Lancashire County Council & PAMMS - Case Study
Lancashire County Council (LCC) is responsible for a population of 1.2 million across the county, collaborating with other bodies in the north-west region including Blackburn with Darwen Borough Council, Lancashire and South Cumbria Integrated Care Board, and Blackpool Council for their service delivery.
In this case study, we look at Lancashire’s relationship with Access PAMMS (Provider Assessment and Market Management Solution) and how our commissioning toolkit is supporting their market management, through oversight, analytics and market shaping.
Management Challenges
For Lancashire County Council, they had three elements they wanted to address:
- Market shaping
- Market management
- Quality assurance
During the Covid-19 pandemic, the authority realised that their relationship with the provider market was very disjointed. This was due to having a multitude of methods of communication, rather than a priority or preferred channel, as well as varying different requests or expectations from one provider to the next. Similarly, the metrics used to assess performance and competency were also different.
Some of this was due to the scale and scope of the county council, but regardless, this was incredibly inefficient to the point of being actively detrimental to the care at hand – something these providers fed back to Lancashire County Council in last couple of years.
LCC has over 400 care homes in their patch, with 100 domiciliary providers on their books and the remainder on their radar. The context of two or three phone calls or emails with each one quickly adds up to a large amount of engagement, which in turn requires a large commitment of resources.
This is where Lancashire’s challenge hits its crux: they need a single contracting approach that then optimises the communication channels and cuts away duplicate conversations or multiple, differing requests.
Lancashire’s Goals
The Covid pandemic forced Lancashire County Council’s hand into making firm and rapid decisions on collaboration, but the experience - purely regarding the cooperation – was a positive one. This then provided learnings that could be formalised as good practice guidelines; things that LCC and their partner providers could move forward with.
The goal is one version of the truth – something at Access we have written about with other NHS Trusts and local authorities. A centralised or singular record built to be a hub of intelligence, but with appropriate safeguards around privacy and data protection.
For Lancashire County Council, just like with other organisations in and around health & care, the hindrance to efficiency was duplication; of information but also effort. In their own words it was “fluff” and it was a distraction that was reducing a provider’s capability to respond or react promptly.
With that one version in place, that will then allow staff within both the commissioning and contract teams more time to work with the providers, meaning better quality conversations and a greater idea of where there’s room for improvement, which then becomes future planning, development, and leads to innovation.
“We knew that we needed to invest in something; invest in a platform that would work collaboratively across the different asks that we had as different authorities and as the NHS.”
- Victoria Tomlinson, Senior Commissioning Manager, Lancashire County Council
How Access has helped
The Access Group works with many local authorities and councils across the UK, and the solution we offered and Lancashire County Council onboarded was Access PAMMS - Provider Assessment and Market Management Solution.
PAMMS is designed to modernise the provider assessment process and provide market insights in the process, on things within the social care landscape such as spending, activity, capacity and availability, as well as forecasting things such as future demand. Other elements include quality assurance, a risk profiler, and Market Position Statements.
Lancashire and South Cumbria NHS Foundation Trust already uses Rio EPR – The Access Group’s electronic patient record solution – whilst Lancashire and South Cumbria ICB also uses some Access services, so the connections were already present and the opportunity ideal for Access to step in and further support Lancashire.
Lancashire County Council has taken the lead by onboarding Access PAMMS, which they described as a result of the “need to share the risks and the benefits” and to lead by example for the local area. With PAMMS, LCC now feels it is able to resolve the challenging conversations around things such as the Better Care Fund, and how saving hospital admissions is saving money but increasing demand for social care which is taking money.
In addition to PAMMS, Lancashire County Council is also using the Access CM software for care management, to assist with intermediate care delivery. This is focused on reablement and returning independence rather than homecare, but that’s a potential avenue for the future. For now, LCC wants to get people discharged from hospital as quickly as possible once determined its safe, and allocate the care provision to minimise their dependency on support services.
The Results
Lancashire County Council has been delighted by the Access solutions onboarded so far, but more work is needed across the county to continue to change the culture around technology so that more people are more willing to do more with care software – thus achieving greater outcomes. Speaking at The Access Group’s Local Government Commissioning Conference at the Crown Plaza NEC, Birmingham, Victoria Tomlinson highlighted the challenge of convincing established staff; staff who may be wedded to the way they’ve always done things. The benefits are provable, but efforts must be made to get everyone on side and pulling together.
Onboarding our solutions did flag up elements that could be changed in future, such as overly complex contracting where a joint contract might have been more appropriate, or adapting to the systems available rather than being so rigid in processes that there’s a lack of alignment.
The good news is that the benefits are being seen, and they are big. The more time with the software solutions, the better the utilisation will be and hopefully the care outcomes improve even further as a result. Lancashire are already able to assign monitoring and risk assessment duties to other local authorities, to share the workload while they take on additional risk being the forerunners.
This is then releasing capacity within their team and reducing duplication, but it also opens them up to expanding their scope wider regards the care market. LCC can then look at benchmarking, costings, and areas of concern. With the Access CM module in particular, Lancashire County Council are using it for the reablement services, but their intent is to fully re-assess the pathways and processes around this to see if they’re delivering the correct capacity and the correct support.
PAMMS has greatly improved data capture and assessment though, transforming what was the horrible November data collation period to be a smooth and rapid projection of available information regards the market position statement; something that ordinary folk might not read but that gives the commissioners greater confidence in their actions going forward.
Beyond this is futureproofing. AI capabilities are on the horizon for both The Access Group, through Access Evo, but also for other software Lancashire are using. Based on their needs, tools for case note harvesting and for patient engagement/questioning would be helpful towards the goals of further efficiency and greater data insights, and by knowing what it is the local population wants and needs, LCC can truly get the most out of their budget to provide for their people.
