Refreshing the Health and Social Care Alliance Scotland and Scottish Government Partnership Agreement: External Review

4. Funding relationship WITH THE SCOTTISH GOVERNMENT

Introduction

4.1 This section reviews the current funding relationship between the Scottish Government and the ALLIANCE. It summarises financial information about the ALLIANCE and explores ALLIANCE and Scottish Government views about the strengths, challenges and areas for development. It also includes views of policy stakeholders and members, where these related to the funding relationship.

Overview of ALLIANCE income and expenditure

4.2 In 2013-14, the ALLIANCE’s total estimated expenditure was £7.8 million. According to information provided by the ALLIANCE, the Scottish Government provided £700,000 in core funding and £2,474,218 of project funding during 2013-14. In addition, the ALLIANCE received £2,000,000 from the Scottish Government during 2013-14, which it was responsible for awarding to others through the Self Management IMPACT Fund ^[6].

4.3 Since 2011-12 the ALLIANCE’s core and project grant income from the Scottish Government has increased substantially, as ALLIANCE activities have expanded.

4.4 The ALLIANCE has worked to establish the organisation on a more sustainable business footing over the past four years. This includes:

• strengthening its reserves position to allow the organisation to respond to unanticipated financial challenges;
• securing a three year (rather than annual) and higher core funding settlement from the Scottish Government (which better reflects its core costs); and
• seeking, where possible, to recover full project costs when developing new programmes in order to cover the associated additional core costs which are not met by any increase in core funding.

4.5 Those we spoke with in the ALLIANCE highlighted that receiving core funding on a three year basis has supported the ALLIANCE to plan more effectively. It was felt that a three to five year Strategic Partnership Agreement, with an associated funding agreement, would support them to strengthen their business model further.

Scottish Government funding elements

Core cost and funding

4.6 Since 2006, the ALLIANCE has received core funding from the Scottish Government. Originally, this supported 1.5 posts. This rose to ten posts in 2008. The core funding also covers basic organisational running costs – including accommodation for the Hub. The Scottish Government awarded the ALLIANCE £700,000 of core funding per year for 2012-13, 2013-14 and 2014-15.

4.7 Current core activities include:

• policy development work;
• delivering consultation and engagement activities;
• communication activity;
• membership administration and support;
• managing and developing programme activities;
• developing and managing the Self Management IMPACT Fund; and
• running the Hub.

4.8 The ALLIANCE reports that as the organisation has grown substantially – in terms of staff, activities, membership and financial management responsibilities - its core running costs have necessarily increased. It has expanded its core team beyond its original ten members to include 3.5 new posts - a Programme Director (funded partly from core costs), a Policy and Information Officer, an Administrator and an Office Assistant.

4.9 The ALLIANCE estimates its core expenditure totalled £830,381 in 2013-14. Of this, 54% was spent on salaries and associated staff costs and 20% on property costs (which includes the cost of the ALLIANCE office space and Hub facilities). A further 5% of expenditure related to administrative costs, and 5% to running events and conferences.

4.10 According to these figures, the core costs in 2013-14 exceeded the core grant provided by the Scottish Government. The ALLIANCE usually charges a management fee (5% of salary costs), and an amount to cover additional overheads, when developing new programme proposals for the Scottish Government. In some instances, the ALLIANCE has reduced or removed these charges from proposals, in order to deliver work within the available budget. The ALLIANCE reports that it generated £146,323 from these charges to the Scottish Government during 2013-14.

4.11 The £846,323 the ALLIANCE reports it received in funding from the Scottish Government to meet core costs during 2013-14 (£700,000 of core funding plus £146,323 in management and overhead charges on individual programme funding streams) is broadly equivalent to the £830,381 it reports it incurred in core costs.

Project funding

4.12 Table 2.1 provides a summary of all the Scottish Government funded project income at the time of carrying out this review (September 2014) and the time periods it covers. The table illustrates the wide range of projects underway, and the variability of funding periods.

Governance, monitoring and evaluation of Scottish Government funded activity

4.13 There is a wide range of governance, monitoring and evaluation approaches in place to support the programmes the Scottish Government funds and the ALLIANCE delivers. The table below provides an overview of these, based on the information the ALLIANCE provided to us during the review process.

