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Better, Brighter Futures


Introduction 2

Background 2

Commissioning Cycle and Intentions 3-7

Outcome Framework, Commissioning Process and Needs

Assessment Schedule 8 - 10

The Justification 11

Next Steps 11 - 12

Guidance Notes and Fitness for Purpose Accreditation Process 13 - 15

The Dimensions and Methodology explained 16 - 21

Scoring, Assessment and Evaluation Criteria 22 - 28

Self Assessment Schedule 29 - 45

Accreditation Application Form 47 - 62

References and Acknowledgments 63

This Accreditation Tool is intended to provide a We have asked: ‘How do we know what we are
structured method of assessing the health of your actually getting?’ and ‘How do we know that it
organisation, to measure the impact of your will meet customer needs and expectations’
services and to demonstrate effectiveness.
The Approved Preferred Provider Scheme is
The tool incorporates relevant recommendations designed to meet with pre-qualification
from the Health Care Commission and forms part requirements in the event of future tenders,
of a suite of tools and techniques being developed significantly reducing the resources required to carry
to contribute to the process of a Whole System out repeated pre tender work, it also lends support
Review of Drug and Alcohol Services. to Continuous Quality Management should a
contract for service(s) be subsequently made.
An earlier version of the Accreditation Tool has
already been in use at North Tyneside Council and The toolkit is however concerned with the
has been used as an illustration of best practice by production of a standing list of approved preferred
NIHME and CSIP for commissioners involved in providers and aims to lessen the reliance on
managing and developing provider markets. ‘Beauty Contest’ approaches to commissioning.

This Tool Kit has been drafted to conform with EU

Procurement Directives, details can be found at
How the Accreditation Tool Kit the Office of Government Commerce’s website in
can help you the Procurement Policy and EU Rules section.
It will help you examine your organisation to identify
strengths on which you can build and those areas
where improvement may be appropriate. Background
Every day we ask service users and their families to
It will establish a base position against which you can make life-changing decisions. We do this because
assess priorities for action and measure the effect of we are committed to tackling inequality, improving
any changes you make. quality of life and reducing premature morbidity.
Making each and every opportunity really count is
It will provide for the opportunity to benchmark in at the heart of our vision for substance use
order to compare with others, learn from experience services and we believe that by working together
and so speed up the improvement process. we can ensure that each and every service user
gets the right care and treatment, at the right
time, every time.
How the Accreditation Tool Kit
will be used in different types To achieve our goals the City of Sunderland is
focused on meeting our Local Public Service
of procurement activity Agreement 2 Objectives and we will be moving
The Tool Kit is designed to create transparency,
towards an outcome based approach to the
openness and honesty, lessening the dependency
commissioning of substance use services. Our
on traditional procurement and selection systems
Commissioning Intentions are detailed on pages 4-
based on information asymmetry.
7 and represent the progress made implementing
the Commissioning Cycle shown on page 3.
Although the details within the Tool Kit may be
complex and require some creativity in how you
make your responses, the main thrust of the
approach is quite clear and simple: improve
information – much in the same way that we
would not buy a house without the information
given in a survey or a car without reference to its
service and ownership history.

The A.P.I.E Commissioning Framework

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Statement of Commissioning Our Vision

Intention 2006 - 2011 Our vision is for all citizens with PDU / PSU to
This draft strategy outlines the priorities and benefit from opportunities for appropriate
commissioning intentions for The Safer treatment to improve physical health, provide
Sunderland Partnership in addressing the needs of positive mental well-being, which includes
working age adults (18-64 yrs) with Problematic involvement with community, friends and family;
Drug Use / Problematic Substance use. meaningful activities and occupation; active
learning and leisure and having the basics in place,
Aims of the strategy such as good health care, housing and financial
The strategy aims to: security. People with significant PDU / PSU should
• promote the mental and physical well-being of have access to the same opportunities that
PDU / PSU in Sunderland promote the safety and well-being of all citizens,
but they should also be able to access specialist
• ensure the needs of adults of working age with services which provide for their individual needs
PDU / PSU problems are positively and and preferences, promoting their recovery from
effectively responded to the effects of PDU / PSU.

• satisfy the requirements of national policy

(Government Strategy to Tackle Drugs) and
local priorities (Local Area Agreement)

• revise commissioning in order to deliver to the

aspirations of service users and carers and
expectations of choice and recovery

• provide a framework to enable engagement

with a range of strategic partners to develop
new service solutions to meet local needs
(including the exploration of Social Enterprises).

Future Service Priorities and Priority 3: Prescribing Services Fit For Purpose
Commissioning Intentions
Priority 1: Equitable Access to services without Commissioning intention 3a: To ensure that access to
prejudice to criminal justice status or prescribing services is based on assessed need and
geographical location available to individuals within their communities.

Commissioning intention 1a: Develop the current Commissioning intention 3b: Develop a model for
treatment modalities to meet the capacity and fully integrated Specialist, GPwSI and Shared Care
demand for both those within the criminal justice services which meet the needs of PDU / PSU in
system and those outside of it. Sunderland.

Commissioning intention 1b: Undertake a needs Commissioning intention 3c: Services, to have the
assessment and gaps analyses in the six regeneration appropriate level of clinical governance in place.
localities within the city of Sunderland and map this Including prescribing regimes commensurate with
across those providers currently in treatment to best practice.
identify the geographical locations for the
establishment of treatment services and Commissioning intention 3d: All prescribing
interventions to meet the local needs of PDU / PSU. services to have the necessary nursing and clinical
support to provide safe and effective prescribing to
both PDU / PSU
Priority 2: Develop services that are client
facing and collaborative in the delivery of Commissioning intention 3e: All prescribing
treatment modalities services to be commissioned as part of integrated
services with the appropriate referral and
Commissioning intention 2a: Through the integrated care pathways established.
operation of an Approved Preferred Provider
Scheme identify those organisations that are able
to respond flexibly and creatively to meet assessed Priority 4: Day programmes / community
client need and demonstrate an ability to work opportunities
collaboratively with partner agencies in the
interest of the client. Commissioning intention 4a: Existing day services
will be reviewed and commissioned to ensure that
Commissioning intention 2b: Commission whole they promote social inclusion and access to
integrated services which require high levels of mainstream opportunities with equitable access
integration and collaboration to meet the needs of for both Criminal Justice and non Criminal Justice
PDU / PSU in Sunderland. This will include co clients.
location and multi agency bases located through
out the Partnership based on assessed need, Commissioning intention 4b: Existing use of Local
rather than historical arrangements. Authority Grant and other grant aid will be
reviewed in order to determine what is appropriate
Commissioning intention 2c: To remove un- use of the grants and how to ensure funding
necessary barriers and steps into treatment. By agreements which support voluntary sector
having a single point of contact from which all provision are sustainable.
client journeys are begun. This will be within both
the criminal justice system and outside of it. Commissioning intention 4c: A review of all
structured day programmes and day care activities
Commissioning intention 2d: Through setting joint will be conducted and mapped across local needs
targets with all providers for pull through referrals assessment. Services will then be configured to
from each part of the system remove any best meet the assessed needs of PDU / PSU in
opportunities for anti competitive practice and Sunderland
actively measure collaboration as an outcome.

Commissioning intention 4d: Adult Services on Commissioning intention 5e: We will establish
behalf of the Partnership will work with all strategic partnerships with housing providers and
Directorates of the City Council to ensure that others to secure sustainable accommodation
their services address the social inclusion of provision and where appropriate exploring the
people with PDU / PSU. possibility of shared ownership schemes.

Commissioning intention 4e: User-led services will Commissioning intention 5f: Given the anticipated
be developed, specifically exploring the use of the reduction in services funded under Supporting
Clubhouse model and or Peer Led Services. People, the Adult Services and Housing
Directorates on behalf of the Partnership will seek
Commissioning intention 4f: Employment services to ensure sufficient resources are secured for PDU
will be reviewed alongside commissioning partners / PSU, that they are targeted most appropriately
and evidence-based models will be commissioned and that impact of change is managed with users,
in the light of national guidance. carers and partners in drug and alcohol services.

Commissioning intention 4g: A set of vocational

and social outcomes will be agreed against which, Priority 6: Support for carers
effectiveness of day services will be measured
which will be used to inform commissioning Commissioning intention 6a: The Carers Strategy
decisions. will determine the direction of carers support
services across adult services for PDU and should
be extended to PSU.
Priority 5: Housing and related support services
Commissioning intention 6b: An action plan for carers
Commissioning intention 5a: We will publish a of PDU / PSU will be drawn up following the
detailed accommodation strategy for PDU / PSU in completion of the commissioning of a Carers Service
partnership with the Housing Directorate, Teaching
Primary Care Trust commissioners and housing
and support providers to ensure that there is an Priority 7: Cross Cutting Agendas with other
appropriate supply of sustainable floating support, service areas
supported housing, emergency accommodation,
residential care provision to meet the needs of Commissioning intention 7a: Work with
people with PDU / PSU. commissioners in other service areas will ensure
that gaps between services are identified and
Commissioning intention 5b: We will engage addressed. i.e. Hidden Harm and Young Peoples
operational services and providers to review services
information on accommodation needs of the
existing population of people using Drug and Commissioning intention 7b: Work with mental
Alcohol services to improve the intelligence to health services to ensure a comprehensive
support strategy development. approach to people with PDU / PSU problems who
also have problems with their mental health.
Commissioning intention 5c: We will work with the
Housing Directorate to ensure that the Supporting Commissioning intention 7c: Service specifications
People strategy and Housing strategies reflect the will clarify the need to respond appropriately to
identified needs of adults with PDU / PSU. additional or complex needs and data collection to
enable monitoring of the demographics of those
Commissioning intention 5d: We will work with using the service including gender, age, ethnic
housing providers to review and develop pathways origin, disability and other areas of need.
into ordinary tenancies to increase the accessibility
of this provision.

