Hertfordshire County Council – Case Study 

As with many local authorities, Hertfordshire County Council faced several challenges related to adult social care commissioning, which include: 

1. Financial Pressures and Market Insights: Hertfordshire’s commissioning team had to navigate the financial challenges of an increasingly strained social care system. Securing thorough, up-to-date insights into what was being commissioned – both locally and regionally – was crucial for maintaining quality while also controlling costs. Understanding the broader picture, including national and regional trends in care provision, was vital to making informed commissioning decisions.

2. Diverse Care Requirements: There was a growing need to develop commissioning strategies that reflected a wide variety of care needs. This included not only traditional services but also new types of care that support people’s independence, such as shared life schemes and more enhanced supported living. The council needed a better understanding of how different care models were performing, particularly for complex needs, to ensure the right services were being offered to care recipients.

3. Commissioning Complexities: Collaboration between local authorities, the NHS and other public sector bodies was often required, particularly when commissioning more specialist care. The complexity of these joint commissioning arrangements made it difficult to track performance, quality and spending effectively.

4. Quality Monitoring and Assurance: Hertfordshire’s social care providers, particularly in the nursing home sector, needed more proactive and transparent monitoring to identify quality issues before they became critical. They also wanted a solution to help integrate data from multiple sources, such as contract compliance, performance metrics and Care Quality Commission (CQC) ratings.

Alex Ogle, the Adult Social Care Performance Manager at Hertfordshire County Council, sums up how technology could help overcome these challenges:

“What excites me at the moment about technology and adult social care commissioning is the data and analysis it brings. It allows us to bring together various aspects of commissioning, from monitoring providers to understanding trends in placements and demand across the service.”

To address these challenges, Hertfordshire County Council implemented PAMMS (Provider Assurance Management and Monitoring System) – a robust provider monitoring and performance management software solution designed to give commissioners, care managers and other stakeholders deeper insights into care quality and contractual compliance.

Key Features of PAMMS:

• Real-time quality assurance – PAMMS is integrated with the council’s contracting and commissioning framework, ensuring that the software directly links to key contract standards and performance metrics. This integration allows commissioners to view up-to-date provider performance, track compliance and ensure that the services delivered align with contractual expectations.
• Data-driven decision-making – PAMMS provides a holistic view of care provision by combining key data sources such as provider feedback, CQC scores and contract compliance data. It helps to quickly identify areas where providers may require support and allows the council to take a more practical approach to quality improvement.
• Provider performance tracking – The software features a risk profiler that automates the tracking of quality assurance trends at individual, county and regional levels, helping commissioners identify potential risks and address issues before they escalate.
• Benchmarking and comparison – The ability to benchmark care providers within the council’s own operations and across other local authorities in the region helps Hertfordshire identify best practices, compare costs and evaluate whether value for money is being achieved. 

The implementation of PAMMS has had a significant impact on Hertfordshire County Council’s approach to commissioning and quality monitoring, providing both immediate and long-term benefits. 

Saving Time – Streamlining Operations and Improving Responsiveness

• Real-Time Access to Data – The PAMM system granted the council access to up-to-date information about care providers, surpassing even CQC ratings in its timeliness. The real-time access allows staff to make informed decisions rapidly, particularly in emergency or ad hoc situations where time is critical.

• Quick Identification of Trends – By automating the identification of trends and patterns in care quality, PAMMS eliminated the need for time-consuming manual data collection and analysis. This enabled staff to proactively address recurring issues and focus their efforts on improving care quality.

• Efficient Risk Profiling – Integrating data from multiple sources, PAMMS facilitated the swift identification of high-risk providers. This streamlined process ensures that interventions can be directed to the most critical areas without unnecessary delays, significantly enhancing operational efficiency at Hertfordshire County Council.

• Faster Emergency Responses – In emergencies, PAMMS can now empower staff with immediate access to detailed provider profiles. The capability enables quicker, more informed decision-making, especially during out-of-hours scenarios, reducing response times and improving outcomes.

