Category Archives: General News
It is with sadness that I write this tribute to Sir Bert Massie CBE, Chairman of CECOPS, who sadly passed away on 15/10/2017.
I first approached Sir Bert in 2009 to write a Foreword for a paper I was writing on national minimum standards for disability equipment services; he was very obliging and interested in my work. I kept in close contact from that time, and in 2012 I approached Sir Bert to see if he would be interested in chairing CECOPS, the not for profit standards and certification body for assistive technology services. Bert was delighted with the CECOPS concept and agreed to help me to establish the organisation.
Sir Bert said at the time that the main reason he took on the role of CECOPS Chair was that he believed in its aims and saw it as a vehicle for helping to improve services for disabled and older people, a cause close to his heart.
Sir Bert’s role has been very instrumental in establishing CECOPS; he has been a real champion for the cause. CECOPS’ growth over recent years is largely due to Sir Bert’s wisdom, experience and passion.
Bert was a true campaigner, but he was never a complainer. He only asked for what was right and nothing more. He had a wonderful art of guiding conversations in a way that made others feel that they had made decisions themselves.
Bert’s view was that a good cause is always worth fighting for. He always maintained a cheerful and happy spirit, and had a great sense of humour.
Bert was much more than a chairman, he was also a friend. As well as wanting CECOPS to succeed, he was also genuinely interested in my wellbeing and that of my family.
Bert was a mentor, giving me a positive outlook amidst the gloom. Lastly, he was an inspiration, not just in his role within CECOPS, but more as an individual. He overcame many personal barriers in his life, and more, he worked tirelessly to remove barriers others couldn’t remove for themselves. Thank you for your selfless labour Bert, you will be greatly missed.
Local Government Association (LGA) and NHS England Vanguards signpost CECOPS as a resource to support Technology Enabled Care Services
CECOPS offers standards, software tools, expert personnel and training to help local authorities and health organisations with planning, commissioning and providing technology enabled care services (TECS) e.g. telecare, digital health.
CECOPS is an independent, not-for-profit standards and certification body for assistive technology services.
CECOPS is, where appropriate, one of the resources Local Authorities are signposted to following completion of the Local Government Association’s Social Care Digital Maturity Assessment.
NHS England Vanguard areas currently undertaking Digital Maturity Assessments and requiring support will also be signposted to CECOPS, as a resource to support local areas.
CECOPS’ details are available on the resource repository area for Local Authorities and an online collaboration space for NHS England Vanguards.
Support will include CECOPS’ outcomes-based integrated Code of Practice for Planning, Commissioning and Providing Technology Enabled Care Services. The Code can help organisations prepare for engaging with TECS, as well as providing a quality framework for procurement and provision of services, simplifying the commissioning and tendering of services. Details about the Code can be found HERE.
The Code is supported by a unique self-evaluation and continuous improvement software tool, allowing organisation to self-evaluate their readiness and assist in the monitoring of contracts and services. A free 30 day trial is available on the tool. A flyer for the tool can be downloaded HERE.
CECOPS also has a Strategy and Delivery Unit (SDU), made up of national experts in the space, which can help with assessing, progressing and accelerating organisational readiness. The SDU can help with commissioning, procuring and implementation of services.
The new quality framework and tools uniquely enable CECOPS to work across wider geographical areas and share good practice, thus adopting a community building approach to help achieve a wider and more accelerated adoption of TECS.
CECOPS also offers training programmes for both commissioning and providing TECS.
CECOPS can also accredit services, via an external assessment undertaken by independent assessors DNV GL Healthcare, world leaders in quality and risk management.
To find out more please contact CECOPS: (T) 01494 863398 (M) 07511 667 330 (E) email@example.com
CECOPS is a social enterprise and currently works with approximately 80 NHS organisations and local authorities. CECOPS is CQC approved and has been endorsed by the Association of Directors of Adult Social Services and the Health and Safety Executive, for example. CECOPS is completely independent, having no affiliations with suppliers or service providers. The assessment partners used by CECOPS, DNV GL Healthcare, are also totally independent, which avoids any potential conflicts of interest. CECOPS is chaired by Sir Bert Massie CBE.
I was recently asked to explain the digital health marketplace in the UK and how providers are supposed to access the market. This marketplace includes, for example, telehealth, telemedicine, eHealth and mHealth products, as well as telecare.