Commissioning intention 7d: Work with the Home Priority 9: Diversity
Office and NTA to ensure that the Drugs
Intervention Programme is effectively joined up Commissioning intention 9: To provide a range of
with the wider treatment provision. Ensuring that services that reflect the diverse needs of the
client journeys are effective as a result of access to population of Sunderland. Equal access to relevant
services based on assessed need rather than what appropriate drug treatment services for the whole
is close to hand. population. Commissioners will work with providers
to eradicate unlawful discrimination and promote
Commissioning intention 7e: A closer interface equal opportunities with respect to age, culture,
with crime and disorder will be established to gender, sexuality, mental ability, mental health,
provide greater joined up working with regard to geographical location, offending background,
enforcement, supply and demand, treatment and physical ability, political beliefs, religion, health or
rehabilitation. status or any other specific factors which result in

Priority 8: Strategic Structures to Deliver Priority 10: Harm Minimisation

Commissioning intention 8a: Service Level To provide geographical and out of office hour’s
Agreements will be founded on outcomes for coverage. The partnership recognises the need to
service users and in line with the priorities of this get the balance right between the level of quality
strategy. and quantity of cover to be provided by the
specialist Harm Minimisation and Needle Exchange
Commissioning intention 8b: Greater integration of service. To this end additional capacity will be
the delivery groups and the Strategic Board will be commissioned to specifically increase the access
established with representation from stakeholders of needle exchange within pharmacy in addition to
across the City, including users and carers, expertise, training and support to be provided
commissioners and provider agencies. within tier 3 and criminal justice provision. This will
be undertaken in conjunction with the Harm
Commissioning intention 8c: A revised format will be Reduction Strategy /Treatment Effectiveness
agreed with voluntary and independent sector Groups to ensure that the necessary pathways and
partners for a forum to support development of the protocols into all aspects of the Health Service are
joint agenda between commissioners and providers. accessible from acute through to secondary,
primary and tertiary care for BBV, Hep C HIV etc.
Commissioning intention 8d: We will engage with
commissioners in both the TPCT / LA to consider
how we can work together to improve the capacity
of the voluntary and independent sector to
provide services.

Commissioning intention 8e: A commissioning

information strategy will be put in place to ensure
that the appropriate information is gathered and
collated to enhance the capacity of the Partnership
to commission services according to evidence of

Monitoring To take this project forward we are rolling out Key
Monitoring the implementation of the Priority Objectives 2a and 8a, which includes a:
commissioning strategy needs to involve
independent oversight and a wide range of 1. strategic review of current service provision
stakeholders. To that end, it will be reported to the
Partnership Strategic Board. The involvement of 2. statistical review of service outputs
service users and carers in the evaluation is
important and evidence of delivering the vision for 3. clear and transparent approach to future
services and outcomes for service users and carers commissioning.
will be sought as evidence of effective strategy
implementation. The Approved Preferred Provider Scheme will act
as a step change in meeting with our
The pattern of current commissioning will be commissioning and procurement expectations in
reviewed to ensure that it drives towards, the pursuit of: Key Priority Objective 2a.
delivery of the strategy. New and revised Service
Level Agreements and contracts will be introduced
over time to include clear outcome indicators and
delivery to the strategic vision. The commissioning
statement of intention will help develop a
Commissioning strategy which will form a working
document which may be revisited over its lifetime
to ensure that it remains current, challenging and
effective to changing needs, expectations and

The Outcomes, Fitness for Purpose Assessment

and Evaluation Framework, shown on page 8, will
provide us with means to ensure that people have
the opportunity to:

(i) Behave Safely: service users, their families

and communities are safe from the harm
that is associated with problematic
substance use and know when and how to
get information and help when they need it.

(ii) Promote Well-being: those with a new or an

ongoing substance misuse problem are
helped through planned care and treatment.

(iii) Contribute, Enjoy and Achieve: individuals,

families and communities are helped to
maximise their social and economic well-
being, enjoying a renewed involvement and
prosperity in the City of Sunderland.

Safer Communities: Outcomes Assessment and Evaluation Framework for a Substance Use Preferred Provider Scheme
Promote Well-being Outcomes Contributing, Enjoying and Achieving Outcomes Behaving Safely

To identify and close any treatment gaps between the police, acute
Improve and extend locally based shared care and specialist hospital services, primary care and specialist services as part of the
prescribing services. Harm Minimisation and Reduction Strategies.
To extend and increase the opportunities for volunteering, training and
Increase the availability of personalised care and treatment options. employment for people in recovery or with low to moderate drug and Establish a Pubic and Private Industry Charter of Corporate Social
alcohol dependency. Responsibility
Improve the take up of universal services.
To promote and development self- help and social enterprise projects. Establish a Charter for Community Investment restoring self
Ensure the effectiveness of treatment options. esteem at group, community, ward and city level.
To ensure that the consumer voice is heard and fully incorporated into
Ensure proper and rigorous care and treatment planning. the design and planning of services both operationally and strategically. Implement a continuous health promotion campaign delivering
'can do' information and advice to raise awareness of substance
Reduce mortality rates. To celebrate the achievements of individuals, groups and organisations use, its effects and sign posts to help.
that are successfully integrated into the host communities.
Reduce drop out rates. Ensure that primary care services are adequately equipped and
To ensure that universal leisure and recreational services are available, resourced to identify the health, economic and social risks
Improve retention rates. accessible and used by people with a drug and/or alcohol problem. associated with substance use.

Increase the numbers in treatment. Ensure social and economic balance is restored where health
inequalities exist.

Better, Brighter Futures

National and Local Targets and Indicators

NTA Local Delivery Plan Local Public Service Agreement Local Public Service Agreement
Adult Treatment Plan Local Area Agreement Local Area Agreement
Block 9 and Block 11 Block 9

Evidence Level of Customer Integration (X) is ranked 0-3:

and Fitness for Purpose PEN = 1. Strategic Leadership Purpose and Rationale; PECVA = 1. Communicate and Engage;
3= demonstrates and can evidence effectiveness in all that
Assessment 2. Meeting Need -Business Planning and Clinical Governance; 2. Assess and Plan;
the organisation does;
Shedule 3. Originality and Impact - working with service users and their 3. Intervene and Provide Services;
2= Is awareness of developmental needs and shows
families; 4. Promote and Enable;
preparedness to do meet them;
4. Resource Allocation-working with staff; 5. Working with Others;
1 = shows an ability to meet base line requirements and has
5. Stakeholder Engagement - working with diversity; 6. Commitment to Professional Development;
a learning culture;
6. Financial Management 7. Demonstrates Value Requirements
0= ignores, denies, disregards competency framework

Strategic Leadership Relevance 1. Exists to meet its own priorities and solely uses resources to meet self
Evaluation for Preferred Outcomes:
Meeting Need determined objectives;
Provider Status Stands Out
Stakeholder engagement 2. Shows an awareness of other agencies issues and concerns setting aside some Highly Recommended
Resource Allocation Originality and Impact resources to address issues of common concern; Commended
3. Has a joint or shared commitment to improve outcomes in a particular way Accredited but NOT preferred status
and shares resources to address the identified need;
4. Has a transparent integrated relationship with other partners and pools its
resources to address population needs.
‘Our health, our care, our say’ - Commissioning Process
National Commissioning Framework

National Commissioning Framework

Local Strategic Partnership

Local Area Agreement
Research and Research and
Best Practice Best Practice

Primary Care Trust & Local Authority

Primary and Community Care Joint Commissioning Strategy

Support to
Support to GPs PCT & LA Partnership

Commissioning Commissioning
Practice based
Public Satisfaction Commissioning PCT/LA Public Satisfaction
Survey (PBC) Joint Commissioning Survey

Primary and Community Services

Safer Sunderland Needs Assessment


Focus on Outcomes - individuals families’ communities

Behaving Safely Contribute Achieve Enjoy Promoting Wellbeing

Experts Group

Project Mandate / Clinical Governance

Projection Initiation

Listening to People Statistical Analyses

Confidential questionnaire Review of existing data /

structured and semi structured Interpretation / analyses of findings analyses of data sets
interviews, focus groups and
stakeholder events

Conclusion and Recommendations

The Justification We are particularly keen to explore ways to
Developing a whole system approach will require a embrace the opportunities presented by
concentrated effort to explore purchaser market the White Paper Building Care Around People and
management and the effective partnering Our Health, Our Care, Our Say have an interest in
frameworks, testing the taken for granted developing our understanding of practice based
assumptions – the beliefs, attitudes and behaviours commissioning.
that underpin our day to day work. We think its time
to take stock and listen of the key note messages
taken from `Drug Use 2004, Reducing the Local Next Steps: Developing the
Impact` (Audit Commission, 2004) which tells us: Approved Preferred Provider
Scheme - The Fitness for
`Where local substance use services lack a shared
vision or suffer from competition driven by individual
Purpose Assessment and
personality, service delivery is inconsistent and Evaluation Schedule
incoherent`. The roll out of the Preferred Provider Scheme will
follow five sequential stages, they are:
The Report also states `that partner agencies who
cannot agree upon common priorities will hinder (i) Public notice
effective outcomes for service users and their families`. (ii) Formal application and portfolio construction
(iii) Desk top audit, including a financial
The Report concludes by reminding us that assessment
`differences between individuals and agencies (iv) Panel interview
remains a significant barrier in many areas`. (v) Approval

Our response to the challenges that emerge from the These five stages will combine to form the basis of
Audit Commission Report is a combined crime, a sector wide evaluation and will ask provider
disorder and substance misuse strategy entitled, organisations to demonstrate their strengths in
Safer Sunderland Strategy 2005-2008. The Safer offering ` effective partnering based` single or
Sunderland Partnership will deliver this strategy. mixed modality substance use services.

