CARERS IN HERTFORDSHIRE response to the HCC Scrutiny of
relationships and communications with the Third sector/Voluntary
Sector 31 October 2011
Author: Sue Reeve, Chief Executive
OBJECTIVE: In the context of major changes to national government policy
around Civil society-and the reduction in available funding –to ensure HCC
has in place the best possible arrangements for communicating with and
engaging the Third/voluntary sector
Carers in Hertfordshire
QUESTIONS
Q: What are current levels of funding and type of
relationship/partnership?
HCC is a principle funder of Carers in Hertfordshire, in a joint funding contract
with the NHS PCT. The current value of the grants is significant: we receive
amounts to 79% of our total income this year (£1.2m) The current contract
expiry date of 2013 has been verbally agreed to be extended March 2015 .
Grant income received from CHW was reduced by 12.5% in 2011 following
the October 2010 Commissioning review.
Faced with financial stringencies, we realise HCC maintained a good level of
funding for adult carers and with no cuts to young carers: this makes good
sense, since it is such a strong investment for HCC to support carers. (SROI
Report Baker Tilly, 2011)
Type of relationship
 We are a user led organisation, in our case carer led: An organisation
of carers and led by carers and described in the days of HCC beacon
Award for excellence for Carers as a key strategic partner and “critical
friend” to the HCC and NHS, to implement the national carers strategy
in Hertfordshire.
 By funding us you ensure organisation resources are made available
to carers so they are appropriately informed and supported to be able
to care with confidence at home and to have some control and choice
a voice in commissioning and design of services that affect their lives
/those they care
My analysis of the relationship now is less clear and we have recently
questioned officers about their perception of the relationship HCC wishes
to have.
Communities need the public sector to provide the enabling infrastructure
to allow local people to define local priorities and develop and deliver local
solutions. Carers are central to that because there’re are so many of them;
the value of their contribution and the anticipated increase in future
demand for care. Officers assure us they wish to maintain the key
strategic partner to be maintained but in our view there are some real
challenges arising from changes to:

the role of HCC, devolving some of its functions to commercial as
well as to the voluntary sector. It is essential that HCC maintain a
co-ordinating and integrating focus on Carers. The loss of a specifc
Carers Policy Office position and blending into Health and
Wellbeing structure and forthcoming healthwatch role pose a risk
that carers issues will be lost.
 The commissioning structures and decision making such as GP
commissioning, health and well bing structures and yet to emerge
healthwatch.
HCC Officers are keen not to “throw the baby out with the bathwater”
as there is a successful track record of involving carers , for example
in tendering and in service design, but we have current examples of
cuts or changes that adversely affect carers where there appears to
have been no consultation or involvement in the decision making
process, which robs carers of any control over their own lives. Carers
are simply informed (Examples: rolling respite; Older people LD
service removal of specialist practitioner posts in Mental health
services)
Carers messages are they wish to be represented at every level and wish
for a strong engagement and are telling us to be more campaigningsuggesting they do not feel heard.
Q: How well is HCC communicating with the sector?
Q effectiveness and transparency of HCC processes around changes in
policy and reductions in available funding –how well have voluntary
agencies been engaged
Information giving HCC made laudable attempts to communicate with the sector during the
commissioning review and subsequently through officer meetings, electronic
information bulletins; Information giving about funding opportunities. We were
well engaged and that helped mutual understanding through some very
difficult decision making.
Communication about policy and significant changes need to be improved
The county wide multi agency strategy group is overdue a review (Mark
Lobban previous AD had recognised this months ago).
There is a lot of wide canvassing of views, but little stronger engagement and
participation: decision making takes place elsewhere and in my view
meetings are more about passing information and less engaging with carer
intelligence and views –we are sympathetic to the pace of change but if the
aim is for carers to have more control and choice then there has to be
improved dialogue and more joint planning, as there has been until recently:
more engagement not less in difficult times. Carers in Hertfordshire is not
asked to think about the impact on carers and now asked to monitor this
subsequently
We hear of significant changes through informal means; not appropriately
informed, eg SERCO decision. It gives the impression of information leaked
out, not transparent .
Q How do HCC commissioning procurement processes ensure
voluntary organisations have fair access to HCC contracts and
resources? How joined up are HCC and DCs on commissioning in the
sector
 Issue about how Carers in Hertfordshire can engage
carers in the process, e.g. to inform service specification
whilst maintaining the opportunity to be able to bid for
contracts, i.e. and issue of the management of potential
conflicts
Risk of HCC making “Creator of chaos” decisions;

“You you and you collaborate” –form of commissioning –
we would like to see commissioners positively favour
collaborative bids and maybe make some funds available to
form consortium (carer pathway) the question is what
business model will justify investment and support
collaboration and co-production …

Organisations like us are perceived as capable etc and we
are at what we do, but we are inexperienced at tendering.
So far HCC have taken the view that infrastructure for carers
does not need to be tendered because of the strategic
partner role and the need for stability in the sytem.

