're not expecting there to be massive wholesale amendment at that point. This, this is about fine-tuning, polishing, as it were, the results and then all those changes must be completed and then resubmitted by noon on Monday 3rd, after which there can't be any changes made. We hope that both gives regions a very good opportunity, even though a short space of time, but a-, but a-, but a-, but, but a more flexible opportunity to get inside those things. It should be Monday the 2nd November, is what everyone's just realised. So, it is Monday the 2nd of November. Hope that's okay. Is there another slide for me, or, or is it now open? Oh, right.

 

Hazel Summers:  Yeah, another slide, Ian.

 

Ian Winter:  Okay, no, thanks. Thanks, Hazel. This, this begins to set out-, we, we-, we've talked about this a lot together in the advisory group and in many other places and we've tried to avoid giving a, kind of, really structured proforma. Regions work in different ways, they, they have some different priorities, urgent perspectives and so on and, and of course, they know a lot already and so we've tried hard not to constrain what you say. This is about giving, if I may call it, some shape to it. A shape that allows us in DHSC and nationally at LGA and ADASS to look at the picture and, and get a, a-, an early feel of, of what it looks like. So, we are asking you, as I said, to describe the activity and perspective that, in a sense, is above council level and that may be in very-, in, in different ways according to the, the region that you're in. Then to content on that, which is of greatest significance in that region, about risk, about planning, about support needs and so on and then, as I've said, not a commentary on each SAQ, that, that's not necessary, the SAQ speaks for itself I think, but to, to give what might be the overview of knowledge and intelligence I commented on earlier. There's a-, there's an outline, really, of, of what the, kind of, headings might look like. We'd certainly want you to cover, of course, the key issues of learning from COVID, the contingency arrangements, the market capacity overview, particularly up until March 2021, though we recognise it doesn't stop and start there, but that's the focus of this review and, and, and as importantly, the main risks and challenges.



I'd like to add to that one, if I may, without confusing everything, Leon, the support options, or opportunities that come in that, because that's one of the key messages I want to be able to send back squarely into DHSC as a part of this review, that there, there, there are ways in which some of these risks and challenges can be mitigated and supported from the centre through LGA, ADASS, through CHIP (ph 10.50), through CHIAs (ph 10.51) and all of that in there. And then-, and then again, we've repeated the error of the 3rd of November, just to keep you all on your toes. I think it's the 2nd of November. That's enough from me for the minute, Hazel.

 

Hazel Summers:  Okay, thank you very much, Ian. Yeah, 2nd of November, we've got it and more details about what's required and I really do want to emphasise what you said Ian, there, around the support. It-, it's important to draw that both in the self-assessment questionnaires that individual councils do, but, but actually themes of that in terms of what the regions are asking for and Leon is going to talk a, a little bit about what support is available for the councils during this process. We haven't had any questions in the chat yet, so if I can really encourage people to put questions in and the purpose of today is really understanding that you've looked at the self-assessment questionnaire, you've thought, 'Oh, what does that question mean? What are you trying to get at? Who's the audience for this? What's going to be the ultimate outcome of this review?' etc. So, so please do put your questions in. So-,

 

Ian Winter:  Yeah.

 

Hazel Summers:  Ian, these are questions that have already been raised through, through the sessions you've already done with ADASS region, so can I just ask you to pick up, what is the purpose of the review?

 

Ian Winter:  This review is specifically about giving both assurance into DHSC, (audio cuts out 12:22) information and detail about the risks and challenges and about the kind of support that is required and will be required through both this period and beyond, specifically through the lens of the impact of COVID-19 and EU transition. So, the purpose of the review is to set out, fully, that's why we're asking every authority to, to be a part of it and why it's very important that it's a self-assessment approach, not being done to, or by someone else, but your view of your level of risk, certainly risk to continuity of provided services, both across council-funded and self-funded individuals, across the whole adult social care spectrum of activity. That's important, though we know some are inevitably more at risk than others, but we want to see that within the context of what you're trying to do already, of shaping and developing and managing the market. Then, the strength of your contingency. The way in which you think they're, they're tested and tried and proven and many of you have already done exercises around all of this. So, understanding the levels of confidence you have in your contingency programmes and do they involve other people in that other-, other key agencies and so on and then to set out both your examples of good practice, so that we can properly collate those and, and get those fully shared through LGA ADASS and, as I emphasised and I hope made clear, the kind of support that is really needed, that actually you know best about. You know what works well from your own experience, both as regions and as individual LAs. That’s the purpose of it.



If I do the other bit which, which might come up if I may, Hazel? The review report itself, which will be concluded around the middle of November, will be made available to LGA, ADASS and to local authorities. That's clear. There will be, of course, in the submission to the minister, civil service advice, advice on policy, and that will not be shared. Again, that's not uncommon (audio cuts out 15:22) in fact it's standard practice. It is intended that there will be a summary overview of the report that will be made public. The main body of the review, though shared with LGA, ADASS and LAs, will not be published but there is gonna be a short overview of the review that, that will be published and it's intended that the report to the minister will be made as soon after the middle of November as possible in, in the process. I hope, hope that's-, I hope that's helpful.

 

Hazel Summers:  Thank you, Ian. There are some questions coming up in the chat, but I will come back to them in a moment. Phil, could you just talk a little bit, please, about the role that regions will be asked to play? We've already had some conversation through, through the slides that Ian went. Is there anything that you'd like to add?

 

Phil McCarvill:  Yeah, so I think there's two roles that the regions will play. The regions will play a role in terms of providing additional support to colleagues locally and be able to answer some questions about what's happening within the region, but that's aside from the technical support that we can offer in terms of making sure people can access the links and things like that. But in terms of the regional role in the, the phase-, the phase of the work is really around providing some context to the information which local authorities are giving to, to-, as part of the review and making sure that we're pulling in what we already know, so that when someone at the national level looks at the results from a particular region, or from a particular authority, they know exactly what is going on within that particular region. So, they're pulling out the context, what's already known about the market within the-, within the local areas, what the themes are, where the common issues are, where there are things which have come up, which have maybe surprised people that they've identified as part of this, by looking at what's going on across the region and putting that very much into the context, but also then identifying what's the additional support that would be needed. So, it is very much taking a step back, looking at the context and then also looking at what we've learnt from the other individual reviews. What it's not there to do is to go into, sort of, quantifying five authority ZX. It's more about giving the-, a, a flavour of what's going on within the wider region.

 

Hazel Summers:  Yeah. Thank you, Phil and, and from my point of view, as somebody who works across the region, I think it's really important to get our regional flavour over there about-, because I know working in the North West, like I do, will be very different to what is happening in the South West, or, or South East, for instance. So, I think that's really important to get our key messages across, using the opportunity to get key messages from the region across. So, Leon, what support is available? If you could just give us briefly?

 

Leon Goddard:  Yeah, happy to. We've set up a webpage on the LGA website and, and I'll ask that a link is put into the chat for that website, but links have been provided through other means. What we've also set up is an email address and, again, the email address is on the webpage, but I'll get the link put in there as well. That is for any, any number of different types of queries. What we've had so far, I suppose understandably, is just queries about making sure that the right people have got access to their own council's online platform that they can complete. What we also expect are, the types of questions that have come up on this chat so far are likely to come through that mechanism as well. As Ian said, what we will do is very quickly turn round answers to those questions and load them up on the frequently asked questions, which will be on the website. What will also happen is, we'll take a download of this chat and also answer the questions that have been raised, both verbally and in the chat as well. There'll also be a further webinar a week on Monday, with a very similar format to this. Our thinking is that there's a place for something today, once people have started to look at what's been asked of them, there's likely to be a role for a webinar as well in, in a week and a bit's time, once people are, are getting into the nitty-gritty of completing things. That's all very, if you like, self-serviced. That's there. That, that information and that support.