Historically, Sunderland, has taken a predominately The Fitness for Purpose Assessment and
reactive and `enforcement` based approach to Evaluation Schedule is designed to provide a real
treating the symptoms rather than the underlying time picture of services and will assess current
causes of crime, disorder and substance misuse. The service arrangements against our ability to meet
new strategy rebalances this by building a strategic with both strategic and procurement expectations.
framework that includes action on: Prevention; Early It will also allow both commissioners and provider
Intervention; Local Support and Rehabilitation organisations the opportunity to size their
respective assets and meet with modern standards
We know from experience that partners in of service. Our aim is to future proof the provision
Sunderland have a good track record, taking the of services to people living in Sunderland.
opportunity to use resources more flexibly where the
freedom to do so has been provided. This experience The accreditation tool kit comprises of a three
provides us with the confidence to do things dimensional approach to service evaluation,
differently and while meeting our outstanding drawing upon the lessons learnt in Mental Health,
commitments we will be looking for services that are Learning Disabilities and Older People’s Services,
better aligned and truly fit for purpose. while responding to local, regional and national
concern about the level of service disaggregation
In short we believe that by working to deliver the in the substance use sector.
cross cutting outcomes we will enable the
development of effective partnering, with the
partnership as a whole tackling the underlying
causes of substance misuse more effectively.

The schedule has integrated best practice in
Continuous Quality Improvement, incorporating
the thematic substance misuse expectations, set
out in the Safer Sunderland Strategy and Block 9
of the Local Area Agreement, with Standards for
Health and sector specific competency
frameworks, like the NHS Knowledge and Skills
Framework for Health and Wellbeing, the
Substance Misuse Advisory Service, DANOS, and
the GSCC framework for Heath and Social Care.

The Fitness for Purpose Assessment and

Evaluation schedule will look at service provider
evidence of competence across three dimensions,
these are detailed on pages 13 -21 below.

Guidance Notes 4. Prepare the Documentation for Submission
The main stages, activities and approximate allow 6 - 9 hours
durations for completing the assessment are: Key Activities:
• the aim is to show your organisation in the best
1. Preparation allow 4-6 hours light so prepare the documents with the reader
Key Activities: in mind, 4-6 hours
• decide the scope and boundaries of the Fitness • sign off the finished product with all those
for Purpose Assessment involved in the production of the material., 2-3
• identify who will participate and complete the hours
• determine the timescales for each activity and 5. Prepare your team for the Interviews
set dates for reconciliation meetings etc Key Activities:
• brief participants for consistency of approach • build your team
• develop confidence and trust in each other
2. Purchaser Expected Norms (PEN) • be open and honest
allow 12 - 20 hours
Key Activities: 6. Completing the Whole Fitness for Purpose
• complete the business and accreditation Assessment Process allow 29 - 42 hours
application and attach the accompanying Key Activities:
policies, procedures and audited accounts, • ownership
4-6 hours • leadership
• complete the self assessment questionnaire • inclusivity
and document the evidence for their scoring,
3-4 hours Using the Fitness for Purpose
• collate the data setting out the scores from the Self Assessment
self assessment on a spread sheet, 4-6 hours Having completed your self assessment you are
• seek to reconcile different perspectives in order now able to identify the strengths of your
to arrive at agreement on the evidence and organisation and the areas for improvement in
score for each question in the self assessment order to form a judgement about your expected
3-4 hours outcome on accreditation.

3. Collect the Evidence for the Provider To meet with the requirements for Preferred Status
Evidence of Consistent Value Application you must have answered with 4 or 5 to the
(PECVA) allow 9 - 13 hours questions set out in the Self Assessment Schedule
Key Activities: and be able to evidence this in your ROA.
• determine which services you are going to
profile for the Record of Achievement (ROA), To meet with the requirement for accreditation
2-3 hours you must have answered with 3 or more to the
• gather and collate the evidence to meet the questions set out in the Self Assessment Schedule.
criteria set for each service profile included in
your ROA, 4-6 hours Having identified your strengths – what is it that
• seek to reconcile any differing perspectives in you are doing that makes them effective? Can
order to arrive at agreement on the evidence to these aspects be transferred to other areas where
be submitted with the ROA, 3-4 hours you need to make improvements?

If so, where you scored 0,1, or 2 you may decide to

make improvements. If this is practicable and a
priority then add an Action Plan of Improvements
with your ROA.

Should you need help or advise about the use

of this Tool Kit please contact Alec Fraher
Tel: 0191 553 7952.
Fitness for Purpose
Accreditation Process

ension 2

Provider evidence of consistent value application

Better Brighter Futures

Behaving safely
Promoting well-being
ension 3 Contributing , enjoying and achieving ension
Dim Dim 1

Level of customer integration Purchaser expected norms

PEN PECVA ICAP PPI Board approval

Desk Top Audit Desk Top Audit Consumer Purchaser Board approval
Reference check Asses depth/scope Panel Panel
of ROA
Verify accounts Interview Interview
Validate policy &

[ Depth/Scope of + Depth/Scope
Business Objectives Evidence
6 7
Xn = 2>

Assessed by Assessment Partnership

Assessed by Assessment
suitably qualified and judgement board
suitably qualified and judgement
staff from by expert representatives
and/or by expert
procurement, professional and TPCT board
experienced staff consumer
strategic finance panel of directors
from SCDT panel
and SCDT

Fitness for Purpose
Accreditation Outcomes
Providers or partnerships assessed as scoring
2> have met with the criteria for accreditation.

Those organisations, which on balance, are 1> yet

<2, may be accredited with requirements.

Providers assessed as scoring 1 or 1> may be

asked to undergo a walkthrough audit, where
practicable, of their service(s).

The accreditation banding is show below:

Accredited and nominated for preferred provider status 2>

Accredited with requirements 1><2

Not accredited but promising 1

Not accredited with no further review 0

The First Dimension:
Purchaser Expected Norm(s)
This aspect of your organisations work has be
grouped into Six Key Business Objectives which are
shown in figure 1 below:

Fig 1

Key Business Objectives Indicative Evidence and DOH Standards for Better Health

Strategic Leadership
Supportive and effective partnering (D2;D8;D11;D13; C17;C18)
Relevance and Rationale

Meeting Need -business Optimum organisational and clinical management

planning/clinical (C5;C6;C7,C8;C9;C10;C11;C12;C13;C14;C16;D2;D3;D4;D5;D6;D7;D8;
governance C17;D11)

Originality and Impact -

Care and treatment delivered in line with best practice
working with Service
(D1;D2;D9;D10;D11;C2; C5;C6;C13;C14;C17;C6;C18;C19)
Users and their families

Resource Allocation - Shared performance aspirations

working with staff (D2;D4;D5;D7;D12;C5;C6;C7;C8;C10;C11;C20;C21)

Stakeholder Maximising opportunity by reducing the felt and actual barriers to

engagement -working services for individuals, families and communities.
with diversity (C2;C7;C12;C18;C23;C24)

Properly audited accounts and sound day to day arrangements for the
Financial Management
administration of all monies. (C7;C20)
Purchaser Expected Norms (PEN) will be assessed
on the form and content of key business and care
planning policies and procedures. The depth and
scope of the policies and procedures submitted as
evidence of competency will be used to assess the
provider in this dimension.

Purchaser expected norms Business objectives Results

The Second Dimension:
Provider Evidence of
Consistent Value Application
This aspect of your organisations work has been
grouped into Seven Core Competencies, which are
concerned with a more detailed look at direct work
with service users, their families and communities.
The Seven Core Competencies are shown in figure 2:

Fig 2

Core Competency and Multi-Standards

Indicative Evidence

Communicate and Engage To engage with individuals, families and

communities, seeking to minimise the factors that
DANOS: cause risk and need.