A marketplace is formed where there is demand for a product or service, and when this demand is supplied. Of course then, markets grow and evolve over a period of time.
Within the digital health space, on the supply side there is a vast range of products and services, but the demand side is unclear. The need is there, but organisations responsible for planning and commissioning services are often unsure of how best to engage with some of the technologies available and to procure these. What works? Where do we start? Is it cost effective? How can we assess service impact?
So we could reasonably conclude that the marketplace for digital health is not well defined and has not yet matured. This is discouraging for providers, especially SMEs, and there is confusion about the best approach for accessing the market. This could even cause a provider, particularly a smaller one, to ‘give up’. This would be a shame if they had an excellent product which they were struggling to sell.
It is important for those on the demand side to be clear about what it is that they want to procure or commission, and that they are ready for adopting the technologies and services. Organisational readiness is often an area overlooked; yet this is such an important issue to address to ensure the marketplace matures and thrives.
While there are some pockets of excellent working in getting products to segments of the market e.g. acceleration programmes, processes are not the same across different geographical areas and sectors. These issues are not limited to the UK. From conversations I am having with people overseas, the situation is pretty much the same internationally.
The imbalance between the supply and demand sides of the market cannot continue.
So, what can be done?
To help shape the marketplace, CECOPS has developed the first ever International Code of Practice for Planning, Commissioning and Providing Technology Enabled Care Services. This is an outcomes-focused quality framework for procurement and provision of services. It offers an end-to-end solution which addresses all aspects of the marketplace.
This new framework for the first time provides structure to the marketplace and is set to become the recognised benchmark.
Working with the Code will help to create and shape a more balanced marketplace. Following it will also help to ensure an organisation’s readiness before engaging with digital health. The Code can also act as a framework to support providers coming into the space, so that they have a clearer understanding of what might be required of them.
Using the Code within tender specifications simplifies the procurement process. As the Code is outcomes-focused, it encourages providers to be innovative. It will also help to achieve sustainable economic growth in the space; as growth for some providers is currently minimal and short-lived.
As the standards and certification body for these services, CECOPS is also able to accredit services via an external assessment.
Some of the many benefits of this new approach include:
- Marketplace development and maturity
- Brokering improved relationships in the marketplace
- Accelerating organisations to a state of readiness
- Achieving sustainable economic growth for the sector
- Simplifying procurement, commissioning and contract management processes
- Better chance of realising benefits from providers’ products and services
- Saving time and cost (by providing a ready-made framework)
- Improved quality and performance
- Local, regional, national and international benchmark and platform for sharing good practice and having a community building approach
- Improved clinical, wellbeing and financial outcomes
Copies of the International Code are available from here. The Code is free to organisations registered with CECOPS.
To find out more about CECOPS accreditation scheme or the Code, please get in touch.
Brian Donnelly MSc, CEO, CECOPS CIC
E: firstname.lastname@example.org | +44 (0) 7511 667 330 | T: +44 (0) 1494 863398 | www.cecops.org.uk
Having previously worked in the public sector I have personally been guilty of procuring technologies without firstly giving a lot of consideration as to how ready the organisation was to use the technologies effectively. For example, does the organisation have the right skills, resource, capacity or information systems to benefit from such technologies and measure service impact?
Not considering organisational readiness appropriately means that it is likely the technologies will not meet their intended purpose, and neither will expected benefits be realised.
This oversight is something that happens regularly, especially within the public sector. We have all witnessed it with failed local and regional technology related projects, as well as national multi-million pound IT projects, for example.
I once knew someone who bought £500K of telecare ‘boxes’ for a local authority. After 6 months the ‘boxes’ were still in a store; no one knew how to deploy and use the contents of the ‘boxes’!
On a national or even international scale, the cost of investing in technologies without ever realising their full potential or improving care to patients and users must be colossal. This is a complete waste of public funds.
Organisational readiness: For too long the focus has been on the provider and supplier end of the market; whilst this has its place, time and consideration has to equally be given to the planning and commissioning end of the market. It is in the long term interest of good providers and suppliers of technology to provide their products, solutions and services into organisations that are ready.