What we're also more than happy to do is any other, if you like, ad hoc support that perhaps we've not thought about, but that might be needed in the regional mechanisms or if there's councils with particular issues that they want to talk through, we're happy to do that. We just want to support councils to, I suppose, produce the most effective, but also efficient means of, of completing these returns. So that's our main role and if I could just add to what's already been said about the support after the reviews have been completed. The sorts of conversations there are trying to take support in its broadest sense. So, that might be about what support a particular council needs, it might be, for instance, support that councils think can be made legislatively, or at a national level around, for instance, information around self-funders, the interaction with CQC and other things. So, please take that in its broadest sense and it might not be something that somebody gives to you, it might be something done on a-, on a wider scale that will just help you support you and the functions that you're carrying out but, again, happy to take any, any other thoughts or suggestions around the sort of support we could provide.

 

Hazel Summers:  Okay, thank you very much, Leon. The first question from, from the people of our oracle (ph 21.04) is from Tom Stansfield (ph 21.06). Tom said, 'How are the review findings going to be used to benefit and support local authorities?' Ian, I think that's for you, really.

 

Ian Winter:  Sorry, just-, yeah. Well, the key issue is, I think there are three things and perhaps I would say this, wouldn't I? Anything that helps central government, through the Department of Health and Social Care to really understand what's happening in the front line, as it were, particularly in local authorities, it seems to me is important. That's not a trite comment, having worked in DH for a number of years before this role and worked in-, asna DASS and a DCS I, kind of, know the, the disconnect that can occur from time to time and it seems to me incredibly important that the reality of what is being dealt with on the front line is properly set out and put into context. Exactly the points that Hazel and Leon and Phil have already said. That's the first thing and anything equally in that, that assists any minister, I'm not picking on this minister, but any minister or Secretary of State, to be well informed and informed in a balanced way about the sector, as I might call it, it seems to me is critically important. Especially when they will be making, in all sorts of ways, key decisions about the future of adult social care. So, I'm not naïve in that, but I'm certainly very keen on the fact that it helps to inform and advise policy, which should not be written in a vacuum. That's, that's the first thing. That might sound a bit high level. It's, it's not meant to be.



The next one that is just as important is that, I certainly will (audio cuts out 23.22) DHSC and ministers to get a firm grasp of how important the levels of support that they give to LGA, ADASS and others, I'm using LGA ADASS as the example here and therefore to local authorities, is, is, is vital. It's, it's not an add-on extra. It adds tremendous value to what's going on, but it is equally vital to ensure that (1), government policy can be carefully disseminated and worked on, but (2) that there's a level of real support in the front line, even at times like this, when there is such massive pressure. So, that's why I think it's important that DHSC are as engaged as possible and they are, with this and are committed to it and committed to a report going directly in (audio cuts out 24.22) the minister as quickly as possible in this period. So, I think it helps understanding, it helps decision making. I think it helps levels of commitment to support being continued, targeted and developed. That-, that's my view and that's certainly been my experience over a long number of years.

 

Hazel Summers:  Thank you. As, as a follow-up to that, Ian, Andrew Morrison's asked, 'What relationship read across does this have to the LA winter plans?'

 

Ian Winter:  Yes.

 

Hazel Summers:  I need to say that they don't have to be submitted in October. My understanding of the winter plans, and Phil and somebody else might contradict me, is that you just have to assure DHSC that you have one. You don't have to actually submit the plan, but how do you see the read across working, Ian?

 

Ian Winter:  Yeah, no, it's a great question because it's been asked in a number of places. We, in DHSC, if I can count myself in that group for the moment, are already in very close contact, both with the taskforce, I met with David Pearson yesterday, who I know well from his time as ADASS and mine and also with the key team in DHSC who we've already met with and are now meeting with on a regular basis to-, they are different things. Don't let me pretend they're the same, they are different because they come at this from a slightly different perspective. They're-, the questions are slightly focused in a different way, but we will bringing alongside the key issues of support and development from the winter plan, which of course, in turn, aligns with the taskforce, and this review and both at key-, at civil servant level and at senior civil servant level. I've already had those discussions about how we make sure that that happens as, as it begins to coalesce at the end and the, the questionnaire, in total, has been shared with many of those key colleagues and they've commented on them. The main design, of course, was done by the LGA, ADASS and regional colleagues, but, but they made-, had comment on them and, and that's been helpful as well. So, there is-, there is a coming together of that, though they are different things at, at the end of the process.

 

Hazel Summers:  Thank you, Ian. Leon, could you just talk through the process? I think that would be really helpful for people to, to think about-, just about the two different processes. One is the getting the individual self-assessment questionnaire. I just noticed a couple of questions about processes come up in, in questions just to the panel rather than all attendees seeing it. The process for the self-assessment questionnaire and then the process for the regional, kinda, submission, if you like, if we call them two separate things. So, can you just talk-, take each in turn? I think that would be helpful for everybody.

 

Leon Goddard:  Yeah, I will do. So, the, the self-assessment questionnaire will be completed by each council. That's the online platform that you've all had access to through a link that was sent to your DASS last Thursday. So, the result of this process will be 152 versions of that and what that consists of are specific questions that ask you to select one of the, the options and that also asks for free text, free text responses. I've just seen a few questions about those responses and the thinking around the word counts, but also the way that the questions are set, is to give lots of different opportunities for people to describe their situation. So, if it doesn't feel applicable to describe it under question one, then there would be an opportunity later on to describe that same information. So, people shouldn't feel restricted by the questions or the word count, but that, in it's entirety, will be 152 submissions, one per council, of that self-assessment questionnaire. The regional role in that process will come. We expect it to come during, 'cause we know what regions are going, but that will be a, a, a-, if you like, if I can say that secondary report role.



It will be a role that regions play that help councils complete that document in as full and as clear way as possible. So, that's the, the first thing. What there will also be are nine separate regional overviews which, as Ian described, will make reference to the council SAQs, but are entirely separate in terms of how they are written, how they're produced and how they're submitted. The, the-, what they do is they come together with the same date, of Monday the second of, of November, but they're two separate things. So, what that will do is that will be primarily be led by the region making some reference to the council self-assessment questionnaires. That will be entirely free text, it will be less structured, deliberately, than the council returns, but what will happen this coming Monday is further clarity will be given around what that regional return should look like by way of a pro forma and that's simply responding to requests from regional colleagues who've suggested that would be helpful, but for those on the call on works in councils who don't have any regional responsibility, your primary and, and essentially sole focus will be on completing the return that represents your own council's position.

 

Hazel Summers:  And that is to be completed online.

 

Leon Goddard:  Correct.

 

Hazel Summers:  Isn't it? Yeah, yeah, okay. So, none, none of those other things, okay, thank you very much. Interesting question from, from a colleague which says, 'What would be an example of good practice for contingency planning?' Is it-, is it, kind of, strategic? Is it structural? Is it-, what, what would we see as a good example? Okay, Ian, and then maybe Phil and then Leon, maybe all of you, actually, for that one.

 

Ian Winter:  Yes, there'll, there'll be perspectives to this, I, I'm absolutely sure and there's another question that, that is, is slightly aligned with that, I think, that I've read from Carl that, that talks about contingency planning. Kind of, what are we really looking for in that? Well, I mean, in a way, contingency planning isn't, isn't an 'it' in itself. You can't say, 'What's your contingency planning regarding nursing homes and risks?' Without saying, 'Well, we've got a wider plan about contingency that might, might involve the, the other agencies,' and so on and so on. What I would say is, from this review, the, the questions about your contingency planning is very particularly, though not exclusively, to do with your answers about risk in the areas that you've been asked about. That's the way I would come at that. Now, you might have a, a very broad contingency plan, you'll have all sorts of risk plans, I know, but we're asking, in this, about your own confidence, not someone else's, in your contingency planning. Has it been tested? I think there's a question-, there is a question there that talks about, were there to be a, a, an-, a, a serious incident, emergency incident, a failure of services, what, what have you got in place to deal with that? And many authorities will already have had to deal with some things like that, both in an emergency and perhaps in a more planned way. So, from my point of view, the contingency here is particular to, in the question in the later part of the questionnaire, is about the planning you've got in place and how supportive and tested you think it is and what you might think about needing or wanting to do to make that even more clear and supportive. That might be with other agencies, it might be with colleague councils and so on. So, so, that, that's the, kind of, narrow answer to that question. I hope it doesn't cut out what Phil or Leon want to say.

