COVID-19 resources on Commissioning

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COVID-19: Government procurement and supply of Personal Protective Equipment. Forty-second report of session 2019–21

House of Commons

Findings of an enquiry into the Government procurement during the COVID-19 pandemic and the supply of personal protective equipment (PPE). The shortages of personal protective equipment at the front-line in the first wave of the pandemic was one of the biggest concerns in March and April 2020. As well as NHS front line workers there were others front-line workers who required high grade PPE – particularly in social care settings, which were mainly private businesses. The evidence suggests that stocks ran perilously low; single use items were reused; some was not fit for purpose and staff were in fear that they would run out. Government faced significant challenges in having to work at pace, using emergency procurement procedures, in a competitive international market. However, its failure to be transparent about decisions, publish contracts in a timely manner or maintain proper records of key decisions left it open to accusations of poor value for money, conflicts of interest and preferential treatment of some suppliers, and undermines public trust in government procurement and the use of taxpayers’ money. The Government’s decision to prioritise hospitals meant social care providers did not receive anywhere near enough to meet their needs, leaving them exposed. Many workers at the front line in health and social care were put in the appalling situation of having to care for people with COVID-19 or suspected COVID-19 without sufficient PPE to protect themselves from infection. The report calls on the Department of Health and Social Care to develop a better understanding of the needs of both NHS organisations and, crucially, allied health and social care sectors.

Last updated on hub: 10 February 2021

Busting bureaucracy: empowering frontline staff by reducing excess bureaucracy in the health and care system in England

Department of Health and Social Care

This is the government response to a public consultation on reducing bureaucracy in the health and social care system. COVID-19 has demonstrated the benefits that lifting bureaucratic burdens can offer and given us some learnings in terms of the best ways to do so. This document outlines the actions that can be taken to drive changes to culture and leadership, simplify assurance and accountability processes and review the system architecture to drive better integration of services. Ultimately empowering people to get on with their jobs and deliver better outcomes. The report highlights eight priority areas for action: data and information will be requested, shared and used intelligently; system and professional regulation will be proportionate and intelligent; day-to-day staff processes will be simple, helpful and effective; the government will legislate to make procurement rules more flexible; GPs will have more time to focus on clinical work and improving patient care; appraisals will be streamlined and their impact increased; there will be greater digitisation of services; and a supportive culture is needed at a national and local level.

Last updated on hub: 26 November 2020

The supply of personal protective equipment (PPE) during the COVID-19 pandemic

National Audit Office

This report focuses on the supply of personal protective equipment (PPE) during the pandemic. It examines: responsibilities for PPE supply in England (Part One); the emergency response to PPE shortages, focusing on the performance of national bodies in obtaining and distributing PPE to local organisations (Part Two); the experience of health and social care providers and their workforce (Part Three); and the Department of Health & Social Care’s (the Department’s) new PPE strategy (Part Four). The Government initially considered it was well-placed for managing the supply of PPE in a pandemic, with tested plans and a stockpile in place. But neither the stockpiles nor the usual PPE-buying and distribution arrangements could cope with the extraordinary demand created by the COVID-19 pandemic. As a result, government’s structures were overwhelmed in March 2020. Once government recognised the gravity of the situation it created a parallel supply chain to buy and distribute PPE. However, it took a long time for it to receive the large volumes of PPE ordered, particularly from the new suppliers, which created significant risks. There were further difficulties with distribution to providers and many front-line workers reported experiencing shortages of PPE as a result. The initial focus on the NHS meant adult social care providers felt particularly unsupported. Government has budgeted an unprecedented £15 billion of taxpayers’ money to buy PPE for England during 2020-21. It has paid very high prices given the very unusual market conditions, and hundreds of millions of pounds-worth of PPE will not be used for the original intended purpose.

Last updated on hub: 26 November 2020

NHS Reset: a new direction for health and care

NHS Confederation

This report summarises the insights from an engagement exercise with health and care stakeholders, including a survey of more than 250 leaders from across the NHS, as part of NHS Reset, an NHS Confederation campaign to help reset the way the system plans, commissions and delivers health and care in the aftermath of the Covid-19. The report focuses on the key challenges that the health and care system faces, including: health inequalities; the health and care workforce; funding and capacity; integration and system working; letting local leaders lead; and social care. In relation to the latter, the report argues that ensuring the effective functioning of the NHS will require a reform of social care, including stable and adequate funding, a social care long term plan that runs parallel to and supports the NHS Long Term Plan, a well-resourced and trained workforce, and outcomes-based commissioning. The report posits that five factors will be fundamental to achieving a sustainable health and care system. These are: honesty and realism – government investment to support new ways of working that will enable it to fully and safely restore services, as well as the understanding of the public while services adjust and deal with a large backlog of patients needing care; extra funding; a lighter, leaner culture – empowering local leaders and clinicians to adopt more agile ways of working; integrating health and care; and tackling health inequalities – through a radical and conscious shift towards a strategy based on population health.