HSC 438,437,419,413, 233,226

PH02.00 -06,PH04.00-06

Assess and Plan To work in partnership to develop packages of care

and treatment, protection and control

. EUSC 01 – 15; EUSC – 46,48,52,53.
CHS 2, 3, 7. GEN 6, 7, 8.
HSC_I14,21,22,24, 325,328,329,335,


Intervene and Provide Services To provide services to achieve change through the
DANOS: provision of support, care and treatment, protection
AA1;AA3;AB7;AC3;AD4;AF2;AG3;AH9;AH10; and control.


Provider of evidence of
Competency framework Results
consistent value application

Core Competency and Multi-Standards
Indicative Evidence

Promote and Enable To enable individuals, families and communities to

use their own strengths and expertise to
DANOS: AA4;AB2:AB5; lead a fulfiling and satisfied life


PH02.00-06; PH04.00-05;PH05.00-04; PH07.00-


Working with Others To demonstrate inclusive planning and effective

partnering arrangements in the delivery of services
DANOS: to individuals, families and communities.



Can demonstrate the ability to resolve professional

Commitment to Professional Development
dilemmas and conflicts, balancing rights, needs and

HSC 3119,23


Shows how the organisation assists people to

Demonstrates Value Requirements
increase control of and improve the quality of their
own lives and can demonstrate identifiable values
which inform practice and underpin structure.
AA4; AC4; BA2
HSC3119, 3121,MCI_D4


The Third Dimension: Level of
Customer Integration (X)
This aspect of your evaluation is concerned solely
with the extent to which services can demonstrate
integration across the other two dimensions, PEN
and PECVA. The construction of this dimension is
based upon PCS analysis. PCS analysis is a way of
examining how anti-discriminatory practice
becomes a sewn in feature of service delivery. The
seven core competencies are assessed against the
provider’s ability to meet with the descriptive
expectations shown in the columns.

Fig 3
Level of Customer
3 2 1 0
Meets Value Demonstrates a Shows an awareness of Shows a commitment Ignores, denies,
requirements considered professional the need to integrate to issues of quality disregards or fails to
value base showing how joint business planning demonstrating that recognise the
the integration of and care planning with service provision is importance of a value
business and care consumers and can tailored to the needs of base in both business
planning processes show that the latter is a specific client group and care planning, has
promotes the interests becoming central to and adheres to a a rigid, defensive or
of consumers and meeting business commonly held belief dismissive response to
communities , and objects within a shared that supports the issues of power and
issues of self value based system. promotion of services discrimination.
determination, users rights, illustrating
recognising that the how people are
tensions inherent in involved in care
both business planning planning
and care planning must arrangements.
meet with a clear value

Level of Customer 3 2 1 0
Can show how shared
Communicate and differing
Demonstrates the Can present well Shows an inability to
and Engage ability to form effective ordered arguments conceptualise the
perspectives are used working relationships based on adequate context within which
within the with individuals, data collection but is the work is being
organisation/partnershi agencies and reactive in forming undertaken,
p showing how colleagues both effective working misunderstanding the
consumer views are internally and relationships with purpose of
integrated, and has externally and conveys others and presents relationships with
documented strategies confidence to others the information if only others.
for assessing need at about the work being requested to do so.
all levels, both done and is open to
internally and learning from
externally, and how this consumers.
shapes business

Level of Customer
3 2 1 0
Shows an ability to The provider can Has started to show an Fails to make effective
Promote and enable work in partnership demonstrate working understanding of an use of service users,
with consumers and in a genuinely and authentic application carers and staff
other stakeholders; consistently of empowerment and strengths. Fails to
enables choice and empowering way; has applies this to practice; identify the
self-determination by identified and uses all shows advocacy skills opportunities for
sharing information, processes and has identifying the offering choice taking
knowledge and skills; policies which strengths of service control away from
optimise human strengthen the assets users and their support service users, carers,
resources by matching of individuals, groups networks. staff and stakeholders.
learning opportunities and communities;
to achieve growth and Shows confidence in
change. the delivery of services
based upon balancing
the needs of service
users, carers and

Level of Customer
Integration 3 2 1 0
The provider Demonstrates a Shows an awareness of Little or no reference is
Assess and Plan consistently produces thorough and accurate the need to made of conceptual
business plans, funding business planning use/develop inclusive models of
and operational cycle; makes sensitive business and care organisational size or
strategies which take and informed planning processes and identity, shows rigidity
account of the social professional can show that a base in ideas and planning
context service users, judgements about line structure exists for leaving little scope for
carers and business priorities; making and reviewing change.
communities. Can achieves the above in decisions.
show continued partnership with
consumer participation consumers,
in planning at all levels; communities and other
networks with stakeholders

Level of Customer 3 2 1 0
Draws upon an Shows consistency in Shows an awareness of Has a limited
Intervene and established and up to its service delivery and the range of options understanding of the
date range of follows through on available to provide options available to
provide services theory/evidence in all plans made; shows the services; can recognise provide services and
its work, with well use of theory and and assess the the techniques for
established methods appropriately resources needed to carrying out the work;
connections between and can justify actions offer services; requires direction to
business planning, care by evaluating encourages prepare plans and
assessments and the outcomes within the participation and misunderstands
distribution of limits of a contract; can feedback from service theoretical
resources; makes the show how users, carers, families underpinnings of
widest available improvements to and others; show the interventions made.
options accessible to services benefit service use of professional
consumers and users, carers, families judgement.
communities; show and communities.
how services are
evaluated in
partnership with
service users, carers
and others.

Level of Customer 3 2 1 0
Shows a clear Shows an informed and Shows how the agency Lacks the ability to
understanding of the critical awareness of its meets with base line analyse own work; is
Working with Others statutory and legal place within the social legal and regulatory unwilling to be
requirements to care and health care requirements; shows challenged about poor
undertake work; market; shows beginning of ability to performance; lacks
challenges organisational acumen develop practice and confidence to carry out
discriminatory practice and understands policy within work; fails to meet
appropriately; shows institutional constraints organisational limits assessed need; unable
positive outcomes for in its direct work with and boundaries. to take responsibility
consumers and consumers. for bad practice.

Level of Customer 3 2 1 0
Shows a preparedness Demonstrates the Uses routine Shows a low
to examine and importance of staff supervision to identify commitment to
Development of develop own value supervision, colleague learning and self training and
organisational base and organisational support and training; development in others., development;
competence development; can question existing accepts, within limits, dismissive of ideas of
contributes actively to policy and practice, different standards and team building and
the professional identifying areas for values among staff, evades or ignores the
development of staff; improvement; shows a and can show sensible importance of team
can demonstrate a clear ability to organise arrangements for meetings, consultation
learning environment; operational staff and workload management and the development
shows how shows how recording of adequate policies;
responsibility is of activity promotes does not take
managed and the learning; all front line responsibility for
systems both activity is incorporated learning and has not
administratively and in to wider committed resources
otherwise works in organisational needed for
support front line structures. improvement.
activity; recognises the
use of new knowledge
gained from
consumers without

Level of customer Competency

Business objectives Results
integration framework

Working-Out and Assessing
the Dimensions
As mentioned above the evaluation is designed to The third dimension (X) draws down the data
provide a three dimensional picture of a provider(s) collected in the first two dimensions and assesses
functions – its purpose, processes, practice and the level of customer integration.
the impact these have on society.
In this way the overall evaluation of a provider can
The first dimension is concerned with purchaser be measured by applying the following rule:
expectations or Purchaser Expected Norms (PEN)
and has been formulated to elicit key business X(PEN + PECVA)= 2>
knowledge about individual agencies and
partnerships; This is shown diagrammatically in figure 4 below:

The second dimension (PECVA) looks in more

detail at the evidence provider agencies have
supplied to support their case for accreditation.;

Fig 4

Purpose Policy Practice People

People and engage
Policy and Professional
strategy development
Level of

Customer Partnership Asses and plan
Integration and Processes
resources Intervene and
Promote and
Impact enable

Diversity Working with


Learning Innovation

The Maths
The X(PEN+PECVA)=2> rule, is known as a utility
formula. Utility formulas are used to allow for the
assessment and analysis of data, which would
otherwise be difficult to measure or judge.

The X(PEN+PECVA)=2> rule will be utilised in the

following way:

Inside the Brackets:

the depth and scope of key business policies + the depth and scope of documentary evidence
the number of business competency areas the number of practice competency areas
This part of the formula is based on a simple
numerator/denominator relationship or a ’how
many/what kind’ assessment. To illustrate the
minimum requirements for accreditation this part
of the formula would look like this:

(12/6 + 14/7) = (2+2)

In this illustration the provider or partnership has adapted to suit the specific issues faced by other
submitted 12 documents (policies and procedures) consumers groups.
that satisfy the base line requirement for
accreditation. In this instance 12 is the numerator, As mentioned on page 8 above this dimension was
the ‘how many of a kind’ number; this is divided by adapted from the work of Professor Neil
the ‘what kind’ or denominator, in this instance the Thompson and is designed to assess the extent to
number 6, which is the total number of areas which a provider or partnership promotes and
requiring a policy or procedure. demonstrates anti-discriminatory practice.