 

Hazel Summers:  So, Leon, do you want to come in and then Phil?

 

Leon Goddard:  Yeah, and I'll just give some specifics that what we know is that some councils are in a position where, at the very, sort of, intensive end, they've got contracts to-, with providers in, in case that people had to be moved or provision had to be changed. They've also got, maybe, in-house services and they've got arrangements there. We also know, through the COVID situation, councils have created banks of staff. I would say they're all at the very top end of what contingency might look like and I think this-, the key thing here is it's not to think of best practice in a sense of what's-, what are we doing that no one else is doing? I would encourage people to think about, what are we doing that's just working, that, that works when we need it to work? And that might be things like information-sharing agreements, either with providers or with local neighbouring colleagues in councils. It might be identifying individuals within the council who you know that, in the situation where there's maybe a care home that's about to close, they've all got a very specific role in that, they know who they are, they know what the, the role is, what the position is. It's about a series of steps that I'm sure you're all doing and taking anyway, that you know that, when you put the totality of 'em together, they either mitigate or prevent-, they either prevent something happening that may otherwise of happened or they mitigate the impact of something that perhaps can't be prevented. So, it's just about that commentary of what works for you, maybe drawing on some of those specifics, but not feeling like it's got to be some, kind of, all-singing, all-dancing, 'We've got this provision as a backup and that provision as a backup,' 'cause we'd know that, in reality, that's just not how the system works. It doesn't work on backup provision, it, it works on the right processes, the right practice so that when things do happen, everyone's clear on how they need to respond. So, that would be my suggestion around what works as opposed to necessarily seeing this gold standard. Just, what works for you?

 

Hazel Summers:  Thank you, Leon, really good points there. Phil?

 

Phil McCarvill:  I don't have anything particular to add at this particular juncture on that subject. I have put something in the chat, which answers the question about the winter plan arrangements, which is-, which is quite clear about it's about providing assurance that you've, you've got a winter plan in place, rather than submitting the winter plan, as was suggested.

 

Hazel Summers:  Yeah, yeah, okay, thank you, that's really helpful. I think, from my point of view, just thinking, when this process started, we were looking at care-home-, Phil will remember, we were looking at care-home viability really, was the, kind of, starting point but I think we have got to a point where this is really about making sure services happen. So that if there is something happens to a provider in your area, that you have the services in place to ensure that those people who need it get the service that, that, that they are familiar with, or that they can-, that their needs are met in that way. So, so a really important message around contingency plan. Leon, did you want to say something else?

 

Leon Goddard:  Yes, if I could just add, what we know as well, through COVID, is that a lot of councils worked with providers of day-provision to, to move it away from buildings-based, and to, to, to work with, kind of, the situations that were playing out. But again, I would think that's a very good example of a contingency approach, that meant those individuals still got the support they needed, albeit in, in not a buildings-based way, but in a way that was perhaps more remote, but also met their needs. So, again, I hope that's just another example of this is not just about, 'What happens if a care-home closes?' This is looking across the piece, and it may also be about either changing the way that current provision is made available, it might be about providing something that looks and feels entirely different to what previously it looked like, but it still meets those-, the needs of the individuals that need it. So, again, just thinking broad about that and not just, 'What's the replacement for it?' Or, 'What happens if something occurs?'

 

Hazel Summers:  Yeah, yeah, agree with that, and I think it, it is worth us just really thinking as well, as-, at what point would it be incredibly difficult to manage all contingency plans? So, there is a question in there, isn't there, which says, you know, if you-, if you lose, you know, 10% of your services, could you manage? If it's 20%, what would happen, and, and what would your plans be in those-, in those circumstances, etc.? We've had a question from Nick, who's asked-, says, 'It's useful to understand how this review really relates to the wider taskforce, force work, and related gap analysis', and do you we think there'll be any other returns on the back of those recommendations? I don't know, Ian, if you know the answer to that? Ian, you're on mute.

 

Ian Winter:  I just didn't get the last bit of that question, I'm sorry, Hazel.

 

Hazel Summers:  Do we expect further returns that relate to other recommendations from the-, from the wider taskforce work?

 

Ian Winter:  I don't know, is the answer. I think, as I said earlier, I, I do know that what comes from this review will be, what I call, sat alongside or aligned with, whichever words you want to use, what the taskforce both are doing at the moment and thinking about doing. And that's, kind of, reactive discussions in DHSC. I don't know what other follow-up there might be with that, but as I said, David and I met yesterday and are gonna continue to meet over this next short period, to keep in touch with how best we make sure that works together.

 

Hazel Summers:  Okay, thank you. Are there any plans to get something brief on the individual different sectors' view of things, to validate and support our submissions? That's from Rick, who I know well, in Warrington. I'm, I'm wondering, I suppose what you might be asking there, Rick, is, are we talking to providers and others to say-, or other colleagues about-, to make sure that we get their view, to say whether our plans are right? I hope I'm not paraphrasing you there too much, Rick. Ian, I think that's probably you again. On mute.

 

Ian Winter:  I'm struggling to get that, I think it's gone now.

 

Hazel Summers:  Yeah, you're fine, yeah, we can hear you.

 

Ian Winter:  Yeah, sorry. Touch screen. Yes is the-, is the short answer. You are encouraged, where you want to, but this has be for each LA to share, discuss, draw in, the views of the providers. I didn't say this earlier but I think it's self-evident, you're not asked, in your self-assessment questionnaire, to name providers. I, I think that would just create another whole scene of activity that wouldn't be terribly helpful. But of course, for some authorities, it, it would be fairly easy to determine if they had a-, main providers in a particular area, to determine who it was. That, that's, that's neither here nor there for the moment. But yes, you are encouraged to discuss it both with your key partners and to-, with key providers if you think and believe and your working relationship with them, through collaborative commissioning and so on, would, would be helpful in that. And, and expressing that as a view that you have shared and gleaned information from would be, I think, really helpful.

 

Hazel Summers:  Thank you, Ian, and that's what we anticipated really, wasn't it? Leon, do you want to come in?

 

Leon Goddard:  Yeah, just, again, trying to establish some points of clarity. Ian, correct me if I'm wrong but I don't-, there's no plan for, for instance, for individual council returns to be shared with providers, is there, at any level?

 

Ian Winter:  No, absolutely not, and I'll reinforce that, Leon, 'cause it is so important. It's why I made the first point I did. No, SAQs will not be shared outside of the grouping that I've already referred to, and, and, and that is colleagues at, at ADASS, colleagues in LGA, and they will be shared in full when they're submitted finally on 2nd November, with DHSC. That's, that's what we've set out very carefully in this process, and when there-, when there is any published overview, that will not either name councils or providers. It, it will be an overview of the review to give a-, to give that kind of national picture. There may be some regional comments in that, I. I have no idea what that will look like at the minute, but it will only be very short, to just keep faith with, with-, get some transparency into that. But I hope that fully clears that up.

 

Leon Goddard:  Fine, and, and if I could clarify something else as well, you mentioned about councils are encouraged to talk to providers, could I, again, just draw a distinction that I think we'd, we've encourage all councils at all times to be working closely with the provider sector around risk-management and around contingency planning. But aside from that ongoing, useful conversations, my understanding is, there's not an expectation that councils make explicit reference to conversations with councils-, with providers throughout this process in their SAQ. So, we're not expecting to see that specific, 'We talked to them this week about this.' We just-, there's an expectation of a, a reflection of ongoing conversations and joint working. Would that be a fair comment?

