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Locality Commissioning - Provider Led Reviews (PLRs)

What are PLRs?

Cornwall Council and NHS Kernow are developing a system of Provider-Led Reviews (PLRs).   Home care and supportive life styles (SLS) providers who are taking part will assess the level of need of their clients. Proposed changes have been sent to:

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  • The Council
  • Kernow Clinical Commissioning Group (KCCG) 

A social worker, case co-ordinator or health assessor reviews the proposed changes. If approved, they are quickly able to be updated and changed.

This Provider-Led Review concept is replacing the FSD (Flexible Service Delivery) process.

We are now formally inviting all providers to take part in this new process.   

PLRs have freed up significant capacity to support high priority clients with unmet need.  This is critical in the current pandemic to help with system flow.  We hope as many providers as possible will take part. 

1. Register as a PLR provider

Please email registration request to contractsadults@cornwall.gov.uk. Ensure you have 'PLR Registration attention Derek' in the subject line in the first instance. You will need:

  • a current  NHS.net email address which will be used to submit the reviews.  You must have this address in advance of submitting a PLR. Don't have an NHS.net email?  Instructions on how to register via NHSnet Fastrack are at the Digital Social Care website NHSmail webpage
  • The staff who will be undertaking the reviews will need to have completed the following: 

    • Minimum of NVQ 2 in Health and Social Care 
    • Care Act and Mental Capacity Act training within the last 12months 
    • For reviews of people with Autism, the reviewer needs to have specialist Autism training. This is to be completed within the last 12 months 
  • The person submitting the reviews will need to attend a PLR training webinar where we will explain the process and how to use the assessment form.  This is also an opportunity to ask any questions about the process.

2. Complete a PLR training webinar 

The next set of training dates are now available:

All sessions will run 2pm to 3pm and places must be pre-registered.

February dates:
9th, 11th, 12th
15th, 17th, 18th, 19th
23rd, 24th, 25th, 26th

March dates:
1st, 2nd, 3rd, 4th, 5th

To take part, please provide names of staff with a preferred date to attend a webinar to contractsadults@cornwall.gov.uk with 'PLR Webinar link request - attention Derek' in the subject line. 

3. Review your packages and complete a PLR form 

Do the reviews with the person and/or their family to ensure they agree and can input on the proposals made.

Put the completed review into the PLR online form and submit.

Please review the PLR guidance document  which supports this part of the process. It will be utilised in the training webinars also.

The decision-making process varies depending on how much change is being considered:

Brokers process any changes that are 25% or less of the original care package. (Without a need for verification by a social work professional). The broker will update the purchase order and issue a new service agreement. The change is then implemented. We will then set a new review date for 12 months’ time.

Social care workers review change requests that are more than 25% of the original package. This is a desk top exercise, but if the worker needs more information, they may speak to you and the client.

A health assessor reviews all health packages. The worker reviewing the proposals can either:

  • agree to the changes proposed
  • agree with amendments, or
  • decline the proposals.

Brokers/Buyers process any agreed changes. A new service agreement is issued via the DPS system.

If you have any queries please contact contractsadults@cornwall.gov.uk in the first instance.  Please put 'PLR query' in the subject line.

A small test and learn of the PLR concept was done during the first phase of the pandemic in 2019.

Completed reviews in the first 2 months were 212. All reviews with changes under 25% of the total package had 100% approval and 94% of changes over 25% were also agreed. This told us that providers are very well positioned to undertake reviews.

The benefits of Provider Led Reviews include:

  • people have a faster response to changes in their needs. This enables better risk management and improves safety
  • reduction in 'over-prescription' which can lead to greater dependency
  • impactful work by providers who know their clients (people) well
  • more autonomy and trust around the people who care for that person

Home care providers talked to their clients and discussed their current care needs. After this conversation possible changes to the package were sent as part of the test and learn project.

A social worker, case co-ordinator or health assessor reviewed them. Throughout April and May 2019, 212 reviews were submitted and 94% were approved.

We have learnt that:

  • the process was quite manual and time consuming
  • providers know their clients well. This puts them in a good position to lead this type of review
  • providers used their skills and person-centred knowledge to make recommendations
  • improved trust with providers and commissioning body/s

After the project a series of meetings took place.  Everyone agreed it was an idea to progress.  

We developed a web-based Microsoft from which mirrors our own review documentation. This means that a provider led review is care act compliant.

Return to main Locality Commissioning in Cornwall webpage.