Not only should organisations assess their own readiness prior to committing to acquiring technologies, there is a role also for providers and suppliers to help ensure organisations are ready.
So how can organisations make sure they are ready before taking a leap into the world of technology enabled care services? This is very important now that technologies are playing more of a role in health and social care provision.
Good News: We are glad to inform you that CECOPS has some new developments which will help!
First end-to-end outcome-based International Code of Practice for Planning, Commissioning and Providing Technology Enabled Care Services
We have just developed the first ever end-to-end outcome-based International Code of Practice for Planning, Commissioning and Providing Technology Enabled Care Services. Following the sequential steps set out within this Code will help to ensure organisations are ready before engaging with technology enabled care services. It will also help to ensure any service implemented results in the best possible outcomes, and that the service is innovative and sustainable.
The new CECOPS Code is available from HERE. The Code is FREE to organisations working with CECOPS.
To supplement the Code, CECOPS has also developed a self-evaluation and continuous improvement tool for both planning and commissioning TECS, as well as service provision. This tool can also help with determining organisational readiness and implementing new services. There is a free trial available so you can see how it works. Details can be downloaded HERE
“..this is more than a Code of Practice; it is a map, a guide and a chaperone. It is thought provoking and a source of inspiration.” Roy Lilley, Health expert and analyst.
Get in touch: If you would like to discuss any of the above issues please get in touch.
E: email@example.com | +44 (0) 7511 667 330 | T: +44 (0) 1494 863398 | www.cecops.org.uk
The first ever Code of Practice and support tools covering all aspects of planning, commissioning and providing technology enabled care services (e.g. telehealth, telecare, eHealth, digital health) have been developed by CECOPS, the independent standards body in the UK for assistive technology services.
Uniquely, this new Code, which sets out standards covering every aspect of services, offers an end-to-end and whole-system approach, ranging from the early planning stages through to post-implementation of services. It can be looked at as a value-chain solution that interlinks those responsible for planning and commissioning services with service users, through the activities of clinicians and providers.
‘…this is more than a Code of Practice; it is a map, a guide and a chaperone. It is thought provoking and a source of inspiration.’
Roy Lilley, leading expert and analyst in healthcare
The Code is complemented by a unique and powerful self-evaluation and continuous improvement tool iCOPS®, which helps organisations to self-evaluate services, assess readiness before engaging with TECS and drive their own quality and performance agenda.
It is anticipated the Code and support tools will encourage wider adoption of TECS and set the benchmark and framework for all organisations in the sector to work to.
Following the Code enables the longstanding barriers to adopting TECS more widely to be overcome, ensuring projects and initiatives are delivered with the best possible outcomes, with the ability to measure their success and embed sustainability.
These latest developments offer a quality framework for the procurement and provision of services, with the ability to assess, influence and improve outcomes, as well as streamlining the whole contract management process.
The introduction of this Code means that CECOPS can now extend its accreditation scheme across all assistive technology related services (e.g. telecare, telehealth, wheelchairs, electronic assistive technology, disability equipment), nationally (UK) and internationally.
The new Code and iCOPS® tool incorporate the following subject areas:
PART ONE: PLANNING AND COMMISSIONING
- Strategic Planning and Preliminary Considerations
- Involvement of Stakeholders, Users and Carers
- Partnerships, Joint Working and Integration
- Governance, Ethics and Risk Management
- Business Case Development
- Investment and Funding
- Service Requirements and Specifications
- Contractual Arrangements
- Eligibility Criteria and Self-funding
- Legal & Regulatory Obligations and Standards
- Information Technology and Information Management
- Marketing and Promotion
- Performance Management and Continuous Improvement
- Measuring and Evaluating Service Impact
PART TWO: SERVICE PROVISION
- Governance, Risk and Ethics
- Legal & Regulatory Obligations and Compliance with Standards
- Managing Referrals and Assessments
- Procuring Technologies, Equipment and Services
- Implementation of New Technologies and Services
- Trialling, Assembling, Installing and Demonstrating Technologies and Equipment
- Involving Patients/Service Users and Carers in Decision Making
- Management of Medical Devices/Technologies
- Management of Assets and Inventory
- Monitoring and Alerts
- Quality Management Systems
- Health and Safety Management
- Staff Competence
- Information Technology, Management and Governance
- Collaborative Working
- Third Party Contractors
- Marketing and Promotion
- Contract and Performance Management, and Continuous Improvement
- Measuring and Demonstrating Service Impact
The new Code is currently available to organisations working with the CECOPS scheme.
