Decision details

17.1

The Executive Director, Communities submitted a report setting out the work undertaken by the Sheffield Drug and Alcohol Co-ordination Team to develop a commissioning and procurement plan for publicly funded community drug and alcohol treatment in Sheffield.

17.2

RESOLVED: That Cabinet:-

(a)

notes and approves the Sheffield Drug and Alcohol Community Treatment Commissioning and Procurement Plan, including the model of ‘end to end’ services and the associated cost savings as outlined in the report;

(b)

delegates authority to the Director of Commissioning, in consultation with the Cabinet Members for Health, Care and Independent Living and Homes and Neighbourhoods and Director of Commercial Services to approve the Procurement Strategy for the tenders for each service;

(c)

delegates authority to the Director of Commissioning and Director of Commercial Services in consultation with the Director of Legal and Governance to agree contract terms and approve a contract award following the tender process; and

(d)

delegates authority to the Director of Commissioning in consultation with the Cabinet Members for Health, Care and Independent Living and Homes and Neighbourhoods and the ability to take such steps as he thinks appropriate to achieve the outcomes outlined in the report.

17.3

Reasons for Decision

17.3.1

The proposals in the report are based on a robust commissioning process. There is an annual process of detailed analysis of local need and trends carried out to inform local commissioning. There is proactive quarterly performance monitoring on currently commissioned services which have been used to identify good practice and shortcomings within the current model and provision. There is reference to national strategy, performance indicators, funding models and national clinical and good practice guidelines moderated against local need and demand. These processes have informed the development of the commissioning and procurement plan and the associated service specifications.

17.3.2

There has been further reference to the investment that successful drug treatment completions bring to the City in the form of the Public Health Grant and the expected Health Premium. There is a need to commission effectively and resource sufficiently in order to secure the outcomes required to maximise the investment and potential gains through the Health Premium. This is balanced against the financial pressures experienced by Sheffield City Council and the need to spread any investment across a range of public health outcomes. The commissioning and procurement plan recommends cost savings of £1.2m across 3 years as achievable without negative impact on service users, communities and performance.

17.3.3

The report follows 6 month internal consultation within Sheffield City Council on the outline commissioning and procurement plan which set out the proposed type and volume of treatment to be commissioned and the associated costs and savings from the commissioning model. A further 8 week Public and Stakeholder consultation was launched on 4^th November 2013 and the outcomes of this were included as an appendix to the main report.

17.3.4

Commissioning and Finance within the Communities Portfolio, Commercial Services and the Director of Public Health have been key stakeholders in the development of this plan.

17.4

Alternatives Considered and Rejected

17.4.1

The “Do Nothing” option of re-tendering all current services using the same model and specifications was considered as part of this process. This option was rejected because the current system was only ever an interim position in the total reconfiguration of the treatment system which commenced in 2009. Option 1 does not address the current problems in the system of non-value adding steps, hand offs and unnecessary transfers for clients to receive support. It does not address current performance issues of a plateau in treatment exits. It does not rebalance the treatment system towards non opiates. It does not achieve the required cost savings.

17.4.2

Combine drug and alcohol services into single services. This option was rejected because it does not meet the current expressed preferences of alcohol service users to be treated separate from drug users. It does not ensure a differentiated offer or distinct culture of service for non-opiate users as a minority group within drug and alcohol treatment services. This will be retained as an option in future procurements as the treatment population changes and is less dominated by opiate use (assuming the current trend continues and 10% of the opiate using population leave treatment successfully and do not return).

17.5

Any Interest Declared or Dispensation Granted

None

17.6

Reason for Exemption if Public/Press Excluded During Consideration

None

17.7

Respective Director Responsible for Implementation

Richard Webb, Executive Director, Communities

17.8

Relevant Scrutiny and Policy Development Committee If Decision Called In

Healthier Communities and Adult Social Care