Similarly, the provider or partnership that has It is used in the utility formula to put a numerical
submitted the minimum of 2 documentary pieces value on the extent to which a provider or
of evidence across the entire 7 core practice partnership can show the centricity of service
competencies; the total number of evidence would users, their families and communities in all that
be 14. In this instance 14 is the numerator, ‘how they do.
many of a kind’ number; this divided by the ‘what
kind’ or denominator, in this instance the number Descriptive statements and their numerative value
is 7, which is the total number of areas requiring are provided in Figure 3 above.
evidence of competency.
For the purposes of the illustration the value given
Outside the Brackets is 2. This value would describe a well-run provider
that has shown it knows what it is doing.
Level of Consumer Integration (X)
This dimension has been constructed from direct
work with carers and service users, most notably a
learning disabilities consumer group called SUSTD
and Carer Representatives to a Learning Disabilities
Partnership Board. Since this time it has been

The formula would now look like this:

2 (2+2) =?

The X factor has been placed outside the brackets

as it acts to amplify this dimension and serves as a
balance between large and small and; new and
established providers or partnerships, allowing
each to be considered on merit.

The 2> Standard

This standard is derived from a base line

expectation requiring that Providers can
adequately show what they can do, the numerative
value 2> simply means that sufficient
documentary evidence has been submitted.

The calculation of this standard is shown below:

2(2+2)= 8


the sum of the competencies evidenced

the sum of the outcomes available

The overall formula reads as follows:

Xn ( the depth and scope of business policies + the depth and scope of practice evidence) = the sum of evidence submitted
6 7 4
A detailed explanation of each dimension is
provided on pages 25-27.

Purchaser Expected Norms The depth and scope of the policies and
procedures determine whether or not a provider
(PEN) will be awarded 1> in this dimension. For example,
The PEN figure will be derived from the value given
the scope of, say, an Equal Opportunities Policy
to the form and content of key business and care
could cover the following: Service Provision; Staff;
planning policies and procedures put forward by
Contractors; Management Committee.
the provider as evidence of their competency.
Each policy area would, in turn, also detail the
The existence of, say, a business plan clearly
procedures for implementation, how access to
showing how the provider has arrived at its current
services is governed and monitored; targets areas
position, both operationally and financially, if
for policy development; recruitment, selection and
accompanied by sound accounts for the past three
retention and anti-discriminatory practice.
years and up to date policies for the smooth
Providers supplying this level of detail will be
running of the organisation will score 1.
awarded 1>.
Providers showing evidence, which demonstrates
Should the provider show how these documents
both top down and bottom up planning with
relate to one another i.e. as part of an audit trail
mechanisms in place for the inclusion of service
required by their approach to Quality Assurance and
users, carers and staff and; shows evidence of a
can present documentary evidence of this then the
learning culture and joint or partnerships will score
provider will be awarded the maximum of 3.
3. Providers showing more than the base line
requirements to score 1 but who cannot
Where providers can evidence the existence of
demonstrate full inclusion will score 2.
depth but not scope a score of 2 will be awarded.
The base line expectations is shown in figure 5
additional information regarding the legal status
and identity of the provider is secured by way of Provider Evidence of
the formal application. Consistent Value Application
Fig 5 The evidence used to determine PECVA is
assessed from the providers’ submission of a
1 Mission Statement and Core Values Record of Achievement (ROA), references and
2 Organisations Policy and Objectives other testimonials offered as evidence. The ROA is
made up of FOUR service profiles:
3 Organisations
Quality Assurance
and Objectives
4 Equal Opportunities Policy The Four Service Profiles include:
5 Record Keeping
Three illustrations of service(s) or projects that the
6 Health, Personal and Medical Care Provider is proud of
7 Health and Safety
8 Personal Safety
9 Development Strategy and Business Planning One illustration of a service or project that did not
go to plan.
10 Complaints
11 Insurance This dimension is evidence based and requires that
12 Personnel and Staff Support providers offer a minimum of two pieces of evidence
across all competencies. The Fitness for Purpose
13 Training Assessment Matrix is shown below in figure 6:

Fig 6

Intervene Development
Objectives/ Communicate Assess Promote Working Meets value
and provide of professional
Competency and engage and plan and enable with others requirements
services competence


and Impact
Working with

PECVA requires that a minimum of two pieces of
documentary evidence be submitted across the
competency framework for each key business
objective, for all four illustrations.

The range of indicative evidence(s) are detailed in

figures 1 and 2 above, they are intended as guidance
only and are not exhaustive. The evidence indicators
cited work at a general level so that they can be
applied across the range of service provision for both
drugs and alcohol. The purpose is to identify the
activities that Providers would normally undertake in
the course of their work.

Each ROA is intended to detail the Providers learning

experiences of working with service users, their
families, communities and allied professionals,
therefore, demonstrating the Providers’ competency
to meet need. The illustrations submitted must be
sufficiently contrasting, demonstrating the
transferability of knowledge, skills and values. The
required contrast should be apparent in the evidence
that Providers submit, having selected illustrations of
service, which show quality, coherence, and
sufficiency of evidence. It is expected that the
evidence submitted by Providers will vary in nature
and emphasis according to their own opportunities
and responses to existing commissioned need.

Level of Customer
Integration – X
Service Integration is assessed by the attribution of a The ICAP Process
numerical value to the extent to which Providers
meet the descriptors set out in Figure 3 above. The Independent Consumer Accreditation Panel is
a consortia of local consumer interests and
This part of the assessment schedule is comprises of:
determined by:
ICAP Membership
• Group interview with the Independent Kevan Martin - North East Regional Alcohol Forum
Consumer Accreditation Panel (ICAP) (Panel Chair)
Sharyn Charlton - Regional Forum Representative
The group interview with ICAP is concerned with
(ICAP convenor)
Customer and Community Results and will ask:
Karyn Jackson - Regional Carers Representative
• Is the Provider meeting its customers’ needs Jane White - Regional Carers Representative
and how is this known? Tracey Collins - Fences Houses Action Group
Kate Conquer - Sunderland Carers Association
• Do customers feel they are being valued, cared for Darren Jacob - Director, Voice North East Ltd
and their needs properly addressed and satisfied?
Peter Sanders - Director, Voice North East Ltd
Paul Creighton - Director, Voice North East Ltd
• What impact does the Provider have on the
locality and community in which it operates?

submissions ICAP Feedback
made to the
record of provider summary to
achievement to interview provider
Accreditation Panel
ICAP members

All providers assessed as 8. Community Results – What impact does your
Organisation have on the locality and
scoring 2> will be nominated community in which it operates?
for Preferred Provider Status.
Preferred Provider Status will be awarded to 9. Key Performance Results – Is your Organisation
those Providers/Partnerships, which can able to demonstrate its performance to its
demonstrate an ability to have worked in joint or customers and other stakeholders who have an
Partnership arrangements. interest in substance misuse?

The award of Preferred Provider Status will require

Providers/Partnerships to attend for a thematic
interview with the Purchaser Panel.

The theme for the interview will be: What Is Your

Vision for the City of Sunderland?

When addressing this question, Providers and

Partnerships will be asked to show how Your Self
Assessed Competency meets with the
expectations of the City of Sunderland.

To gain Preferred Provider Status each

Provider/Partnership will have to demonstrate the

Your self assessed

1. Leadership – Do managers demonstrate the
role and importance of sound business and
clinical governance and lead by example?

2. Policy and Strategy – What are your

Organisations Aims and Objectives and how are
they developed?

3. People – How well does your Organisation

manage and develop people?

4. Partnerships and Resources – How well does

your Organisation use its assets, help manage
those of the sector and create partnerships
with other organisations to mutual benefit?

5. Processes – How effectively are things done to

reach your objectives?

6. Customer Results – Is the Organisation meeting

customers’ needs and how is this known?

7. People Results – Do people enjoy working

within the Organisation and do they feel they
are being valued, cared for and their needs
properly addressed and satisfied?

The Purchaser Panel
Evaluation Matrix
Competency/Judgement 1 2 3 4
Works to meet Shows an Has joint or Has a
own priorities awareness of shared transparent
and solely uses others issues and commitment to integrated
resources to concerns, setting improve relationship with
meet narrowly aside some outcomes for other partners
defined self resources to consumers, and pools
determined address issues of works in an resources to
objectives. common inclusive way address
concern. sharing population need.
resources to
address the
identified need.

Policy & Strategy
Partnership & Resources
Customer Results
People Results
Community Results
Key Performance Results


Mostly 4’s
Mostly 3’s

Stands out
Highly recommended
[ Preferred status is
recommended for those
scoring above this line
Mostly 2’s Commended
Mostly 1’s Accredited but without preferred status

Purchaser Panel Role

Debbie Burnicle Head of Service (Panel Chair)
Joanne Cholerton Community Safety Manager
Jim Usher DIP Lead Officer
Ian Sammut-Smith Probation
Stuart Thompson Joint Commissioning Manager
Linda Nicol Procurement
Marietta Evans Public Health
Another Independent Clinician
Keith Davison Finance Manager
Self Assessment Schedule
1. Leadership

0 1 2 3 4 5 Evidence to support marking

Don’t know No – this doesn’t This happens Yes this usually Yes this is This is an integral
happen occasionally but happens but it recognised as the part of our culture
Do Managers demonstrate the role and importance of there is no could be way we do and operation and
consistency improved business and we can be regarded
Effective Treatment and lead by example?
achieve real as best practice

1.1 Has your organisation clearly defined it’s role and strategic
objectives and the values by which you should operate?

1.2 Is the Senior Manager always involved in strategic planning and use
of outside resources?

1.3 Do managers outside your immediate work place understand and

actively support the requirements for effective treatment?