A published hard copy and eBook version of the Code will be available to purchase in the coming weeks.
The iCOPS® tool is available for purchase now. A FREE 30 day trial is available.
If you are interested in purchasing a copy of the Code, becoming CECOPS accredited or trying out the iCOPS® tool, please get in touch.
T: 01494 863398
M: 07511 667 330
Note to editors:
CECOPS CIC is a UK-based independent, not-for-profit, standards body for assistive technology services. CECOPS is widely supported by regulators and professional organisations. CECOPS is often cited as a requirement in tender specifications, and, although relatively new, is already working with approximately 80 organisations in the UK, with growing international interest.
NHS England recently announced that to give people more choice and control about the care they receive, personal health budgets will be extended to cover wheelchairs from April 2017.
This move is intended to support the government’s target of enabling 100,000 people to benefit from greater control via personal health budgets by 2020/21.
It is proposed that Personal Health Budgets (PHBs) will replace the current wheelchair voucher scheme as part of efforts to improve services for over 1.2 million people that currently use wheelchairs.
NHS England claims the new personal health budget scheme will offer more choice over what wheelchair can be acquired, and will include a detailed care plan to help users make informed decisions about their wheelchair. They claim care plans will not only cover purchasing the chair, but will also include guidance on future maintenance, repair and replacement needs. Without a business case or impact assessment or relevant evidence, it is difficult to assess at this stage exactly how the model will work in practice.
NHS England has been reviewing wheelchair provision over the past 2.5 years, and introducing PHBs would appear to be in response to the findings of that review; however we sincerely hope that issuing PHBs for wheelchair users is not the only outcome of that review, as PHBs cannot possibly be a solution to the numerous problems associated with these services.
As the independent standards body in the UK for wheelchair services, CECOPS welcomes the move to extend personal health budgets to these services, and we have in fact already included the use of PHBs in our Code of Practice. The use of PHBs for wheelchairs will be an area which our assessment processes will cover, for organisations seeking accreditation with us.
Notwithstanding our support of measures to improve wheelchair services and user experience, we do have some concerns which we hope will be addressed before the introduction of PHBs for wheelchairs in April 2017.
We feel that if the areas of concern below are not sufficiently addressed, the roll-out of PHBs for wheelchairs will not achieve its well-intended aims. At this point it is unclear how PHBs will work better than the existing voucher scheme, and this is something we would like to hear more about from NHS England Personal Health Budget team.
Could PHBs exacerbate current difficulties associated with disjointed services?
Disabled people often require a range of assistive technology (AT) related services e.g. communication aids, posture equipment, adaptations. As the different AT services generally operate independently of each other, people usually undergo several different assessments to cover their various and holistic equipment needs.
The current model is costly and is far from being person-centred. Offering a PHB exclusively for one type of assistive technology (i.e. wheelchair) could potentially exacerbate the problem, and would appear to go against the direction of offering more holistic, personalised and person-centred care.
The following quote from a service user clearly demonstrates current difficulties, and why offering PHBs exclusively for wheelchairs won’t help with wider issues:
“It was great that I eventually got an indoor/outdoor wheelchair, but I couldn’t get in or out of my home because the adaptation hadn’t been done. I was given a communication aid but no-one would agree to mount it to my wheelchair.”
Will PHBs address long waiting times?
One of the main problems associated with many wheelchair services is the waiting times. It is not uncommon for people to wait 18 months for a wheelchair.
PHBs won’t address waiting times, as they are not set up for that purpose. In fact, PHBs could even increase waiting times, for reasons explained below.
The main reason currently for long waiting times is lack of funds. PHBs won’t introduce any new money, and purchasing a wheelchair at retail price under a PHB rather than at bulk contract price will be more expensive. In addition, wheelchairs bought under a PHB belong to the user and will never come back into the wheelchair service to be reissued to another user. This could add significant pressure to current overstretched budgets and increase waiting times for all wheelchairs, whether under a PHB or not.
Will PHBs help people who need equipment urgently?
