What is it?
Commissioning is a process, not a thing. When operating well, commissioning is a systemic process whereby local need is identified and provision to meet that need is secured within local financial constraints and with the meaningful participation of service users. Commissioning is dependant upon needs analysis, planning and contracting and is not simply a procurement exercise. It also requires review and adjustment in order to maximise positive outcomes for children.
Who is generally responsible for doing it?
In the main, commissioning in social care has been in the domain of the NHS (and primary care trusts in particular) and local authorities. Increasingly, collaborative working through children’s trusts is resulting in a joint commissioning approach.
Who else is often involved?
Alongside the statutory agencies, commissioning often involves colleagues in the voluntary sector who are commissioned to provide specific services. More critically, they are involved in the review and adjustment of provision based on outcomes. Young people and their families are also crucial participants in the commissioning process. But developing such a collaborative approach takes time and commitment and outcomes will not be immediate, so expectations must be managed.
What does good commissioning in children’s services look like?
Good commissioning is a healthy and transparent process. It includes service user participation, clear expectations of providers, regular discourse and review, and an openness to change and adjustment. Good commissioning will deliver value for money and quality services tailored to local children’s needs. Ultimately, good commissioning results in improved outcomes for children.
What does bad commissioning look like?
Bad commissioning is a lack of meaningful involvement on the part of those using the service, poor operational relationships across all parties, and an over-obsession with cost as opposed to outcomes. Equally, the lack of a “mixed economy” of provision could reflect unimaginative commissioning. When it feels like bean-counting and number-crunching, it’s time to think again!
What is the impact of limited budgets or budget cuts on commissioning?
You can only commission what you can afford and it has to be done in the real world. All commissioning activity must take place within transparent fiscal constraints. But commissioners must also be wary of voluntary sector partners, for example, providing more than they are commissioned for. Full cost recovery has begun to address this, but budget cuts in particular can leave projects fragile and vulnerable, which will ultimately have an effect on outcomes.
Can commissioners of children’s services also be good providers?
Yes. Good practice is good practice and the same principles of user participation, analysis of need, monitoring of provision and outcomes are relevant to all providers, be they in-house or external. Increasingly, in-house providers are having to exist via the commissioning process and a set of clear expectations and agreements.
What are the key policies and documents a good commissioner should know by heart?
There is a huge range of useful material available, particularly on the Department for Education and Skills website, which concentrates on many examples of good commissioning practice (see below). But the most crucial documents are your local plans and strategies and, in particular, the local children and young people’s plan. Contributing strategies, such as those linked to child and adolescent mental health services and tackling teenage pregnancy, are also very important, as are recent inspection and joint area review reports. Fundamentally, if you’re commissioning services which are not priorities in these documents, your methodology is flawed.
Chris Martin is service manager for partnerships with Havering Council’s children’s services directorate