1.4 Do managers throughout your organisation act as role models in

promoting and using your knowledge and expertise?

1.5 Are your managers personally involved in the way that your
organisation operates and continually trying to make

1.6 Are your managers actively involved with customers, partners,

suppliers and other stakeholders in understanding and where
possible, anticipating needs?

1.7 Have your managers established mechanisms for ensuring that

your organisation meets the overall Partnership needs?

1.8 Do your managers actively support the wider community and

initiatives to enhance the take up of services?
0 1 2 3 4 5 Evidence to support marking
Don’t know
No – this doesn’t This happens Yes this usually Yes this is This is an integral
happen occasionally but happens but it recognised as the part of our culture
there is no could be way we do and operation and
consistency improved business and we can be regarded
achieve real as best practice

1.9 Do your managers update and improve their own skills?

1.10 Do they encourage staff to do likewise?

1.11 Do your managers promote teamwork, learning, creativity and


1.12 Do your managers personally support, encourage and motivate

individuals and teams and recognise their performance?
2. Policy & Strategy

0 1 2 3 4 5 Evidence to support marking

Don’t know No – this doesn’t This happens Yes this usually Yes this is This is an integral
happen occasionally but happens but it recognised as the part of our culture
What are your Organisations objectives and there is no could be way we do and operation and
consistency improved business and we can be regarded
how are they developed?
achieve real as best practice

2.1 Does your organisation participate in the development of the

overall Partnership’s policy and strategy?

2.2 Does your organisation take into account the overall Partnership’s
objectives when developing its own?

2.3 Does your organisation specify the needs and expectations of

customers, employees, partners and other stakeholders when
developing its own policy and strategy?

2.4 Is your business strategy based on sound data, appropriate

research, and analysis of measured performance and the lessons
learned from previous experience?

2.5 Does your business strategy take into account wider central and
local government strategies and initiatives?

2.6 Does your business strategy take account of new techniques and
developments in technology?

2.7 Does your business strategy take full account of the role and
opportunities provided by outside agencies and collaborative
organisations, eg NESEP, GONE, NTA, BoTM?

2.8 Are your policies and strategies periodically reviewed and updated to
ensure they are relevant to changes in the operating environment?
0 1 2 3 4 5 Evidence to support marking
Don’t know
No – this doesn’t This happens Yes this usually Yes this is This is an integral
happen occasionally but happens but it recognised as the part of our culture
there is no could be way we do and operation and
consistency improved business and we can be regarded
achieve real as best practice

2.9 Does your organisation have contingency plans to cover

emergency situations and other perceived risks?

2.10 Have the key operational processes that are crucial to delivery of
your policy and strategy been identified?

2.11 Has your business strategy been communicated to all relevant


2.12 Is there a plan for implementation of your business strategy with

milestones, success criteria and standards defined to measure
3. People

0 1 2 3 4 5 Evidence to support marking

Don’t know
No – this doesn’t This happens Yes this usually Yes this is This is an integral
happen occasionally but happens but it recognised as the part of our culture
How well does your organisation manage and there is no could be way we do and operation and
consistency improved business and we can be regarded
develop people?
achieve real as best practice

3.1 Does your organisation have a comprehensive policy and plan for
recruiting and retaining the right people with the right skills?

3.2 Does the organisation actively canvas and take into account your
people’s views and feedback on human resource and other policies
and strategies?

3.3 Are there plans to maintain and develop as appropriate the skills
and knowledge of everyone in the organisation?

3.4 Are regular performance appraisals carried out?

3.5 Do your people have clearly defined objectives and performance

measures that are linked to your objectives?

3.6 Are there established mechanisms for effective communication

with and between people – up, down and horizontally?

3.7 Are there mechanisms for caring for people (eg flexible working,
home working, health & safety, equal opportunities) and providing
reward and recognition, appropriate and fair?

3.8 Are people encouraged to actively engage with customers?

0 1 2 3 4 5 Evidence to support marking
Don’t know
No – this doesn’t This happens Yes this usually Yes this is This is an integral
happen occasionally but happens but it recognised as the part of our culture
there is no could be way we do and operation and
consistency improved business and we can be regarded
achieve real as best practice

3.9 Are people encouraged to develop their own skills and expertise?

3.10 Do managers monitor and manage people’s workload?

3.11 Are people empowered and encouraged to develop the behaviours

inherent in high performance team-working and cross functional
4. Partnerships & Resources

0 1 2 3 4 5 Evidence to support marking

Don’t know
No – this doesn’t This happens Yes this usually Yes this is This is an integral
happen occasionally but happens but it recognised as the part of our culture
How well does your Organisation activity use its own there is no could be way we do and operation and
physical assets, help manage those of others and consistency improved business and we can be regarded
create partnerships to mutual benefit? achieve real as best practice

4.1 Does your organisation activity proactively develop and manage its
relationships with key suppliers to mutual benefit?

4.2 Have working relationships been established with other

appropriate professional bodies in order to obtain maximum benefit
for your Customers?

4.3 Have strategic partners for collaborative services been identified

and developed?

4.4 Are there systems and processes in place to monitor and control
the operating costs and use of resources?

4.5 Does the organisation have an active role in commercial

assessment of capital and revenue spend?

4.6 Does the organisation carry out or contribute to risk assessments

on capital and revenue spend?

4.7 Does the organisation fully participate in Best Value

Reviews/Market testing?

4.8 Is the organisation involved in managing the physical assets such

as property, equipment and materials?
0 1 2 3 4 5 Evidence to support marking
Don’t know
No – this doesn’t This happens Yes this usually Yes this is This is an integral
happen occasionally but happens but it recognised as the part of our culture
there is no could be way we do and operation and
consistency improved business and we can be regarded
achieve real as best practice

4.9 Are systems in place to identify and assess any new technologies
that may impact on the organisation?

4.10 Is there a defined policy and plan for managing information and
knowledge? E.g. learning from experience, best practice, availability
of specialist skills

4.11 Is there an appropriate process for monitoring and reducing the

transactional costs of small value spending?

4.12 Is the organisation actively promoting the use of electronic

systems and are there plans to meet this need?

4.13 Do people have access to the right information to allow them to do

their job effectively? E.g. Internet access, customer database, e-mail
5. Processes

0 1 2 3 4 5 Evidence to support marking

Don’t know
No – this doesn’t This happens Yes this usually Yes this is This is an integral
happen occasionally but happens but it recognised as the part of our culture
there is no could be way we do and operation and
How effectively are things done? consistency improved business and we can be regarded
achieve real as best practice

5.1 Has your organisation defined all the key processes necessary to
deliver its objectives?

5.2 Are processes tailored to meet the needs of customers, suppliers

and other stakeholders?

5.3 Is the effectiveness of these processes measured?

5.4 Is responsibility for improving processes clearly defined?

5.5 Does your organisation operate any quality, environmental or safety

management systems?

5.6 Is the service provided analysed to assess the customer’s


5.7 Is the service effectiveness benchmarked?

5.8 Are customers, suppliers and other stakeholders consulted and

involved in improving processes?
0 1 2 3 4 5 Evidence to support marking
Don’t know No – this doesn’t This happens Yes this usually Yes this is This is an integral
happen occasionally but happens but it recognised as the part of our culture
there is no could be way we do and operation and
consistency improved business and we can be regarded
achieve real as best practice

5.9 Is there an established and recognised system in place for good

practice in one area to be communicated and adopted in other

5.10 Is the effectiveness of any changes to your processes assessed?

5.11 Do people understand their role in seeking improvements to the

way they work?
6. Customer results

0 1 2 3 4 5 Evidence to support marking

Don’t know
No Yes -but we don’t Yes , and we can Yes, we can show Yes we can show
use the show inproving steady excellent
Is the organisation meeting it’s customers’ needs and information trends improvement over performance over
how is this known? effectively 3 years 5 years

6.1 Are customers asked how they feel about the services provided?

6.2 Do customers’ views agree with the procurement activity’s views of

the service provided?

6.3 Does your organisation have any targets for customer satisfaction
and improving these - E.g. Service Level Agreements?

6.4 Are these targets being met?

6.5 Are levels of customer satisfaction benchmarked with other


6.6 Is there an effective system for handling and rapidly resolving


6.7 Are complaints about your organisation analysed and

improvements made?