Last updated on hub: 01 October 2020

Cohorting, zoning and isolation practice: commissioning for resilient care home provision: a report to the Social Care Sector COVID-19 Task Force

Care England

Guidance on developing good practice in cohorting, zoning and isolation practice in care home settings as a means of ensuring the effective implementation of the Public Health England (PHE) national guidance and high standards of infection prevention and control. Various examples and documents already exist which exemplify notable practice and provide national guidance. This document brings some of this together to address particular questions for the Task Force. As well as providing advice to the Task Force, it might also act as a checklist for commissioners to assess what they have already done / might do. It is split as follows: context; some key principles to guide work in this area; describing good practice in cohorting – within existing provision, or in dedicated facilities; what this means for commissioners and how they work with care providers recognising the critical relationships between them; resource considerations; and practice examples and references.

Last updated on hub: 17 September 2020

Guidance for local authorities and clinical commissioning groups in the delivery of direct payments and personal health budgets

Department of Health and Social Care

This guidance sets out key expectations of Local Authorities and Clinical Commissioning Groups in their delivery of direct payments and personal health budgets to support people’s continuing care and support needs, and to manage and mitigate the impacts of COVID-19. The guidance covers: continuity of care and support; allowing flexibility; key steps for LAs and CCGs to take; supporting the person and direct payment capability; supporting personal assistants with Statutory Sick Pay (SSP); contingency arrangements for people who employ personal assistants; and support for people using direct payments and receiving community health provision. This guidance intends to complement existing guidance and statutory duties. Any inconsistency between this guidance and the legislation is to be interpreted in favour of the legislation. [First published: 21 April 2020. Last updated 24 August 2021].

Last updated on hub: 15 September 2020

Social care: time to grasp the nettle

NHS Confederation

This report, part of the NHS Reset campaign, explores the opportunities and challenges ahead for health and social care. The COVID-19 pandemic has highlighted the critical role that social care plays in the delivery of health and care services. But it has also exacerbated the underlying weaknesses in social care and demonstrated the need for fundamental reform. The report argues that four critical factors are needed to reset social care: a stable, well-funded social care service – without social care reform leading to a sustainable system the NHS will not be able to deliver high-quality care in the wake of the pandemic; a long-term plan for social care to address the imbalance that was already present in the social care service, as well as a fundamental review of the model of social care provided in England; a well-resourced and trained workforce – a national, integrated health and care workforce strategy would go some way to tackle the crippling workforce issues facing social care; and outcome-based commissioning – the NHS needs a joined-up approach to commissioning, with people at the forefront of local decisions.

Last updated on hub: 07 September 2020

The future of commissioning for social care

Social Care Institute for Excellence

SCIE's latest commissioning guide that focuses on the immediate future of commissioning in light of COVID-19.

Last updated on hub: 26 August 2020

Voices from lockdown: a chance for change: interim findings report


This report focuses on the first three months of lockdown in the UK, looking at the needs and experiences of marginalised women and girls and the implications for the voluntary and community organisations that support them. It provides insights collected from an online survey of 72 organisations working with women and girls at risk, in-depth interviews with professionals from those organisations and interviews with the women and girls who use those support programmes whilst facing multiple disadvantages. The research highlights the challenges faced by this specialist sector, as well as important learnings and innovations being developed. It suggests that two concerning trends are emerging: firstly, that more women and girls are in need of support; and secondly, that their needs are increasingly more complex and urgent. While the demand for services is growing, nearly half, 46 per cent, of organisations reported that their financial position during the lockdown had worsened. Of those organisations that saw their financial position worsen, 30 per cent were small providers, supporting less than 25 women a month, with an income of less than £50,000. The report makes recommendations to ensure four core ambitions for recovery can be achieved and the specialist sector is adequately funded and supported: ensuring equality, insight and transparency to achieve effective commissioning and funding decisions; building respect, dignity and participation, removing the barriers to support services for women and girls; empowering local responses and driving collaboration through funding and commissioning; valuing expertise and growing innovation, harnessing the full potential of the women’s voluntary and community sector.

Last updated on hub: 17 August 2020

Hospital discharge and preventing unnecessary hospital admissions (COVID-19)

Social Care Institute for Excellence

This guide discusses the lessons learned from hospital discharge and avoidance during the COVID-19 pandemic. It highlights challenges faced and good practice to prevent unnecessary admissions going forward.

Last updated on hub: 31 July 2020

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