People with rapidly progressive conditions, such as motor neurone disease or some types of multiple sclerosis, require access to equipment urgently. Sadly, fast-tracking of services for these people is not generally in place.
Providing people with PHBs is not likely to address this serious problem. Presumably there will be a waiting list for accessing PHBs just as there is for loaned equipment, as without new money there will still be funding issues. We feel strongly that this area should be looked at as a priority; it is disgraceful that some people die whilst waiting to receive vital equipment.
One solution could be that the PHB scheme includes a fast-tracking arrangement so that eligible people have access to funds immediately to buy everything they need quickly. Obviously there would need to be clinical professionals involved to facilitate and advise.
Could PHBs for wheelchairs actually be more costly?
As previously mentioned most wheelchairs are purchased by the NHS or out-sourced provider under a bulk contract or framework, in some cases at significantly discounted prices. With PHBs, people will purchase equipment outside of these agreements from retailers at high street prices, which are very likely to be much higher than the prices currently paid by the NHS for wheelchairs. PHBs will have to be of sufficient value to cover the retail price of a wheelchair, otherwise people will not take them up! As this cost is likely to be higher than is currently paid by the wheelchair service, this could strain wheelchair budgets.
In addition, there are significant savings and cost avoidances under the current model where wheelchairs are reissued by wheelchair services. For example, a wheelchair costing £2000 issued 3 times over its life results in a cost avoidance of £4000; whereas 3 of the same wheelchairs purchased using PHBs will cost £6000. Equipment purchased using a PHB will not be recycled within the wheelchair service, and is in effect a sunk cost.
If PHBs for wheelchairs are widely taken up it could have a drastic effect on wheelchair service budgets.
Could wheelchair users be exploited?
There will need to be proper support and safeguards in place to ensure people using their PHBs to buy wheelchairs are not exploited by retailers i.e. being sold something they don’t actually need, or charged an excessive amount. It is recognised that people are consumers in other aspects of their lives, and should be able to make their own choices; however some buyers will be in a vulnerable position, making a large purchase in an unfamiliar market, which could leave them open to exploitation without appropriate guidance, safeguards or support.
When the Department of Health introduced the retail model several years ago for aids to daily living, there were cases reported of people being exploited by retailers, so this is a real concern.
Could using a PHB compromise clinical needs being met?
A PHB for a wheelchair will only be for a limited amount, although it is currently unclear how this will be set. Wheelchair users will be able to top up from personal funds if they want a higher specification wheelchair. There is a risk that wheelchair users acquire an item which does not meet their clinically assessed needs.
This is a high risk area and it is vital that users get the right wheelchair to avoid problems associated with postural care and pressure, for example. It is difficult to see how it can be ensured that retailers are competent to advise on these matters, some of which require specialist clinical input.
Failure to address the above issue could mean people end up with equipment that doesn’t meet their clinical needs, resulting in further health problems such as a pressure ulcer.
PHBs and Training
As yet no guidance has been made available from NHS England Personal Health Budgets team on training for frontline staff with regards to PHBs for wheelchairs e.g. what training is needed, who needs to be trained, who would carry out the training and who pays for it. It could be a costly and timely exercise for local areas to formulate their own guidance on this, and deliver their own training, which could potentially be a barrier for wider adoption.
CECOPS hopes the above issues will be sufficiently addressed before commencement of this initiative in April 2017; we would be willing to work with the NHS Personal Health Budget team to work through possible solutions.
Many of the areas of concern can be addressed by following our Code of Practice and working with our accreditation framework, which is now formally approved by Care Quality Commission and being adopted by many wheelchair services across the country.
Brian Donnelly, CEO, CECOPS
CQC says: ‘The CQC will work with CECOPS to ascertain how best to incorporate information from the scheme. Schemes will require written agreement with the participating services to permit that the results of assessments can be shared with the CQC. In the interim, any publically available information (for example CECOPS accreditation status) will be taken into account in the CQC inspection methodology.’
CECOPS CEO, Brian Donnelly, says: ‘This is fantastic news and a great achievement for CECOPS and for organisations working with us. We are glad CQC see the merits of our standards and assessment processes. Going through the very thorough CQC application process has enhanced the service we offer. We believe this further endorsement will enhance engagement with our credible scheme.’