 

Ian Winter:  Yeah, very fair, very fair, and we had briefed, I had briefed, nationally, the provider grouping that meets colleagues from LGA and ADASS who are involved in that as well, and they're aware of this process, and I've been very clear as well, in a sense, from the questions that they've asked, which have been the opposite, probably, other side of the coin, as you've asked, Leon.

 

Hazel Summers:  Okay, thank you, thanks very much.

 

Ian Winter:  (inaudible 43.25) that with them.

 

Hazel Summers:  Okay, thank you, that's really, really helpful and clears that up. And Phil, you put a note in around the winter plan. Could you just talk through it, just so that we're-, absolute clarity for people, in case they've not read your response in the chat?

 

Phil McCarvill:  Yeah, so, the, the wording was just taken directly from the Department of Health and Social Care's website, states that 'local authorities much put in place their own winter plans, building on existing planning, including out-, local outbreak plans in the context of planning for the end of the transition period, and write to DHSC to confirm they have done this by 31st October 2020'. So, it's a requirement to write, to confirm that you have a plan in place, rather than to say, 'Here's our plan.'

 

Hazel Summers:  Yeah, that was my understanding of it as well. Thank you for confirming that. Okay, we don't appear to have any other questions, unless I'm missing something here. No? No, so, I'm not going to prolong this just for the sake of saying we had a whole hour put aside for this. I'm assuming, by the fact that there's a-, not questions, oh, hang on, there's-, there is a question there. 'Is there-, is there guidance on what specifically should be in the letter related to the winter plan?'

 

Phil McCarvill:  I'm just putting a link to the, the bit of the DHSC website which has the details of what-, is, is where I've got the-, I've got the statement about what's required. So, I'll, I'll include that in the chat.

 

Hazel Summers:  Okay, thank you very much. Well, is there anything from my colleagues, Leon, that they want to add, and Ian-, and we have had another question around, 'How about other commissioning bodies input e.g. CCG (ph 45.19), reliance upon system involvement to support at home first.' I think that, kind of, comes back to the same questions that we were talking about around providers. There's an expectation that you will have included them in your contingency planning. So, Ian, could you come back on that, and then Leon, probably?

 

Ian Winter:  No, I think-, I think you're dead right, Hazel. There is space in the-, in the SAQ to, to make notes about the degree to which other key players, agencies, locally and, maybe, regionally have, have been engaged and involved. And, and there may well be a regional overview of that position, as well, depending on your NHS component parts, if I can call it that in, in, in regions. So, yeah, you're expected to comment on it and, you know, that, that will be helpful in, in understanding it.

 

Hazel Summers:  I, I think there's an element in there, isn't there, not just about you have talked to your CCG colleagues, your community health trusts, or providers, etc., and whoever is involved in your contingency planning. But, but an expectation, probably, that you will have talked to neighbouring councils, as well, particularly if you share providers.

 

Ian Winter:  Yes, very much. And a, a number of regions have already had that conversation with me, as I've been going around the regions, because they have got particular linkages, because they share key providers. So, therefore, they, they would want to have a, a, a joint view of the risks and, indeed, of the mitigation and, and contingency. That, that's, that's true. And, and, while, again, we can't insist on this, we've certainly encouraged councils, through this process, to share their SAQ with each other. That's a more general point but, specifically, where local authorities boundaries lend themselves to sharing providers, and some dependency, maybe, on some providers. It's, it's pretty important that that's-, that that's put together. And where you've got integrated or shared commissioning arrangements, that's equally important to make some note of. And the-, and the SAQ gives flexibility to be able to, to, to do that.

 

Hazel Summers:  So, I suppose some of the things I had been thinking about, Ian, was that, if, if provider A was to go under, and more than one authority shared that provider, but also your contingency plan was to use provider B, and their, their also plan was to use provider B. Without naming them, how would you know that you both looking for the same support, without sharing your self-assessments and making sure that you were aware of each other's contingency planning?

 

Ian Winter:  No, exactly right. That, that, I think, is the-, is the strength of, of, you know, co-working, as it were between particular authorities.

 

Hazel Summers:  Okay, thank you.

 

Ian Winter:  My, my original responsibility is DH London and, and, obviously, London is writ large with authorities that are very, very closely bound together, by many of those things that you have talked about. But not only London. It's, it's but one example.

 

Hazel Summers:  Yeah, okay. So, certainly, in Greater Manchester, where I worked, there is a lot of, kind of, cross boundary working, etc. Leon, did you want to come in?

 

Leon Goddard:  Just to say that, I think to wrap up a few of the points, that this is very specifically the local authority describing their perspective on their local area. Clearly, they don't operate on their own in that local area. There is other providers. There is other external agencies, health agencies, third sector. Other, other councils commissioning in, and around the borders. But it, it's very much about that council's commentary on their situation. How they perceive it, how they think it will play out and, and trying to bring that to life in a way that-, whilst the underlying issues may be the same, around workforce or, or other things, it's actually their own perspective, which may differ from the council down the road. Even though, there's on the face of it, a very similar scenario. So, it's just trying to bring that to life. But, like Ian said, it won't then be checked with, what do health think of what you've said? What do providers think of what you've said? This is-, this is for the eyes only of, of a few small-, of a few people in, in DHSC, LGA and ADASS. But it's about your perspective, and your chance to tell that story, and give that perspective, and hopefully a lot of rich information will come out of there.



That helps us dig under the surface of, 'Well, what does workforce issues mean?' What, what does that actually mean in practice and, and the like, and to try and get a really localised sense of that from yourselves.

 

Hazel Summers:  Thank you, Leon. And I think, on that note, and as there are no other questions, thank you, Phil, for putting the link in there. I'm sure that'll be very helpful to people on the call. There has been quite a bit of confusion around the winter plan, and whether you'll submit it or not. I'm hearing it in many places. So, so, thank you for that. I think our key messages are self-assessment is about your own local authority's view of, of, of your contingency planning. And it's around service continuity. And how you make sure that the needs of your service users are met, should something happen. And, but also to think about at what point may you struggle with that? There's an expectation that you will have talked to providers, CCG colleagues and other agencies, but nobody will be checking that out. You know, nobody is going to be ringing up, you know-, you know, your care providers and said, 'Have they had a discussion?' It will be anticipated, and I know absolutely all local authorities have worked really hard with providers during COVID and regular calls, etc. So, they will be able to include some of that information within their self-assessment. The self-assessment is online.



There is a closing date of 21st, yes? Yeah, the 21st of October. And, at that stage, regional colleagues will have a brief look, to see if there's anything glaring, which they may want to make some amendments. And then, alongside that, there will be a regional overview, where the regions will be pulling together a flavour of your region. About what the key issues are, the key challenges, what the learning from COVID has been, what the support requirements might be across that and what, what other-, what other might need to be taken. What other asks there might be within that. So, so, that is the process. I hope we've made that clear for you. Just to let you know that there-, as Leon said, there will be another webinar. So, this, this is, kind of, at the start of the process. You've just got the form. You've started filling it in. There's an opportunity to come back in, in, I think it's a week on Monday, to, to, to come and say, 'Actually, we're struggling with this question. Not really sure about what you mean about that.' Please, if you want to attend that, please do so. So, so, with that in mind, I just wanted to thank all our panel members and thank you all for attending, and good luck with the SAQs. Thank you very much. Bye, everyone.

Moderator:  Hello everybody. This is, as I said, Hazel Summers. I'm the Care and Health Improvement Advisor for the north-west at the LGA, but I also have a lead role around commissioning our markets and workforce. So, today is the second of the webinars we've run on the service continuity care market review, and it's purely a question and answer session. We ran one last week, also, which was at the beginning of the process, for people to ask questions. And this is a second opportunity for-, now you've had a look at the form, if there's anything specific you'd like to ask. So, I'm just going to introduce the panel. So-, and I'll let them say something about themselves. Ian, can I start with you?