Access to tendering: we have used CSF tendering sytem
which used DELTA : our criticism is that there was no
guidance or e-learning available, disadvantages the less
experienced and smaller parts of the sector . Other
examples eg Dept of Health AIMS system and Big Lottery
processes are smarter-HCC could perhaps learn from
those
HCC and District councils not joined up sufficiently on carer development
(links back to the requirement to overhaul the multi agency stargey group) ,
recent experiences of
 DC funding short term carer support that is duplicative and with no
mechanism for checking that funding the carers service in a particular
way is effective (Herts has a wealth of knowledge about good practice
on carers services)

HCC seeking to stop a collaborative locality bid that many people had
spent many hours on for tiny amount of funding (£1900)
RECCO: Strengthen the multi agency strategic approach to avoid
piecemeal development across the county and potentially wastage of
funds on less effective carer support. Review the current group to
assess it current suitability to achieve this end
Q is there a shared understanding between statutory and voluntary sector of
reserves and re-investment as part of contract management

Not in my experience
Q Relevance /fitness for purpose of the Hertfordshire compact? Is it
used? Should it be revamped?
I think it is necessary to have something but have to say I have found it f
little/no use in the past.
Q What should a thriving voluntary sector look like in a time of public
sector restraint? What are the key priorities in terms of supporting the
sector to manage the challenges it faces?
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Able to contribute to strategy particularly HWB and bring the
perspective and knowledge of their constituents to the table in timely
and regular dialogue
Informed in a timely way to be able to effectively challenge and be an
independent voice for the disadvantaged hard to reach multiple
problems
Able and positioned to provide and independent critique of service
provision in the county, especially of the big providers to
counterbalance an overreliance on them to the disadvantage of
Hertfordshire service users and their family carers
Able to demonstrate value for money and effectiveness in reaching
outcomes
Able to bid for large and small scale contracts
Collaborative and mindful of cost effectiveness and value for money
Strengthen local cohesion and the links that hold communities
Challenges
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Maintaining independent voice and the key strategic partner with
different partners involved
to continue contribute to strategic thinking proactive not just reactive
Collaboration-not just for bids but to make services work better eg
hersthelp and support for carer consortium

To work smartly but not lose the raw voice of carers
Q the role of the sector in scrutiny and engagement
 Engaging carers is vital because of the particular contribution they
make to Hertfordshire
 years of experience and best practice important to promote thatr to
new commissioners and avoid risk of losing carer intelligence that
can make all the difference in effectiveness of services and outcomes
 We are invited to some scrutiny and not others and we can’t always
see the logic for when we are invited or not
RECCO: Want to see a “carers chapter” , pulling together carer
intelligence and with representatives meeting with Health and Well
Being Board annually face to face
Q: How are we developing a shared understanding of value and
outcomes?
 Carers strategy outcomes
 Use of SF12
 SROI –mixed messages I think about its importance and
understandings of it by commissioners
 But there is a common understanding certainly for us that we are here
to make a positive difference and are accountable to do so by carers
funders
 What you measure; robustness of data and evidence
 Also not to measure to death –carer getting questionnaires for every bit
of service once the point has been “proved” eg MADFC bureaucratic
and inefficient
Q how are HCC helping the sector to co-ordinate its work as effectively
as possible
 Sharing “touch down” stations, has enabled carers in Hertfordshire to
make substantial savings and close 3 office bases in the county
 Carer pathway, including concept of developing a carers consortium
and wider use of the joint Carer Passport
 Herts help Info giving to the public
Support the principle at the heart of the information strategy: “right information
at the right time from the right person”, but the challenge is to commission it to
ensure that it happens. Otherwise there is a risk of developing an information
monopoly which does not synchronise with the aims of the carers strategy.
The latter is based on evidence of the benefit to carers and preventive
outcomes of signposting /referring carers to a carers organisation providing
the core service that Carers in Hertfordshire provide. This has been the
systematic multi agency approach in Hertfordshire.
Mentoring communications officer –job design recruitment and ongoing
professional development-definitely improved our approach to
communications and helped us to increase our reach to carers