Table 4.1: Programme governance, monitoring and evaluation approaches

Programme or Project	Governance arrangements	Monitoring, evaluation and reporting
ALISS	ALISS programme board.	Self evaluation. Data is collected via core engine analytics, e-surveys, activity tracking and data from emails and minutes. Programme highlight report produced for the Scottish Government via programme board every 6 weeks - includes review of progress, mainly focused on outputs.
Allied Health Professionals	Provided in partnership between AHP, Scottish Government and the ALLIANCE.	Self evaluation. Project Initiation Document (PID) review by partners concerning post outcomes, activity and impact, held quarterly. PID report produced annually for the Scottish Government and copy provided to ALLIANCE programme board which identifies some outcome evidence.
The Third Sector Health and Social Care Support Team	A Programme Advisory group meets quarterly and has a formal role.	Quarterly reports, mainly focused on outputs.
Core activities	ALLIANCE Board, Scottish Government.	Feedback on ALLIANCE communications from members and evaluation forms from Hub users. Reports on outputs via meetings, annual report and annual accounts.
Dementia Carer Voices	ALLIANCE Board, Scottish Government, Cabinet Secretary	Self evaluation and feedback gathered. Quarterly progress reports submitted to the Scottish Government. Final report includes outcomes-focused feedback.
GIRFEC awareness raising project	Strategic funding partnership with Scottish Government. Project Advisory Group.	Self evaluation. Business plan 2013-15 agreed with Scottish Government. Six and 12 monthly reports submitted along with regular meetings with SG. Outcomes-focused approach to future reporting.
Health and Social Care Academy	Academy programme board, ALLIANCE board. Updates given to Third Sector Health and Social Care Advisory Group	Will be self evaluated using a variety of methods – framework to be determined as part of work plan. ALLIANCE to provide progress reports against work programme, including a written report every six months.
House of Care	Under development.	Under development.
Links Worker programme	Overseen by an Executive group which includes representatives from SAMH, Glasgow City Council and the NHS. The governance structure is fixed for the duration of the programme.	Quarterly progress reports submitted to the Scottish Government, focused on outputs. An evaluation of the Links Worker Programme is to be led by NHS Health Scotland, funded by the Scottish Government. The final evaluation report is expected by June 2016 with an interim report to be completed by June 2015.
My Skills, My Strengths, My Right to Work	Stakeholder reference group	Self evaluation built into the programme which uses the LEAP evaluation framework and tools – reporting quarterly to the Voluntary Action Fund who oversee the process for all projects.
People Powered Health and Wellbeing	Programme Board reports to Person Centred Portfolio Steering Group.	A “driver diagram” provides framework for tracking activity of all partners according to programme aims. Likely to include action research, contribution analysis, and ‘person-centred principles’ as a reflective tool. Quarterly reports to Programme Board and Person Centred Portfolio Steering Group
Practice and Partnership Development Programme	Internal to the ALLIANCE and reported to Scottish Government.	Approach in development. Self evaluation using a range of methods. Evaluation framework is being developed to track progress towards outcomes.
Primary Care Development Programme	Partnership between ALLIANCE and RCGP Scotland. Steering group chaired by Professor Mercer from Glasgow University.	Scottish Government meets with project on a bi-monthly basis with six monthly reports on progress.

4.14 During the review process we found some examples of outcomes-focused planning and reporting. This could be mainstreamed to strengthen the evidence about the impact of the ALLIANCE. A new Strategic Partnership Agreement would potentially allow the ALLIANCE to agree clear strategic outcomes with the Scottish Government, and report on these in a more consistent way.

Strengths in the current funding relationship

4.15 Those we spoke with in the ALLIANCE and sponsorship representatives identified a number of strengths in the current funding relationship. In particular, they said that:

• The ALLIANCE has strong working relationships with a range of Scottish Government teams and the Joint Improvement Team. People spoke of trusting relationships, mutual respect and close working.
• The ALLIANCE is responsive to emerging needs. It works well on the development of new ideas, projects and programmes. Some highlighted that the ALLIANCE had been understanding about the challenges faced by Government. The ALLIANCE was also seen as an organisation which could readily provide advice, expertise and support when needed.
• The ALLIANCE’s values, approach and language are very much in keeping with current Scottish Government policy in relation to long-term conditions, self management and the quality strategy. A number of those we spoke with highlighted the important role the ALLIANCE had played in shaping this policy area.
• In a number of policy areas, the ALLIANCE is perceived to have very effectively delivered projects and programmes. A number of those involved in funding the ALLIANCE felt the organisation could be relied on to deliver agreed objectives, and provide good value.
• Some of those we spoke with highlighted that the ALLIANCE is skilled at reporting on its key activities and consultation findings in a clear and readable way.
• According to the ALLIANCE, receiving core funding directly from the Scottish Government has allowed it to build a very strong staff team, and plan its business more effectively. This was seen as having been critical to the success of the ALLIANCE in recent years as it has enabled it to focus on national policy developments. It has also allowed it the flexibility to respond to emerging needs, and even reduce the costs of specific programmes with the Scottish Government, where funding is more limited.