 

M:  Hi, I'm Ian Winter (ph 00.46). I'm the project director (inaudible 00.48).

 

Moderator:  Ian, I can't hear you.

 

M:  Did you say you couldn't hear me?

 

Moderator:  Yeah. I can hear you now.

 

M:  Okay. I'm really sorry, I'm having internet problems this morning.

 

Moderator:  So, Ian is the project director of this particular project around-,

 

M:  I'm really sorry. I'm really sorry, it's been a tough morning. Yeah, I'm Ian Winter. I'm the project director for this project, working out of DHSC but also very closely with LGA and ADASS.

 

Moderator:  Phil, can you introduce yourself please?

 

M:  Yeah, I'm Phil McCarvill and I'm he deputy chief officer within ADASS.

 

Moderator:  Thank you Phil, and Leon?

 

M:  Yeah, hi everyone, Leon Goddard. I work in the Care and Health, Heath Improvement Programme, and I'm a senior advisor on commissioning and markets.

 

Moderator:  Thank you. So, just a little bit of housekeeping first. Can everybody stay on mute, just because we (inaudible 01.48) Internet and make sure your camera's off. If there are any questions, and I'm really hoping that there will be as this is a question and answer session, can you put it in the chat, and then I will ask the appropriate person to respond? And just to let you know that we're recording at the moment. So, so that-, and then the recording from the previous session has already gone online, and this will go online to help support people who aren't-, who aren't here. So, I'm just going to start off with Leon, who's going to talk about what will happen between 21st of October and the 2nd of November. Then Ian will-, Ian will talk through what will happen afterwards. So, Leon, if you could start off please?

 

M:  Yeah, I will do. Just move on to the next slide please. Okay. So, as hopefully people will be aware, the deadline for submissions of the council SAQ is midnight this Wednesday. I just want to let you know a few things in relation to the next few days, and then post that date. So, the first thing to say is if anyone's got any particular issues or challenges with submitting something by Wednesday, please let us know as soon as possible. If that's a technical issue, we can help you with it. If there's something that's maybe more of an issue, at least by understanding it we can hopefully try and work through that with you. So, we're gonna put an email address in the chat, and it's an email address that you can contact that's monitored constantly. So, please do let us know if you've got any issues as soon as possible. So, assuming that councils' SAQs are submitted-, self-assessment questionnaires are submitted by Wednesday, what I know that each region has in place for the next ten days after that is to undertake a-, I would call it a light touch review of those council submissions. So, this is not about the region looking to change or make any substantial (mw 03.44) to, to the-, to the SAQs, but there is a period, up until the 2nd of November, where regions and councils have just asked that there be a-, kind of a reflection on the content of those reviews. So, that's the-, that's what'll happen immediately after the 21st of October, and what regions will be sent is a summary of the council responses to the questions for the councils in their region, okay? So, regional colleagues will be in touch with you to explain what will happen then, but think of that as a light touch review, not an opportunity for lots of rewriting. That's not the intention. Also running alongside this process, and separate to it but running alongside it, is an ask that each region provides what we're calling the 'Regional overview'. The deadline for submission of this is noon on Monday the 2nd, and that should be a regional perspective on the issues, challenges, and support needs across that region. So, it's expected to make some reference to the SAQ documents that councils have submitted but it's not expected to be an analysis or a commentary on those SAQs.



I hope it's clear why it's helpful for regional colleagues to at least have sight of those council submissions in the process of putting that regional overview together. But just to be clear, that's a separate ask, led by regional colleagues, that's entirely separate to what councils are currently working on. What we'll then have is a point at noon on Monday the 2nd of November where regions will have submitted the regional overview, councils will have submitted their self-assessment questionnaire, and a review of that questionnaire between councils and regions, and any minor amendments, if at all, will have been made by noon on Monday the 2nd of November, and no changes to either the SAQ or the regional overview will then be permitted after that date, of the-, Monday the 2nd of November at noon. So, that's just a bit of a whistle-stop tour around the process, key steps, but the key thing to say, if you've not already done so, is as soon as this webinar finishes, we strongly urge all councils to log onto the online form to familiarise themselves, with it. At the last count, probably about 30 councils hadn't yet done that. Just to pre-empt any potential issues, please do that as soon as possible. If anything does come out of that check, then please email the address that's already gone into the chat, just to say, 'We've got an issue, can somebody help?' Okay?

 

Moderator:  Thank you very much Leon. Can we move on to the next slide-, slide please? Ian, can you talk about what will-, what's going to happen once DHSC have received the submissions?

 

M:  Okay, thank-, thanks very much indeed. Well, hi everybody. Let me just take you, you through this fairly quickly, but (inaudible 06.33) important that we get onto your questions or comments. The process, once the bit that Leon has just covered, is that DHSC will be able to both look at all of the self-assessment questionnaires and has the regional overview picture. So, between the 2nd and somewhere around the 12th-13th of November, a final review will begin to shape up. Now, that's based on taking all of the self-assessment questionnaires, analysing them, making sense of them, and getting the overall picture about the seven areas of the questionnaire. Now, now, as you know, those of you that may have already worked on it, the-, the key questions are about risk. The questions are about contingency planning. The questions are about-, provide (ph 07.40) a tipping point. And then there's sections about, particularly, kind of supports that could be useful, or are useful currently, and then your own examples of good practice, both at individual council level and at regional level. So, all of that will be put together to form what will be the final review. The expected outcome of that is there will be a detailed review report. That report will not be public, not be published, but it will be shared with both ADASS, LGA, and with councils. Now, at the same time as that, where there are areas of particular risk, particular and specific asks for additional support, whatever that might involve, DHSC is partnership with LGA, ADASS, will want to follow that up with you. Now, in part, that will use what we might call existing methods, approaches. Colleagues like Hazel, and so on, will be involved with that. In part it might need some development of some different or new types of arrangement, all within that, kind of-, what I'll call the overall envelope of what is going on. But most importantly it will be driven, in very significant measure, by councils themselves.



So, the-, the intention of that is to deliver what councils themselves are saying in their self-assessment, saying what they might need, in terms of additional support at local level, how urgent that is, what it's based on, what the themes of it might be, and so on. And we're expecting that to happen fairly quickly after, let's call it, the middle of November. At the same time as all that, civil servants in the Department of Health will of course be reporting to the minister, making their overview report, and giving advice to the minister, based on what the self-assessment questionnaire is reporting. There's a question about FRI which we'll come back to, because it's an important question. So, the-, there-, there almost certainly will be an overview and summary report, very short, capturing the main headlines, which will in fact end up being published, and therefore be available publicly. As I said, the-, the review and report, per se, will not be published, and will only be shared in the way that I've just described. I'll stop at that point.

 

Moderator:  Thank you Ian. So, what-, I'd, kind of, like to take questions from the floor here, but what we have done is we've actually-, the-, we've had our email address open for quite some time, and these are the questions that you see on front-, in front of you, things that have been asked so far. So, I will go through with them-, them. But if you can put questions in the chat, we'd be really grateful. This is-, this meeting is for you, so anything that you're worried about, or concerned about, please do ask. So, I'm just gonna start with Katie's question. Hello Katie. This is for you, I think, Ian. Can we assume that the final report will be FOI-able? And if so, is there a reason why it wouldn't be in the public domain?