 
Saving Money – Optimising Financial Decisions and Reducing Waste

• Benchmarking and Value for Money – The benchmarking capabilities of PAMMS provide crucial insights into financial data across Hertfordshire providers and sectors. This allows the council to evaluate the cost-effectiveness of services and identify areas for financial optimisation, particularly amidst inflationary pressures.

• Informed Financial Decisions – A comprehensive analysis of care costs across the region enables the council to identify discrepancies in funding and make more targeted, cost-efficient commissioning decisions. These data-driven insights contribute to sustainable long-term savings.

• Market Confidence and Investments – With improved market transparency, PAMMS fosters collaboration between local authorities and care providers. This trust-building facilitates provider investments that align with long-term commissioning goals. Over time this will lead to more sustainable and cost-effective care solutions.

• Improved Risk Management – PAMMS strategic risk assessment tools allow the council to proactively address provider risks and develop contingency plans. By preventing costly service disruptions or provider insolvencies, the council avoids significant financial losses while maintaining continuity of care.

• Strategic Commissioning – The system supports a forward-looking approach to care commissioning, focusing on 3 to 10-year strategies instead of short-term reactive decisions. This proactive methodology minimises the need for urgent, high-cost interventions, benefiting both the council’s budget and the care recipients. 

Other Outcomes

• Improved Quality Monitoring: PAMMS provides up-to-date access to providers’ quality scores, offering a more timely view of performance than CQC ratings alone. This real-time access allows the council to quickly assess care quality, particularly in emergencies or when investigating specific provider concerns.

• Proactive Performance Management: With PAMMS, the council can identify providers that need immediate attention and intervention. For example, trends in quality data can prompt early intervention or targeted support, such as training and development for providers. This proactive approach helps to prevent issues from escalating, especially in critical areas like nursing home care.

• Collaboration with Regional Authorities: The ability to compare data across other local authorities in the Eastern region has been particularly beneficial. Hertfordshire has started collaborating with neighbouring councils, which has improved benchmarking and provided a richer understanding of regional trends in adult social care commissioning.

• Better Strategic Planning: The data insights from PAMMS have driven Hertfordshire’s commissioning strategy, allowing the council to align its operational priorities with real-time market intelligence. For example, insights into provider performance and market trends help shape commissioning decisions and improve long-term care planning. 

Key Benefits of PAMMS:

• Up-to-date quality insights – Quick access to up-to-date provider quality scores, often more current than CQC ratings, helps commissioners address quality issues rapidly.

• Data-driven decision-making – By linking quality data with financial and performance information, PAMMS enables a more informed and strategic approach to commissioning.

• Regional collaboration – The ability to compare data across neighbouring local authorities provides richer insight into care quality, costs and outcomes.

• Improved risk management – The software’s risk profiler identifies emerging trends and allows for targeted interventions to address quality concerns.

• Enhanced reporting – PAMMS supports more efficient and comprehensive performance reporting, providing senior management with actionable data. 

Looking ahead, Hertfordshire County Council is excited about the potential of artificial intelligence (AI) in transforming adult social care commissioning. AI offers the possibility of predicting care needs more accurately, supporting early intervention, and helping to prevent care breakdowns by identifying individuals who may benefit from support before they require intensive care services. 

Moreover, the council is eager to continue expanding its use of PAMMS, particularly in the area of benchmarking. As more local authorities contribute data, Hertfordshire will be able to gain deeper insights into value-for-money across the region, and further refine its commissioning approach. This could also include assessing how to optimise spending on specialist services provided outside of Hertfordshire. 

“With the sharing of more data between local authorities, we can gain richer insights into care provision and, ultimately, improve outcomes for the people we support.”

- Alex Ogle, the Adult Social Care Performance Manager at Hertfordshire County Council

Hertfordshire County Council’s implementation of PAMMS has been a key factor in improving both the operational and strategic aspects of adult social care commissioning. By integrating real-time data and leveraging advanced analytics, the council has enhanced its ability to monitor care quality, manage costs and support providers.

PAMMS has not only streamlined processes, but it has also fostered greater collaboration with regional partners, ensuring that the people of Hertfordshire receive the best possible care in an ever-changing landscape. 

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