Tees Valley Pilot Workshop 3
Commissioning
Lisa Williams, BOND Consortium member and
Independent Consultant
Definition
• Commissioning is about ensuring the right people and
services are in the right place at the right time for all
children, young people and families. It is the overall
process by which services are planned, investment
decisions are made, delivery is ensured and
effectiveness is reviewed. DfE
• Commissioning is simply the process used to decide
how we spend available funds to achieve particular
outcomes.
• Commissioning requires a number of separate but
interlinked activities
Every Child Matters – Children’s Act 2004
Joint Planning and Commissioning Framework for CYP and
Maternity Services 2006
National
targets
Monitor and review
services and
process
Look at outcomes
for children and
young people
Commission –
including use of
pooled resources
Identify resources
and set priorities
Plan pattern of
services and focus
on prevention
Phase 1
Needs assessment and
strategic planning
Published
prospectu
s
Assessing needs
Develop needs
assessment with
user and staff
views
Plan for workforce
and market
development
Decide how to
commission
services efficiently
Look at particular
groups of children
and young people
Deciding
priorities
Review service
provision
Designing
services
Petitions
Patient/
public
Seeking public
and patient
views
Managing
performance
(quality,
performance,
outcomes)
Phase 2
Shaping and managing the
market
Referrals,
individual needs
assessment;
advice on
choices;
treatment/
activity
Shaping the
structure of
supply
Managing
demand
Phase 3
Improving performance,
monitoring and evaluating
NHS - Building on ‘World Class
Commissioning’ DH 2007
http://www.ic.nhs.uk/commissioning
Commissioning models – variations on a theme
Strategic process
for allocating
resources
Identify
needs
Outcomes?
Resources?
Priorities?
What have
we learnt
about needs?
Plan and design
pattern of
services
how well is
the service
delivering
outcomes?
Look to the
market - Does
it provide what
we need?
Tender &
Procure
Disinvest?
Develop
market?
Different levels of ‘commissioning’
• National and regional – low volume, specialist,
complex
• Strategic local e.g. on the basis of the whole
population needs
• Community or partnerships e.g. school clusters,
local services etc
• Large organisation – sub-contracting
• Individual schools (individual departments)
• Personal budgets for individual cases/needs
Commissioning Principles may include…
•
•
•
•
Outcomes focused – decisions
Evidence based - decisions
Transparent and fair – processes
Contestability – where appropriate to drive innovation
and select the best in-house or external provider
• Challenge – to in-house and external practitioners
• Value for money – of all services
• Performance management – for all services
www.commissioningsupport.org.uk
Commissioning practice varies widely…….
Intelligent
Commissioning
Many organisations
operate here
Maximise value from
total local public sector
budget
Effective
Commissioning
 Commissioners
engaging with
communities on the
pattern of services
required
 Commissioners
shaping structure of
delivery
Adequate
Commissioning (status
quo)
 Good control over
existing contracts
Weak Commissioning
 Personalisation
Empowering users and
local communities
Widespread embracing
of behavioural change
Some community led
commissioning
Semi-autonomous
personalisation
Driven by customer
experience
 Decommissioning
 Narrow approach to
commissioning around
procurement and
purchasing
 Historically and provider
led
 Little effective challenge
 Active redesign of
services
Outcome driven
Aiming to be here….
REACTIVE COMMISSIONING
Commissioning and the VCS – how well are you
doing?
Questions for commissioners
• ‘Understand’
– have you involved VCSOs?
– VCS access to local knowledge
– VCS access to ‘harder to reach’ groups
• ‘Plan’
– do you know about existing VCSO services
and what they provide and to who?
– What do you want the local ‘market’ to look
like? Gaps? Areas for strengthening?
Questions for commissioners
• ‘Do’
– Can you help develop services through
procurement processes e.g. can small specialist
services compete with large?
– Have you allowed time and support for VCSO
tendering?
• ‘Review’
– Have you specified appropriate service delivery
outcomes?
– Are you acting on the information you have to take
remedial action where it is needed before critical?
Benefits of involving CYP in commissioning
• Better services - driven by feedback from people who
use them
• Not wasting money – CYP know what works and what
doesn’t
• Making services CYP friendly and accessible
• Gaining expert insight about diverse needs and the
barriers faced by marginalised and vulnerable groups.
• Improved accountability to CYP as stakeholders
• Direct benefits to CYP themselves – including increased
knowledge of services, confidence, skills and networks
Questions for VCS providers
• Understand
– Are you clearly articulating unmet needs in an
accessible and understandable format?
– Do you know what works (evidence)?
• Plan
– Do you provide clear, accessible and
persuasive information on what your service
does now?
– Can you articulate and evidence the outcomes
you achieve?
Questions for VCS providers
• Do
– Do you prioritise tendering – time, skills and activity?
– Have you built relationships that matter to future
tendering?
– Collaborate rather than compete?
• Review
– Do you collect and analyse process and outcome
data and information?
– Are you acting on the information you have to take
remedial action where it is needed before critical?
What added value can you offer?
– Volunteer capacity (how cost effective is this?)
– Organisationally held knowledge and expertise
– Non-profit making – will this demonstrably make it
cheaper than the competitor’s?
– Local brand (how strong is your brand? What is
the perception locally?)
– Accessibility and less stigma - how do you
demonstrate the benefit?
– Attract other funding – have you promoted your
track record?
Characteristics of success
• Leaders who understand the agenda
• Providers who are clear about what they
can deliver to whom, and the outcomes
• Relationships based on knowledge and trust
• The routine engagement of statutory
providers, commissioners, VCS and CYP,
parents and carers
• VCS organisations which understand the
commissioning world
BOND Learning from Practice. 2012, to be published
GETTING IN TOUCH
Website: www.youngminds.org.uk/bond
Email: bond@youngminds.org.uk
Telephone: 020 7089 5050