 

M:  I don't think we can assume it will be FOI-able. I mean, let me preface that by saying anything can be FOI-able, and I think it would be wrong of us, at this point in time, to say, 'No, it won't be FOI-able.' The advice DHSC have got-, just to-, just to remind us, it is ultimately a DHSC report. That puts it in-, because it, then, involves direct advice to a minister, at the end of the day, then the advice we've got is that it's not FOI-able. Now, I-, I only say with the slight caveat of, 'Well, anything's FOI-, FOI-able, and it's just a matter of how things are interpreted at that time.' But it's not the intention that it will be made public. The second strand of that is that while we're not asking, in the SAQ, for any names of providers, quite clearly we're not, though, indeed, the provider market is at the heart of the review, that would also prohibit it also being FOI-able. At the-, because you-, frankly, an individual council, or group of councils, may mention a particular provider, or even type of provider, and therefore it would be possible to determine what that was. It, it is up to individual councils about what they share from their SAQ. I think we said at the outset good practice would be to share it with providers, those parts that are relevant, and also good practice would be to share it with, particularly, NHS colleagues and other key colleagues. All of that is fine, and we encourage that. I hope that, kind of, deals with it from our perspective.

 

Moderator:  Thank you. Katie does go on to say that some LAs will be putting their SAQs in the public domain, but that is a decision for them, isn't it?

 

M:  That is a matter for-, absolutely right Hazel, yeah, and I-, I happen to think that's a good thing, because it's a council's own assessment of what it thinks. It's very helpful, I think, to set out-, to set out the platform on which this is built on.

 

Moderator:  Okay, thank you. Question-, I think I'm going to put to-, to Leon, from-, I think it's from Mark in Salford. Hello Mark. And it's definitely not a daft question. Are there opportunities through this process to inform the significantly delayed adult social care green paper? Leon, and then maybe Ian?

 

M:  Yeah. So, I'll comment on the-, I suppose the content of this self-assessment questionnaire. Please don't feel in any way restricted by what you can talk about, or where you should talk about that. We've tried to structure the questions in a logical way, and hopefully they give you the opportunity to talk about most things, but there's various opportunities where you can bring in something that's-, that doesn't appear to be directly asked for. So, green paper might be one of those things. Please take this opportunity to share whatever you think is causing issues or challenges at a local level. If that's about the green paper, or uncertainty, then explain that in whatever way you see fit. It might be something entirely different to that. A number of councils have said, 'Well, there's not an obvious opportunity to raise issue A, B, or C.' Please just describe it in the way that you see most appropriate. Don't worry so much about exactly where it is, or are you saying it in the right place. Just make sure that this reflects your views.

 

Moderator:  I think Mark, as well, there's a possibility that you could raise it through the regional review, over here (ph 15.30). So, if that was a view from the north-west, where-, where I'm based, we could definitely pick that up there. Thank you.

 

M:  Hazel, (talking over each other 15.43).

 

Moderator:  Yes, Ian, you come in then, please.

 

M:  I was only going to mention one-, one thing on that. Obviously this review has a very specific focus, and that's set out both in the introduction piece and in the narrative, but I'm also very clear that it doesn't sit on its own, and it mustn't sit on its own. So, where it has some read across things like the winter plan, where it reads across-, in a sense, in the bigger picture, to green paper, and the general issues of funding, and how things are gonna be done in the future, then clearly it-, it can't ignore that, and shouldn't ignore it, but it won't get into the detail of that.

 

Moderator:  No.

 

M:  That, that's clearly what we (inaudible 16.27) influence the whole programme of DHSC, and the policy making, and in deed the politics of it.

 

Moderator:  Thank you. We've got a very specific question next, but with regards to the first question. Please give an overview-, which is, please give an overview of the current contingency planning work you are doing to maintain service continuity. Can you elaborate what's required from this response please? Is it specifically asking for what our plans are to maintain service continuity if provider failure occurs, or what we are doing to prevent that happening? It does make perfect sense, thank you. So, I think we'll ask Ian to pick that up, and then Leon.

 

M:  Okay. Leon, come in if I don't get all this, and indeed Phil, because I know you have views about this. In a sense, this is linked to what you may have said, in terms of your highest levels of risk. The contingency that we're looking at is essentially not just, sort of, general contingency approach, which might be at a very developed level, it is directly and specifically related to those areas where you're saying there is some considerable or even imminent risk. So, how well are your plans geared, or targeted, towards those areas that are at risk of breakdown, to-, to use a general term, and how well-tested are they, how well-approached? I think there is a question which refers to something about the-, your council's experience of handling or managing a provider breakdown or failure. And, and many places have got considerable experience of that. So, it is targeted, very much, at the risks that you have identified, and if there's a mismatch there, then clearly that's something that would want to be followed up at a later point. Leon, have I covered it?

 

M:  There's just one more thing I would add. It's-, the question says, 'Is it about preventing problems or is it about dealing with problems when they occur?' That's essentially how I read it. And the answer is both. It's about contingency approach, which-, which may be about work you're doing to prevent things. It may be about things you're putting in place, if things did go badly wrong. It may be about work you've done to address things when they have gone wrong. But it's about the overall bit, so it's neither one bit nor the other, but the overall contingency approach which will involve mitigation, prevention, dealing with problems that occur, all of those things. It's what-, so, yeah, it's what-, it's, it's that breadth of it plus what Ian said about what we're trying to understand.

 

Moderator:  Thank you. Is there anything that you'd like to add, Phil?

 

M:  It was just in terms of-, I think it's really important that-, almost relating this back to the previous question, in terms of-, this will provide another layer of evidence, in terms of what's happening with markets, within local areas, and regionally, and nationally. And so it sits alongside things like the state of care report, state of the social care workforce, ADASS budget survey, and it's another layer of evidence. And that's why it's really important we get an honest assessment of what's going on, and that we can build that picture, so that we can then look at, in the next stage, what support can be provided to provide-, to enable authorities to respond to those challenges.

 

Moderator:  Thank you Phil, that's really helpful. Next question is around the tipping point question. Will this be one question for the market as a whole, on the full online page, or will it be based on type of care? So, for instance will your nursing care, or your resi care, or your home care reach tipping point-, is it for the whole market or is it for individual bits of the market? So, Leon, could you come in on that one?

 

M:  Yeah, I will do. It's for each individual bit of the market, so each service area, and I think this is a good example of where it's helpful to look at the online platform as well as-, I know what a lot of people are doing is looking at the PDF. So, when you-, when you go through the online platform, it will-, it will direct you, and take you down this route. So, it relates to your response to a previous question. But it's important that people are at least familiar with what it-, with how the online platform will work, so that when they're then thinking about their answers, they know what it will ask them and when. But the answer to this specific question is it doesn't ask you to give one generic market-wide position. It will ask you by specific service area.

 

Moderator:  Thank you. That's really helpful. Thanks very much. Next question-, is there anything else that we've got?

 

M:  There's Tony's question, Hazel, if-,

 

Moderator:  Yep, I'm just looking. Publication by individual LAs-, sorry, I'm struggling with my tasks at the moment-, would help the local system but have little impact on the health or survival of adult social care systems in the airing of key issues. Can LGA and ADASS please seriously consider regional and national summaries being published? Phil, could you come in there, and then Leon?

 

M:  Yeah. So, that's certainly something we'll have to go away and think about, in terms of thinking through the implications, but it's a very good question and one that (talking over each other 22.11).

 

M:  Yeah, it's a very good question, and I'd-, I'd come from the opposite end of that question, if I'm honest, but to hear that from-, from-, in this setting, is really useful, and I think we need to take away, as Phil has said. There may well be a good use that we could make of that to keep the profile of this high, of course taking account of the fact that councils have answered quite sensitive areas in relation to their activity that would also need to be, kind of, balanced with that.

 

Moderator:  Yeah. I think it could be helpful to do so, to certainly pick up the regional and the national overview, kind of, from a state of the-, kind of, 'This is what we know,' rather than-, and not identifying individual authorities, or any of that kind of thing. But I think that-, it might be helpful. We'll certainly go away and think about it. There's a plug (ph 23.11) there from Andrew Borwich (ph 23.12) on our north-west guide to contingency planning, I have to say, and I'm (inaudible 23.16) it's really, really excellent. It, kind of-,

 

M:  Yes, very good.