CQC recognises the potential value of clinical service accreditation and peer-review schemes as information sources to support its inspections. Such schemes have the potential to provide useful intelligence and provide independent assurance that accredited services meet standards.
The Healthcare Quality Improvement Partnership (HQIP) has developed, in association with the cross‐college clinical services accreditation stakeholder’s advisory group, a set of criteria to help CQC determine schemes that can provide robust and reliable information for consideration ahead of and during inspections.
If you would like to find out how you can work with CECOPS, and take advantage of our CQC approved status, please contact us: E: firstname.lastname@example.org or call: 01494 863398
We are delighted to announce that we are now offering a CECOPS Approved Software marque as part of our scheme. This means IT companies providing management systems in the assistive technology space (e.g. disability equipment and wheelchair services, telecare, AAC) can now apply for their products to gain this prestigious status.
To gain CECOPS Approved Software status, software systems will have to clearly demonstrate that they meet certain criteria. These criteria are based on how software systems can help to meet the outcomes set out in CECOPS’ Code of Practice.
The CECOPS Approved Software marque is designed to help commissioners and equipment providers with procuring software systems for these services, and provide assurance that the system supports the CECOPS Code, the only available service specific standards for these services. It will also give IT providers the opportunity to demonstrate and showcase the suitability of their products beyond the technical capabilities and functions.
CECOPS’ CEO, Brian Donnelly, said,
“As more organisations are coming on board with CECOPS, it makes sense to have software systems that support our standards and framework. This new initiative will also make the process for procuring systems easier. Most importantly, it will help to ensure people in receipt of these services receive good outcomes.”
Kevin Clegg, the owner of BEST, the first software system in the UK to gain CECOPS Approved Software status, says,
“Now more than ever, we all need to identify and improve our service performance and use as many ways as possible to reduce costs as well as enhance service delivery and the customer experience.
Good standards ensure that these aims and objectives can be met and are not always mutually exclusive. It is possible to manage and maintain a high degree of consistent activity, firstly by setting these standards, then by measuring and meeting them, finally by exceeding them and then re-defining them to improve still further.
CECOPS now maps and sets out national standards we all should aspire to and build on. The CECOPS framework allows everyone involved in the delivery of a service to record and identify their strengths, highlight weaknesses and plan for constant and continuous improvement. Soft Options are proud to support, adopt, and promote these standards and welcome all the benefits realised because of them.
To find out how you can have your software approved, please go HERE or contact us: email@example.com
NHS England recently announced that they are introducing personal health budgets for wheelchairs. This new approach to wheelchair commissioning will replace the current voucher scheme. According to NHS England, wheelchair users have found a number of challenges with the existing scheme, now 20 years old, including a lack of information and guidance around maintenance, repair and replacement as well as a limited number of providers where a voucher can be redeemed.
It is claimed that the new personal health budget scheme will offer more choice of where wheelchairs can be bought as well as a detailed care plan that will help users make informed decision about their wheelchair. The care plans will also go beyond purchasing the chair to also include guidance on future maintenance, repair and replacement needs.
It is also claimed that a wheelchair will form part of a person’s wider care, catering for their individual needs and ensuring a more joined-up approach, a key aim of NHS England’s Five Year Forward View. The new approach will also help NHS England collect meaningful data on wheelchair provision that will further help improve services and address variations in provision across the country.
CECOPS’ CEO, Brian Donnelly, says, “Offering personal health budgets for wheelchairs will be useful for some people. Although not a total solution, this will certainly increase choice and hopefully allow people to get access to the equipment they need more quickly.
We included personal health budgets in our Code of Practice for Disability Equipment, Wheelchair and Seating Services last year.
Following the Code will help commissioners, providers and clinicians and will ensure the necessary safeguards are in place where personal health budgets are used.
We would hope to see personal health budgets eventually being used for all disability equipment so that the holistic needs of disabled and elderly people can be met more effectively.”
CECOPS: A New Outcomes Approach to Commissioning and Providing Disability Equipment, Wheelchair and Seating Services
Our innovative approach to commissioning and providing disability equipment, wheelchair and seating services is gaining popularity in the UK, and beyond.
Why is a new approach needed?
The process for commissioning and providing disability equipment, wheelchair and seating services in the UK has generally been the same for many years, very often involving detailed specifications written by commissioners, with which providers are expected to comply.