“We benefited from working with the ALLIANCE.”
Sponsorship representative

“The ALLIANCE is a very flexible organisation.”
Sponsorship representative

Areas for improvement in the current funding relationship

4.16 We asked ALLIANCE representatives and those with sponsorship responsibilities about aspects of the funding relationship that could be improved. They spoke about a number of connected issues:

• There are a wide range of different approaches to developing proposals between the ALLIANCE and the Scottish Government. Funding agreements cover different funding periods and have varied financial processes, monitoring, reporting and governance arrangements. This complexity leads to a lack of clarity and consistency – for example, in the relationship between core and project funding management charges.
• The large number of funding streams, sponsorship arrangements and financial processes is resource intensive from the ALLIANCE’s perspective. There was recognition that the approach is also demanding on Scottish Government resources.
• While the ALLIANCE produces very good reports, and has supported the development of outcomes-focused evaluation for the Self Management IMPACT Fund, its other reports are more activity-based. The outcomes-focused approach could be mainstreamed, allowing the ALLIANCE to further strengthen the evidence about its impact.
• The short term funding has at times left the ALLIANCE in a vulnerable position, with staff and others concerned about the future of particular programmes and staff positions. This creates uncertainty for those involved, and undermines the value of the ALLIANCE’s work.
• Sponsorship representatives as well as some policy stakeholders and members drew attention to tensions relating to some elements of Scottish Government funding, where the rationale for commissioning the ALLIANCE or other intermediaries to carry out specific projects was not clear. There are opportunities for the Scottish Government to address these issues.
• There are opportunities to strengthen the links between the different Government funded programmes and core work and to share learning.

4.17 The ALLIANCE and sponsorship representatives felt that a new, outcomes-focused strategic partnership agreement would offer the opportunity better to articulate strategic outcomes, report in a more outcomes-focused way, and underpin future funding discussions.

Developing a longer term, outcomes-focused strategic partnership agreement

4.18 We spoke with ALLIANCE staff and a range of sponsorship representatives about the potential advantages and challenges in moving to a new, outcomes-focused, longer term partnership agreement.

4.19 Throughout our discussions interviewees made many similar points about the strengths and challenges with the current arrangements. There was recognition of the particular problems associated with what is now a complex funding landscape, which lacks strategic focus and clarity. In this sense, a new Strategic Partnership Agreement offers the opportunity to:

• move to a more outcomes-focused approach to planning, evaluating and reporting;
• streamline funding time frames and processes; and
• rationalise sponsorship and governance processes.

4.20 It was felt that this could support:

• a continuing strong relationship with the Scottish Government;
• stronger governance and improved accountability for funding;
• greater clarity about the ALLIANCE’s strategic focus and the relationship of all its programmes to this;
• reduced administration and better use of resources; and
• the ALLIANCE to plan its business in a more sustainable way.

4.21 During the review process, sponsorship representatives identified wider Scottish Government approaches which could support the future funding relationship. We heard about examples of other sponsorship relationships which were being underpinned by more strategic approaches, and rationalised financial management processes.

4.22 An internal Scottish Government advisory group for considering incoming third sector propositions to Health and Social Care Directorate has recently been established. This development may offer opportunities to further strengthen the funding relationship with the ALLIANCE.

4.23 Sponsorship representatives also identified potential challenges in streamlining the existing funding and programme governance arrangements:

• Some of the existing programme governance arrangements allow relevant programme stakeholders to be involved. Moving to a single programme governance structure for all the ALLIANCE’s Scottish Government funded projects and programmes may not be desirable – although there was agreement that this could be streamlined to some extent.
• Some projects are supported by wider funding programmes which may have specific requirements in terms of planning, monitoring and time frames.
• While those we spoke with recognised the value in providing longer term funding, officials identified challenges which would need to be overcome in order to commit to funding beyond the current Spending Review cycle.
• If it is too detailed or rigid, there is a danger that any new performance framework will undermine the partnership relationship, and reduce innovation.

“The new partnership agreement needs to reflect the partnership relationship.”
Sponsorship representative

4.24 It is hoped that a new focus on shared outcomes (as part of a new strategic partnership agreement) will provide the right balance between having a clear strategic focus, and allowing room for innovation and flexibility to respond to new developments.

Draft outcomes

4.25 As part of the review process, we worked with the ALLIANCE to develop a draft “outcomes map” for the organisation, which is included as Appendix Two. This built on previous work carried out by the ALLIANCE. Although in draft form, it could helpfully form the basis for future discussions with the Scottish Government as part of the partnership agreement development process.

Summary

4.26 In 2013-14, the ALLIANCE’s total estimated expenditure was £7.8 million.

4.27 According to information provided by the ALLIANCE, the Scottish Government provided £700,000 in core funding and £2,474,218 of project funding during 2013-14. In addition, the ALLIANCE received £2,000,000 from the Scottish Government over this period, which it was responsible for awarding to others through the Self Management IMPACT Fund.

4.28 Sponsorship representatives had many positive views about working with the ALLIANCE. They spoke of it being a flexible, responsive organisation, which had supported progress in a number of policy areas.

4.29 The varied approaches to funding awards, timeframes, planning, monitoring and evaluation, governance and sponsorship processes has led to a complex picture. In turn, this has created a lack of clarity about what is being funded, and the difference being made. In addition, the variable processes and short term nature of the funding is resource intensive and creates uncertainty for the ALLIANCE.

4.30 A number of sponsorship representatives and the ALLIANCE broadly supported the principle of moving towards a new, more strategic agreement and associated sponsorship processes. They felt it could overcome some of the issues with the current model. However, they also identified practical challenges which would need to be overcome.