 

Moderator:  Andrew, do you just want to say something about it, because it's really-, it's really helpful? Do you want to just come off mute? Can we bring him off mute for a minute? And, and just-, Andrew, could you just say what it does? Anybody can bring him off mute? Who's in charge of the mute button? Oh, we might have to come back to it. I can talk about it myself if need be, but it is a really good piece of work, and well worth looking at. It looks at contingency from preventing market failure happening through to what would happen should-, should something-, something happen to one of your providers, and how you deal with contingency of that.

 

M:  Can I just ask one thing, Hazel? Could, could that be sent to me?

 

Moderator:  Yes, of course Ian. We will be able to do that.

 

M:  Thank you.

 

Moderator:  Okay. Question there from Jessica too. Are we able to separate support and living in extra care out from one another on the online form? Leon, you're-, you're closest to the form, I think.

 

M:  Yeah. I'd say what's-, it's a good point that we've-, we've included them as under one option. If you do want to separate them out, I would say the best thing to do is to answer-, choose one of those things in the actual standard answer, and then other the 'under' option, you can add other service descriptions. So, use the 'other' blank text to then add in another service description. So, you might say, 'Yes, it says support and extra living in extra care, but I'm now going to answer just for extra care, and then below what I've done is I've written supported living under 'other', and I'll now give my supported living responses.' So, it's a good point. It's not that easy to do, but by adding another response you can give a response about a different service type, either one that's not there or one that's there but currently amalgamated with another one.

 

Moderator:  Thank you Leon. So, I-, I've got no other questions in the chat at the moment. I think we'll come back to the key questions that have been raised through our frequently asked question email address. So, Ian, if I can come to you for the first four questions really. Just quickly, what is the purpose of the review?

 

M:  The purpose of the review is to, I think for the first time, bring together a national picture of England authorities, all 150, of what the state of the market is, particularly through the lens of the impact of COVID-19 and EU transition. Though, again, they can't be separated picture, some of which we've talked about already today. It is to give DHSC, with LGA and ADASS, a clear understanding of what the key risks, challenges, and what is required to support the whole sector during this period. It's unashamedly a council-based approach, and that's because of the key requirements of the Care Act and the development of markets, the support of markets, continuity of care, and so on. So, it is-, it is specifically about supporting understanding from DHSC, and in DHSC, to all of those questions. Now, the spin-offs of that are much wider, of course, in terms of both regional, national, and into Whitehall, as it were. The views of other providers are being sought generally, though obviously we are focusing hard on what the SAQs-, you've said, What will happen if higher levels of risk or concern-,' well, that's not an easy answer, and we're working on how we would respond to that. It's very important that it's not just a response from DHSC. It's very important it's a response that is both balanced, properly set out, and validated. And that response would be to, let's say, an individual council or, if it were at a more regional level, to the region. And the first question would be, 'What support is already indicated as being required or helpful, and how best might that support actually be implemented?'



So, very much, that would be a joint arrangement, not an imposition, not-, not, not being, sort of, set out from DHSC, but it has to be focused on what's the level of risk and concern, and where is it? 'Where' meaning in terms of social care parts of the market. And where is it geographically? How does it fit with other work that's already being done? Are there gaps in that, and can they be filled quickly, using either existing types of approaches or maybe some new developments, using existing people, or, in some cases, some additional targeted support that might be used? It, it, it's allied to the winter plan activity, and-, and has a read across to that. The last question, 'Who will see my SAQ and at what point?' Well, as we've said, SAQs will be released to DHSC and a small cohort of people there will see it, including me, and that information will be available from your SAQ. Last thing, if I may do (ph 29.37) triangulation-, much of the triangulation of information is, in a sense, occurring as it makes it's-, it's way towards DHSC. At DHSC, it'll be looked at again, both from a regional and individual council perspective, and the kind of triangulation will be to look at public information from SQC, information about markets and providers, market intelligence as I would call it, and then that will be reviewed, in the way that I've described, alongside LGA and ADASS. So, that's how the triangulation will occur.

 

Moderator:  Thank you Ian. Can I just-, can I just come in at this point? In terms of further on about who will see the SAQ, is that not only will it go to DHSC but it will then go onto the regions. So, it will go to your-, I'll just use the north-west as an example, because-, 'cause I'm part of that. It will go to Matt Emerson and Andrew, as the programme leads for this area in north-west ADASS, and it will come to me, as the Care and Health Improvement Advisor. We will then, between us, using whatever means and resources at our-, to write our regional review, but we've also got a small period of time where we go back to DASSs to say-, if there-, if something just doesn't read write, or-, or there's something that contradicts what's happening in another local authority, or it doesn't fit with what-, just an opportunity for us to go back to say, 'Did you really mean that? Did you mean something else? Is that-, have you put that in the wrong place? Are you thinking about-,' there is an opportunity during that period of time for-, for your regional colleagues, in ADASS and the LGA-, so, that's your Care and Health Improvement Advisor and your programme leads, to go back and ask the questions. And then, also, during that period of time, we will be putting the regional overview together. So, we will be seeing that, as well as colleagues at DHSC. I'm wondering, Phil, if you'd like to add anything to that, just in case I've missed anything?

 

M:  No, other than to say that I think it's really important that the emphasis here is on what support will be needed to enable you to tackle these issues, and that's why it's really important we get the honest assessment of what are the real pressures, and what are the pressures across different parts of the market? Because that will then enable us to have some sensible conversations about what sort of support that ADASS, the LGA, and the Department need to provide to enable you to tackle those issues.

 

Moderator:  Yeah, agreed. So, if it was something like, I don't know, nursing care, or it might be-, or it might be your residential care, or it might be your home care market, or-, and it might be over sub-regions or regions-, we should be able to pick that up during-, through this process, in order to draw out the key themes. And Phil's right, because there'll be some national support but there might be some specific regional support that needs to be identified, or sub-regional, or local. So, that's a really important piece. Okay, thank you. Thank you Phil. So, Leon, I think you've half answered this already, but can we come back to it? How do I provide information that doesn't neatly fit into any specific response?

 

M:  Yeah, I'll just touch back on what I've said already, that in terms of the actual council SAQ document, it's about you making sure that wherever it-, wherever you put it, it's the information that you want to get across. Where that specifically is less of an issue, less important-, I think the only distinction I'd make is if you think there's something that is not only of local significance but of regional significance, firstly I'm sure that would already be on the radar of regional colleagues, but I know what's happening in a number of regions is they're having conversations where councils are sharing what they're raising, and then the region can take that information and put that regional angle to it as well. So, I think that's not just about putting the information in the SAQ but making sure that it has got that regional significance. So, that would be just a key point for me to reiterate.

 

Moderator:  I keep turning myself on mute 'cause I've got a cough, and I don't want to cough while I'm chairing. So, Phil, rather than me answering the next two questions, what would you expect to be included in the regional overview, and how and where would you describe the good work that we're doing, both locally and regionally?

 

M:  Okay, so, the regional overview is really there to give us a flavour of what's going on across the regions, and whether there are any particular patterns, and whether-, it's not-, it's not a retelling of the story of individual councils. It's very much to try and draw out the themes, and identify what's going on with-, across the regions. So, rather than handing something over at a national level where people start looking in and trying to second guess what's going on, but actually that-, within that, there's an opportunity to put the context in which the region is operating, what's already known about the market within-, across the region, and there really is an opportunity to promote the good work that you've already done to support the market, and to intervene, and to make-, and to make-, yeah, and to make changes to the way commissioning is done, and the way that providers are supported, and the way particular issues and pressures are being dealt with, and we've very much, from the start of the project, been clear that this is an opportunity to promote the good work that's happening. It's actually a way of promoting the work that you're doing, and to demonstrate the understanding that you have already in place. And the SAQ is effectively another layer of information and a set analysis of what's going on. So, it reinforces the work that you've been doing, and this is an opportunity to show-, to showcase that work.

