Service Reviews – Outline Business Case - Somerset County Council

(Cabinet – 2 May 2012)
2 Options for Change
The options that have been considered are 14 :
A. Redesign services in line with the Localism Bill. The majority of expenditure
(75% of the budget) is used to provide residential care, supported living and
domiciliary care services. These would be difficult to deliver at a local level whilst
maintaining a cost effective and equitable service. Mencap have been vocal in their
concern about devolving this type of service to the community as, although they
believe in greater devolution of power, they continue to highlight the risks that with
increased local decision-making comes less cost effective services that will be
subject to a ‘postcode lottery’. However some services, primarily respite day
services and work preparation services may, in part, be better delivered at a local
level. This option has been rejected for the whole service; however we could
consider alternative models of delivery for day/work services as part of the full
business case.
B. Remain in the county council and continue to redesign and deliver
efficiencies. Under this option we would continue with the existing programme of
change, and develop a Service Plan to restructure and to meet the challenges of
the Medium Term Financial Plan (MTFP), demographic trends and increased use
of Direct Payments (DP).
This option does not fit well with the high level design principles of the Target
Operating Model and exposes SCC to escalated levels of financial risk as more
people choose to personalise their services. Retaining the direct provision of these
services was part of the options appraisal considered by SCC’s Cabinet in October
2010. As a result of the Cabinet decision, the in-house service has been reshaping
to ensure that it is outcome driven, streamlined and more cost effective, with £730k
(including QIPP 15 ) of savings having already delivered and a further £2.6m in the
pipeline. This has enabled the LDPS to begin to provide services that are more
aligned with market costs and which are more flexible and responsive to customer
need. This option is considered further in section 3.
C. Whole service externalisation. Under this option the service would be moved
out of the County Council without a competitive process. There are a number of
different legal vehicles that need to be explored further in the full business case if a
decision is taken to pursue this option, however in order to comply with European
Union procurement regulations it is likely to take the form of a Local Authority
Controlled Company. This option is considered further in section 3.
D. Whole service open market tender. Under this option the whole service would
be subject to an open market tender compliant with SCC contract standing orders
14 Further consideration needs to be given to the model for employment support services as part of the
development of a full business case for any option that is taken forward
15 QIPP (Quality, Innovation, Productivity and Prevention) is a large scale transformational programme for
the NHS, involving all NHS staff, clinicians, patients and the voluntary sector and will improve the quality of
care the NHS delivers whilst making up to £20billion of efficiency savings by 2014-15, which will be
reinvested in frontline care. http://www.dh.gov.uk/en/Healthcare/Qualityandproductivity/QIPP/index.htm
A - 15