6.8 Does your organisation have its own internal systems and
measures for assessing customer satisfaction?
E.g. - cycle times
- number of complaints/plaudits
- take up of framework agreements
0 1 2 3 4 5 Evidence to support marking
Don’t know
No Yes -but we don’t Yes , and we can Yes, we can show Yes we can show
use the show inproving steady excellent
information trends improvement over performance over
effectively 3 years 5 years

6.9 Is there data on customer service training, as appropriate, for staff?

6.10 Are employees’ suggestions for improving customer service

actively sought, pursued and implemented?
7. People results

0 1 2 3 4 5 Evidence to support marking

Don’t know
No Yes -but we don’t Yes , and we can Yes, we can show Yes we can show
use the show inproving steady excellent
Do people enjoy working within your organisation and do
information trends improvement over performance over
they feel they are being valued, cared for and their needs effectively 3 years 5 years
properly addressed and satisfied?

7.1 Are people asked how they feel about working for you?

7.2 Is there an understanding of what motivates people and gives them

job satisfaction?

7.3 Are there targets that address motivation and job satisfaction?

7.4 Do people feel they are given opportunities to learn, develop their
skills and expertise and enhance their job?

7.5 Do people feel they get appropriate support, coaching and training
when they need it?

7.6 Do people feel they can discuss issues within the procurement
activity, openly and frankly?

7.7 Is your organisation perceived as practising and providing equal

opportunities to all staff?

7.8 Do people receive proper performance appraisal and feedback on a

regular basis – not just at a once a year formal occasion?
0 1 2 3 4 5 Evidence to support marking
Don’t know No This happens Yes , and we can Yes, we can show Yes we can show
occasionally but show inproving steady excellent
there is no trends improvement over performance over
consistency 3 years 5 years

7.9 Do people feel they are listened to and their needs addressed?

7.10 Is staff turnover at an acceptable level with retention of key people?

7.11 Are the number of people pursuing vacancies showing an upward


7.12 Are suitable working conditions and facilities provided that comply
with Health and Safety requirements?

7.13 Are people developing their own skills and expertise?

7.14 Are people making improvements to the way they work?

8. Community Results

0 1 2 3 4 5 Evidence to support marking

Don’t know
No Yes -but we don’t Yes , and we can Yes, we can show Yes we can show
use the show inproving steady excellent
What impact does your organisation have on the locality information trends improvement over performance over
effectively 3 years 5 years
and community in which it operates?

8.1 Does your organisation affect the locality and community and how?

8.2 Is it known how your organisation is viewed by those parts of the

community that are affected by it?

8.3 Does your organisation contribute to the local community in terms

of education and training and support for voluntary work?

8.4 Is there information on how your organisation promotes and leads

on crime reduction and healthy living?

8.5 Do your statistics show an improving trend?

8.6 Does your organisation measure how its professionalism, integrity

and contribution are viewed by external bodies?
E.g. regulatory bodies and collaboration partners.
9. Key Performance Results

0 1 2 3 4 5 Evidence to support marking

Don’t know
No Yes -but we don’t Yes , and we can Yes, we can show Yes we can show
use the show inproving steady excellent
Is your organisation able to demonstrate its performance
information trends improvement over performance over
to its customers and other stakeholders who have an effectively 3 years 5 years
interest ?

9.1 Are there measures that demonstrate the added value, savings,
cost effectiveness and efficiency of your services?

9.2 Are there measures that demonstrate the

savings/benefits/contribution that your organisation makes to
customers, stakeholders and the Partnership?

9.3 Can progress in implementing your business strategy be shown.

9.4 Is there performance data on key processes and systems?

9.5 Is there evidence to show that improvements in processes and

systems have contributed to better performance results?
- cycle times
- use of electronic systems

9.6 Are indicators in place that will predict future performance in key
areas of treatment effectiveness?

9.7 Are the benefits of working with consortia, partners and customers
monitored and analysed?
- cost reduction
- added value of innovative services

9.8 Is the knowledge that your organisation obtains and develops

managed and used to best effect?
E.g. - review of previous contract performance
- market research
Completing the Questionnaire Subtract Adjustment = Corrected score

• Sections 1 to 5 ask questions about leadership, the systems and Leadership x 1.66 = -10 =
processes that excellent service arrangements should have considered in
order to deliver the results required. Policy and Strategy x 1.33 = -8 =

Tick one of the numbered boxes after each question based on your People x 1.64 = -9 =
perception of what happens in your Organisation.
Partnerships and Resources x 1.38 = -9 =
Score as follows:
0. Don’t know Processes x 2.54 = -14 =
1. No – this doesn’t happen.
2. This happens occasionally but there is no consistency. Customer results x 3.64 = -20 =
3. Yes this usually happens but it could be improved.
4. Yes, this is recognised as the way we do business, and we achieve real People results x 1.29 = -9 =
5. This is an integral part of our culture and operation and can be regarded Community results x 2.0 = -6 =
as best practice.
Key Performance Results x 3.75 = -15 =
Sections 6 to 9 ask questions about the results, your achievements in terms
of actually delivering the results in a number of key areas. Total Score

Again tick one of the numbered boxes after each question based on your
perception of the results achieved. • The purpose of the scoring system is to give an approximate cross
reference to that used in a full Excellence Model Assessment.
Score as follows:
1. Don’t know • It is inevitably somewhat coarse so variations of up to 20 on the corrected
2. No score should not be regarded as significant.
3. Yes – but we don’t use the information.
4. Yes – and we can show improving trends. • Scoring will allow internal comparison of performance over time and will
5. Yes – we can show steady improvement over 3 years. also allow comparison with others to identify potential benchmarking and
6. Yes – we can show excellent performance over 5 years. sharing of best practice opportunities.

Scoring Method
1. Add up the scores you have given for each criterion E.g. leadership, people etc.

2. Multiply the sum you have achieved by the factor shown in the table and
then subtract the adjustment figure to achieve the corrected score for
that criterion.

3. Add up all the corrected scores to give a total.

Safer Communities Drug Team Sunderland
Accreditation Form
Please complete all of questionnaire - using N/A where applicable

1. General
1.1 Provider Details


Registered Office

Telephone: Fax:

E Mail:

1.2 Local Contact Details


Telephone: Fax:

E Mail:

1.3 Person applying on behalf of the Provider or Partnership



Contact details:
1.4 Are you (please tick)

A Sole Proprietor Partnership

Voluntary Organisation/Charity Private Limited Company

Public Limited Company Unincorporated Association

Registered Social Landlord/HA

Other (please specify)

Please provide a list of Executive and Non Executive Directors; Partners; Associates; Trustees;
Management; Committee members:

1.5 Please list all registration numbers

1.6 If a charity - do you have a deed of trust?

Yes No

1.7 If a Partnership - do you have a Partnership Agreement in place?

Yes No

1.8 Please state the firm’s date of registration and registered number under the Companies Act 1985:
Parts 1.8 – 1.11 to be completed by Limited Companies Only:
1.9 If applicable, date of registration and registered number under the Industrial and Provident
Societies Act 1965-1978:

1.10 If the company is a member of a group of companies, please give the names and addresses of the
ultimate holding company and/or all other subsidiaries. (Use an additional sheet if necessary):

1.11 Would the group or ultimate holding company be prepared to guarantee your contract
performance as its subsidy?

Yes No

1.12 What professional association(s) is your organisation a member of?

Please provide all registration numbers
2. Mapping of current activity
2.1 What services do you currently offer (please put as an approximate %, of your
organisation’s overall activity, where possible)

Training Job Search/Seeking/Placement Support

Business/Social Firm Devp Home-care

Supported Housing Structured Psychosocial Interventions

Registered Housing Benefits Advice/Welfare Rights

Acute & Treatment Services Day Services

Support/Service Use Groups Drop-in

Education Advocacy

Residential Rehabilitation Inpatient Detox

Structured Day-care Structured Counselling

GP Prescribing Specialist Prescribing

Needle Exchange Specialist Medical Intervention

Leisure/Social Activity Other Advice & Info

Referral/Sign-posting/ CJIT
Other (please specify)

2.2 Apart from drug and alcohol problems, what is the nature of your client group (please put
approximate % where possible

People with disabilities People on low incomes

People from ethnic communities Adults with dependents

Unemployed People People resident in excluded communities?

Employed people CJIT

Other (please specify)

2.2.1 Please tell us about the range of disabilities your customers have e.g. physical, learning or
cognitive, indicating the % of your total customer group.
2.3 Please state in which service areas you are seeking accreditation

Training Job Search/Seeking/Placement Support

Business/Social Firm Devp Home-care

Supported Housing Structured Psychosocial Interventions

Registered Housing Benefits Advice/Welfare Rights

Acute & Treatment Services Day Services

Support/Service Use Groups Drop-in

Education Advocacy

Residential Rehabilitation Inpatient Detox

Structured Day-care Structured Counselling

GP Prescribing Specialist Prescribing

Needle Exchange Specialist Medical Intervention

Leisure/Social Activity Other Advice & Info

Referral/Sign-posting/ CJIT
Other (please specify)

2.4 Please state in which service areas you are seeking preferred status

Training Job Search/Seeking/Placement Support

Business/Social Firm Devp Home-care

Supported Housing Structured Psychosocial Interventions

Registered Housing Benefits Advice/Welfare Rights

Acute & Treatment Services Day Services

Support/Service Use Groups Drop-in

Education Advocacy

Residential Rehabilitation Inpatient Detox

Structured Day-care Structured Counselling

GP Prescribing Specialist Prescribing

Needle Exchange Specialist Medical Intervention

Leisure/Social Activity Other Advice & Info

Referral/Sign-posting/ CJIT
Other (please specify)
3. Size of organisation
3.1 Staffing
Please fill in the table below for staff directly employed by your organisation, secondees, and
project workers – basically all personnel that help you deliver your ‘service’

Job role/area of activity No. of full-time staff No. of full-time staff

e.g. General Administrator/Supplies Manager 1 1

3.2 What was your organisation’s financial turnover in your last financial year?: £

3.3 How is your organisation funded? (you can ✓more than one box)

Local Authority National Lottery Charities Board

Direct Payments NHS/PCG/PCT

SRB Partnership Other Charitable Funding

Housing Income Supporting people

HAZ Grant Membership Fees

European Social Fund

Trading Income (please specify)

European Regional Development Fund

Interest on reserves

Other (please specify)

4. Contract experience
4.1 References
Please give names of referees willing to vouch for the professional knowledge, skills, and
experience of the staff operating the agency.