 

Moderator:  Thank you very much. Ian, do you want to add anything to that?

 

M:  No, it, it does what, what, what Phil has-, what Phil has said. That, that's exactly what we're trying to do here. We are also trying, unashamedly, I make no excuse about it, to improve, make more broad, the knowledge and understanding in DHSC about what's really happening, and what councils are doing, that-, that's exactly as Phil has just described it, and what some of the challenges, in real detail, are, and why are they different? They're different in different parts of the country. They're different between different authorities. The regions are different, by every definition you could think of. But it's very important that what we're presenting, ultimately-, ultimately it will be to the Minister, is not only a very accurate picture but a very balanced picture of the complexity, the sheer complexity, of-, of the market, and what the-, the extent and scope of the challenges-, the challenges are. That seems to me to be incredibly important.

 

Moderator:  Thank you Ian. Katie's put up a question around the regional summary. And I know, Leon, you've done some work on this, but sorry if I've missed it but if there is a template for the regional summary?

 

M:  I was just typing an answer there to Katie. There's-, a further guidance document is in the process of being circulated. So, it's being finalised, it's being circulated. It's not a template, in the same way as there's an SAQ template. What the document tries to do is highlight to councils-, to regions that this is absolutely for regions to decide how they want to do it. The further guidance gives some things around the practicalities of literally who do they send it to, and how do they do that, but also-, so, it gives what you might call a steer or further suggestions on the sorts of things they might cover, and how they might do that. So, if you've not already received that, it'll be on its way to you today, but, yeah, please don't think it's a template that in any restricts. It just simply offers some further thoughts alongside those very practical steps around how and when it must be shared.

 

Moderator:  Leon, could you give some examples of some of the suggestions that it makes-, about what it would cover, in addition to what Phil mentioned earlier?

 

M:  There's not a great deal in addition to what Phil said earlier. What it tries to do is just give a flow to it. So, for instance, we're saying-, there's a-, the first part of it is a regional introductory statement, and what we've emphasised that would be a good idea in that statement is for regions to give a flavour of what it means to operate in their region, as opposed to a different region, and we can all imagine what that might look like but there's things like-, in the south-east, then self-funders are likely to be a prominent thing. In the south-west, we know the makeup of their case sector is typically smaller, more locally-owned providers. So, it's just to try and bring to life, for the reader, 'Well, what does it mean to work in this area, and what are the things that are specific to the, the regional-, regional social care sector?' It also then gives a structure to how a region might describe those things. So, we've said-, there's a starting point highlighting what the main risks are, then talking about the key contingency steps that you're taking, and then, at the end, talking about-, as a result of what you've faced, and as a result of what you're doing, what do you think are the major support needs that perhaps others can help you with? So, again, very-, very simple and logical, not in any way trying to, you know, create a weird and wonderful template, but really just trying to give a-, a logical thought process as to how regions might describe that, but of course regions might choose to describe that in a different way, and that's entirely their prerogative. And, again, it just says the practicalities of how it must be shared, and when, just to make sure that no one's guessing at the final stages. What it also says, sorry, at the very start, is that very soon after the deadline for the council SAQ, the LGA will send each region a summary of the-, the council responses, so councils aren't-, sorry, so regions aren't having to create that themselves. So, you know, I hope none of that changes or massively skews what regions were trying to do, or thinking of doing, but it just tries to bring that to life a little bit.

 

Moderator:  Leon, and you've said that-, that, kind of, guidance document will go out today.

 

M:  Yeah, that's right.

 

Moderator:  Okay, thank you. Thank you very much. Okay then, and there's just something here on a few practicalities. I think we've covered this already. Can I publish-, a council publish their SAQ on their council website or similar? This has got your name against it Phil. I don't know if-, I don't know if you've got an answer, or others.

 

M:  I think we-, I think we covered it earlier. I think the view is that it's up to the-, it's the council's individual decision to-, whether they publish this SAQ.

 

Moderator:  Exactly. That's what-, that what would definitely be my thought on that. And Leon, how can I share a copy of my completed SAQ?

 

M:  Yep. So, what we've encouraged councils to do is share this with regional colleagues. We've already described the regional overview. When you click 'submit' on the SAQ, it will then automatically take you to a page that says 'Do you want to download a PDF summary of your SAQ?' If you click 'yes', it will then download, and you can then email it to whoever you want. But just so you know, that step will come after you've clicked 'submit'. You can obviously submit it before Wednesday, and if you do you can also share it with anyone you want to, be it internally, be it externally, but that's probably the best way to do it. And then just coming on to the last point, if you've accidentally clicked 'submit', if you email the email address I mentioned at the start of the call, what we can then do is essentially unlock your response, and allow you to then make changes to it. But if you have clicked 'submit' the only way you can make subsequent changes is by contacting us. So, we suggest you do that as quickly as possible.

 

Moderator:  Okay, thank you very much. I think that's come to the end of our questions, unless there's some others. No? So, there's no more questions in the chat. So, I think we've probably covered all the key areas. Is there anything that our panellists want to say, any final words? If I start with you, Ian.

 

M:  Yeah, I think I've lost my video, but I hope that doesn't matter.

 

Moderator:  We can hear you still.

 

M:  No, that's okay. That's brilliant. Thanks ever so much, everybody, for joining. Just to press, as Leon said at the beginning, and Hazel, I hope that gives enough clarity to now get this-, this done. The, the bigger, the greater, the number that respond gives real credibility to the issues that we've just begun to outline in this session, and I think that that's a very important part of this. Many authorities that I've met with, or regions that I've met with, over the last two or three weeks, have said this is of great value, both to them individually and as regions, but I want to stress how important it is to get a very full and cogent picture back into DHSC, especially at this time, and as many, many things are still moving within this complex environment.

 

Moderator:  Thank you Ian. Leon, is there anything that you'd like to add?

 

M:  Just a very practical thing, just to say, again, if people haven't yet accessed the online questionnaire, I would strongly suggest people do it. It does-, it operates in a slightly different way to the Word document and the PDF document, and it will just take a little bit of time to get your head round it. We've already have one question today that's alluded to that. So, I'm putting myself in your shoes. I'd suggest people do that as quickly as possible. Any issues, anything-, if you see any problems with submitting it before Wednesday, just email the ADASS.LGA address and we'll deal with that as quickly as we possibly can.

 

Moderator:  Thank you. We have been responding very quickly. Phil, is there anything that you would like to add?

 

M:  Just to reinforce that issue, that it's the detail and the flavour of what's going on within the local area, and then regionally, that will determine how successful this project is, and actually will then determine the support that's available for local authorities and regions to deal with the issues which it will raise.

 

Moderator:  Yeah, thank you Phil, and that was my point really, that we've absolutely (mw 44.38) got to use this opportunity across local government to get across what the key issues are, but also to demonstrate how good we are at planning around contingency. You know, we have a long history of-, we have a long history of it, of contingency planning, and-, and certainly in my previous jobs I've had to shift over 2,000 hours of care over a-, over a weekend, you know? This is not unusual to us, but-, but we are in unusual times, and I think that's particularly why the question about the tipping point is there. Under normal circumstances we could manage, but what about if there's more than one provider closure? And then how would we do that? So, it's important to get out the key issues, the key challenges, what contingency plans that you have put in place and what your support requirements are. And so, with that, I'm just going to thank all of our panellists, and thank you for attending, and-, and just to reiterate what Leon said, if you have any issues at all, use the email address in the-, in the chat box that we put there. Please use it, and we will respond as quickly as possible. Okay, thank you everybody, and have a good rest of the day. Okay, bye-bye.

 

M:  Thanks for that. Thanks everybody.