Stifling innovation and creativity: The process of commissioners writing specifications is time consuming and costly. It has also been found in many cases to be too prescriptive, which can fetter innovation and creativity of providers, and clinical and technical staff. It forces the provider into compliance mode, where they have to work to the exact requirements of the specification and nothing more, meaning that what is set out in the specification is what will be delivered for the duration of the contract.
This approach can prevent frontline staff from making suggestions for better ways to deliver services, making improvements, meeting changing policies, strategies or demands, and it does not often result in improved outcomes for people using the services.
Compliance, not continuous improvement: The current approach to commissioning services does not generally seek for, or encourage, continuous improvement, meaning that people receiving services often have to settle for a ‘just good enough’ service for the duration of the contract. This is largely owing to the fact that the provider is commissioned and paid to comply with the requirements of the specification, and nothing more. This is an inherent weakness in the age long processes currently used.
Outputs, not outcomes: Furthermore, there is often an emphasis on measuring outputs including, for example, the number of activities related to the service. The overall performance of services is often assessed on these outputs, or data sets. Whilst important, outputs only capture one dimension of the service and do very little for influencing or improving quality-related outcomes for people using the services.
When services are commissioned and provided in this way, there is a certain inevitability about the mediocre levels of service that will ensue.
The New Approach
CECOPS and support tools: Recognising the need for change, CECOPS Community Interest Company (CIC), the independent standards body in the UK for disability equipment, wheelchair and seating services, has introduced a new model and support tools for assisting commissioners and providers to help improve services. Already, many health and care organisations are working with CECOPS.
CECOPS CIC has an officially recognised Code of Practice for these services, and offers a registration and accreditation scheme. CECOPS also offers a self-evaluation, compliance management and continuous improvement software tool, iCOPS®.
Outcome focus, not just outputs: The CECOPS Code is made up of forty seven outcome based standards. Some commissioners are already requiring providers and clinical teams to report against these outcomes, meaning that the provider, for the first time, now has the flexibility to choose how best to meet the outcomes, without being fettered or restricted by having to comply with a rigid and detailed service specification.
An outcomes based approach also helps service users to know what level of service to expect. It reduces the need for commissioners to write lengthy and detailed specifications, and ensures all aspects of service provision are comprehensively addressed.
The CECOPS outcomes are service related, and following them ensures the people receiving the service receive safe, good quality and effective care.
Continuous improvement, not just compliance: Whilst compliance with the requirements of a specification or standards could raise the bar in terms of service quality and performance, it can equally breed a culture of apathy i.e. just good enough. Neither should regulation be relied upon for improving quality and performance. Quality and performance management needs to be everyone’s responsibility, and providers should be in control of driving their own improvements. CECOPS has developed a tool, iCOPS®, which helps organisations to self-evaluate their own service, and it cultivates a continuous improvement focus with the view to delivering an outstanding service. This tool also supports compliance and regulatory obligations as it collects all supporting evidence in one place.
Improved contract management: Commissioning services involves a lot more than writing service specifications and tendering services; it includes the day-to-day management of contracts; this requires a lot of time and effort.
To help with this, the CECOPS model includes accreditation; this means that an assessment of the service is undertaken by CECOPS’ assessment team, DNV GL Healthcare (world leaders in quality and risk management).
Accreditation provides (external) assurance that the CECOPS outcome-based standards are being maintained. The assessments are risk rated and weighted, meaning that the commissioner will get a report highlighting any areas that need to be focussed on. This significantly reduces the time and effort of managing these large contracts.
Equally, providers can use accreditation as a means of managing contracts and making improvements.
The simplicity of the CECOPS model and how to get started: Commissioners can simply include CECOPS registration and accreditation in specifications, and require that the provider must evidence continuous improvement year on year using the iCOPS® tool.
Equally providers can directly seek to be registered or accredited and use the iCOPS® tool.
“This is a small change in process, but results in significant change in outcomes. This pioneer approach to commissioning and providing these services is long overdue.” Brian Donnelly MSc, CEO, CECOPS CIC
For further information CECOPS can be contacted here:
T: 01494 863398 | E: firstname.lastname@example.org | W: www.cecops.org.uk