There has been a general sense that some relationships with providers have deteriorated in the last two years due to the current financial climate; the retendering of major contracts; decisions around cost of care; the lack of clarity around the future shape of the care market in Essex; and the extent to which the current ECC structure has displaced care providers from Adult Operations as a significant amount of their dealings with the county council have been through the Commercial and Commissioning Directorates.

The Care Act requires local authorities to help develop a market that delivers a wide range of sustainable and appropriate high-quality care and support services for users in their communities to choose from. This will not be achieved without providers and ECC working in partnership based on more integration and mutual collaboration. These new ways of working cannot be achieved without good communication, mutual trust and greater openness.

There has been a steady increase in the pressures being placed on the whole care system due to increased demand, acuity and the overall reduction in resources. This has manifested itself in a reduction in capacity and concerns about quality and the overall ability to maintain and sustain a vibrant care market in Essex. There is also growing evidence that providers are starting to withdraw from local authority work because it is not financially viable.

Issues affecting relationships between care providers and ECC emerged as a significant issue when work was undertaken to look at care provider quality during 2015-16. 2 As part of developing the strategy for improving quality, relationship management became one of the four building blocks to improve quality and drive transformation and integration:

• Vision - Set out a clear vision, direction of travel and quality expectations for the market 
• Assurance - Be confident we can measure and assess the quality of the market and assure ourselves and service users and carers about the level of quality on offer
• Intervention - Intervene to support and enable providers to improve quality
• Relationships - Underpinned by more effective relationship management and partnership working based on a set of agreed 'quality principles' 

During 2014 a project led by Georgia Dedman looked at how ECC engaged with care providers and identified a number of issues that had undermined relationships. These included, messages being sent to the market that were inconsistent; a lack of clear direction and leadership; and no joined up approach and co-production to engagement events. A series of recommendations were put forward, and improvements made, but not all have been implemented to date.