We may also approach any of the statutory agencies named below to give a view of your agency’s
performance and to confirm information provided in the completed questionnaire.

Name and Position Name and Position
Name and Address

Referee 1

Referee 2

Referee 3

Referee 4

Referee 5

4.2 Contract Schedule

Please identify details of contracts with other Local Authorities or purchasers currently held by
your company.

Local Authority:

Contact name and


Telephone number:

Start date: End date:

Contract type:
(unless indicated)

Approx annual value: £

Local Authority:

Contact name and

Telephone number:

Start date: End date:

Contract type:
(unless indicated)

Approx annual value: £

Local Authority:

Contact name and


Telephone number:

Start date: End date:

Contract type:
(unless indicated)

Approx annual value: £

Local Authority:

Contact name and

4.3 Please indicate which of the following apply to your organisation:
Yes No

Abbeyfield Standard

Business Excellence Model

CSHS Code of Practice

Community Legal Services

Foyer Federation

Housing Corporation

Charter Mark

CSCI Registration

Investors in People




Please provide supporting evidence/copies of all selected validation frameworks/accreditation certificates.

4.4 In respect of any contracts you or your organisation may have entered into:
Yes No

Have damages been awarded against you?

Has a Contract been terminated on the ground of your default?

Has a Contract not been renewed due to your failure

to comply with the terms of the Contract?

If Yes to any of the above, please provide details

5. Financial viability
5.1 Who is the person responsible for the organisation’s financial matters?



(if different from main)


5.2 Please use the space below to provide the names and addresses of any Banks with whom
you hold current and/or loan accounts that may be approached for references:

5.3 Please complete Reference Request for Bank Reference (Appendix A).
5.4 Please enclose copies of the audited financial statements in respect of the company
making the application, together with the audited consolidated financial statements of the
group (where appropriate), for the last three years: (Please also include if available)

Business Plan

Financial Projections

Annual Accounts

Auditor’s Management Letter

Auditor’s Report

5.5 Please provide details of your Insurance cover for Public and Employers Liability.
Your Insurance Company should complete Appendix B.
6. Health and safety
6.1 Does your company have a Health, Safety & Welfare Policy document?

Yes No
6.2 Do you comply a management of Health & Safety at Work Regulations?
If yes, a copy may be requested, (covering General Policy, Organisation and Arrangements) as
required by section 2(3) of the Health & Safety at Work Act 1974 and any codes of safe working
practices issued to employees.
If no, how many persons do you employ?

6.3 Who has overall and final responsibility for Health, Safety & Welfare in your

6.4 If you have 5 or more employees:

Yes No
Do you employ a Safety Officer?

Yes No
If yes, please state their name and qualifications:

6.5 Is your company/organisation registered with the HSE?

Yes No
6.6 Do you have a formal safety manual and company approved safe working practice and

Yes No
Please enclose copies of your organisations Health, Safety And Welfare Policy policies and relevant
procedures in relation to safe working practices
6.7 How does your company supervise Health & Safety at locations where your company
personnel work?
6.8 Has your company/organisation suffered any statutory notifiable accidents (RIDDOR) in
the last 3 years?

Yes No
If yes, please provide all necessary details

6.9 Has your company/organisation been served any improvement or prohibition notices by
the HSE or other enforcing body in the last 3 years?

Yes No
6.10 Has your company/organisation been prosecuted in the last 3 years?

Yes No
If yes for either 6.9 or 6.10, please provide all necessary details
6.11 If you have 5 or less employees, or if your company does not comply with any of the above
legislation please enclose written details of:

• Risk Assessment
• Reporting Hazards
• Protective Clothing
• Smoking
• Violence in the Workplace
• Emergency First Aid
• Moving & Handling
• Control of Infection and Notifiable Diseases
• Accident Reporting
• Disposal of waste materials
• Lone workers policy

7. Employment policies and procedures
7.1 Equal Opportunities:
7.1.1 Do you comply with the Sex Discrimination Act 1975

Yes No
7.1.2 Do you comply with the Equal Pay Act 1975?

Yes No
7.1.3 Do you undertake to comply with the Disability Discrimination Act 1995?

Yes No
7.1.4 Is it your policy to comply with your statutory obligations under the Race Relations Act 1988?

Yes No
7.1.5 Do you operate an Equal Opportunities Policy?

Yes No
Please enclose a copy of your Equal Opportunities Policy/supporting evidence of the above.
7.1.6 Has any ruling been made against yourself or your organisation by any Court Tribunal in respect of
the above legislation?

Yes No
If Yes, please provide all necessary details

7.2 Employment procedures

7.2.1 Does your organisation undertake Criminal Records Bureau checks on all paid staff and volunteers
employed in the delivery of services?

Yes No
7.3 If no, how do you ensure that the protection of vulnerable people is maintained?

7.4 Do you have a written policy covering employment practices?

(please enclose all relevant copies)

Yes No
7.5 Do you have induction programmes in place for new staff and volunteers?

Yes No
7.6 If yes, are the principle elements of the programme documented?
If so please include a copy with your submission.

Yes No
7.7 Does your organisation adhere to the Working Time Regulations Act 1998?

Yes No
7.8 Can you guarantee that all employees receive at least National Minimum Wage?

Yes No
7.9 Can you confirm employees and volunteers receive the following:

Written Contract

Written Statement of Employment Particulars

Job Description

Appendix A
Sunderland City Council
Combined status enquiry and consent form
Private and confidential Enquiry to: The Manager
Bank Name:

Sort Code No: Linda Nicol

Supplies Manager
Sunderland Royal Hospitals
Name: Kayall Road
Address: Sunderland
Tyne & Wear
Post Code:
Tel No:
Fax No:
Contact Name:

Name of Customer: Information requested on:

I/we request your opinion as to the means and
Account number: (for identification purposes only) standing of
Customer address:

N.B. This section should be altered to match your and his/her trustworthiness in the way of business
requirements to the extent of £
To be completed by the person who is the subject
of the enquiry Consent

Subject’s full name: I/we

Subject’s bank: consent to

Full name and address of enquirer: Bank plc

me/us to Sunderland TPCT and agree to the above
bank debiting my account with the charges from the
above bank which would otherwise have been
payable by Sunderland TPCT



Appendix B
Sunderland City Council
Certificate relating to service provider
(to be completed by the insurer or brokers)
Service provider:

Home name & address:

This is to certify that the undermentioned policies provide all the insurance
cover for the aforementioned contract.

We have noted your interest in the policies and will inform you should the
insurance’s be discontinued before the expiry date.
Liability insurance’s

Type of policy:

Policy number:


Period from: Period to:

Limit of public indemnity any one incident:

(£5,000,000 required): £

Employers liability (£10,000,000 required): £

Special exclusions (if any):

Insurers/brokers stamp or seal

Professional Indemnity
References Acknowledgments
Alec Fraher: Mental Health Accreditation Tool cited The accreditation tool was developed by Alec Fraher.
in Developing and Managing Provider Markets Dr The formula X(PEN+PECVA)=2> is the trademark of
Tony Ryan. Commissioning eBook Alec Fraher and Associates Ltd.

S.P. Hargreaves Heap and Y. Varoufakis: Better, Brighter Futures is also the name of a peer
Game Theory 2nd ed. Routledge London. led project developed by Peter Sanders, Director
Voice NE Ltd who have kindly extended its use in
Neil Thompson: Anti-Discriminatory Practice. this document, and to ICAP for giving freely of their
Rutland London. time and patience to bring value(s) to this exercise.

Welsh Assembly Government: Commissioning

Framework for Substance Misuse for Safer
Communities Partnerships.

Department of Health: Our health, our care,

our say.

Safer Sunderland Partnership: Local Area


Stuart Thompson: Draft Substance Misuse

Strategy. Safer Sunderland Partnership.

European Foundation for Quality Management:

The Procurement Excellence Guide.

Useful links



Sunderland City Council
Safer Communities Drug Team
Development and Regeneration Services
PO Box 102
Civic Centre

Telephone: 0191 553 7952


As part of Sunderland’s commitment to a balanced and sustainable future this leaflet is

printed on paper made from 80% recycled post consumer waste. Please recycle it again
after use by putting it in your Kerb-it box or your paper bank.