At the conclusion of the research phase a detailed analysis of the data (see Section 2) was shared and presented to the core provider group and a group of senior officers representing Commercial, Adult Operations and Commissioning. Both groups met separately to discuss the analysis and agree possible areas for improvement (AFIs) before attending a joint session on 10 October 2016 (see Appendix A).  At this session seven areas for improvement (AFIs) were agreed in principle on the basis that more detailed work was required on how these might be taken forward. 

The group also agreed to take some initial actions to be completed by the end of December 2016 whilst awaiting a set of more detailed recommendations. These actions were as follows:

1. The merger of EICA and CPN and the desire to grow the new association to represent more providers, particularly larger providers;
2. To re-invigorate the ESB Care Sector Group, the ESAB Care Provider Network and to continue to develop  the locality provider forums, building on the concept of 'the right people, having the right conversations, at the right time';
3. To develop a forward plan that ensures providers can shape the agenda of key engagement meetings/groups, and advice is given to how this should be done;
4. Clarifying roles and responsibilities and who and where decisions are made that affect  providers;
5. To arrange an initial  strategic   discussion with care providers to discuss some of the '6 month challenges'  linking this to a way of drawing in more providers into the relationship management  work and the renewal of EICA/CPN network; and
6. A joint communication should be sent out to all relevant officers and care providers related to the outcomes of the meeting and the project overall.

If the majority of providers and officers wish to move forward from the current situation, and this review suggests that they do, it will require drive, focus and effort from all parties.  This initially 

will need to come from the leaders of both sides, building on those providers and officers that have already been instrumental so far in bringing this project to fruition. 

Initially, we would encourage incremental steps in order to rebuild trust and ensure whatever joint actions are agreed to take forward first are delivered successfully and made known to everyone.  As confidence and trust grows then the pace of change can be accelerated.  We do not see why, with the right commitment from both sides, that most of the recommendations set out in this report cannot be implemented within 9 to 12 months.

We have argued the cost for doing this would be small due to the overall efficiencies it would create as well as improving the quality of decision making between providers and ECC. This in turn will ensure strategies and plans for delivering services to SUs will be stronger and more robust in an increasingly unstable environment.We think the window of opportunity to make the changes required is limited because of three reasons.   Firstly, hope and expectations have been raised by this review and some good will has returned to relationships between providers and ECC. This needs to be built upon quickly to re-energise and give further hope that both sides do want to find better ways of working together; secondly, the merger of EICA and CPN is a welcome development but must be seized upon to make it a success and to support the development of a single provider voice in Essex. This will greatly enhance engagement work and provide a stronger platform for driving change and integration; and, thirdly, if through improved relationships life is not made easier for providers, they will increasingly walk away from LA work and this will reduce capacity further, drive up costs and push down standards of care.

We have a 'vision' for the care market in Essex and this will not be achieved without improving relationships between care providers and ECC.

In summary this will require:

• Buy-in and leadership to make the recommendations in this report real, starting with a serious and unified commitment to the 'New Deal';
• Care providers, and their leaders, to grow their capacity and capability to enable the majority of providers to engage and work more effectively with ECC both strategically and operationally;
• ECC officers to trust, respect and involve providers more in the work that affects them most which, in turn, will require officers to pay more  attention to the day to day, as much as to setting out a clear direction for the market and being more honest about what can be achieved in the current environment; and
• All sides to recognise that improving relationships will not happen overnight but is eminently achievable as well as necessary.