The Lancashire Mental Health and Social Care
Partnership Board
Made up of representation from Local Authorities, NHS Trusts, the Third
Sector, Service Users and Carers
‘Working together to improve mental health’
The Lancashire Partnership
Commissioning Model:
facilitating third sector participation
Dr Christina Lyons and Michelle Lyons
Faculty of Health, University of Central
Lancashire (UCLan)
Rationale
 2006 public consultation on future of mental health
services
 Service user and carer aspirations for more choice
 Limited third sector provision of mental health services
Who is the model for?
 Usual suspects:
 Commissioners, finance and procurement officers, informatics,
contract monitoring officers




Third sector organisations
Service users, carers, members of the public
Practitioners (including students)
Businesses
What is the model?
 Framework and toolkit supported by evidence and
values
 Whole commissioning process not simply procurement
 Wider social and economic aspirations
What is the model?
 Evidence based – literature and field observations
 Values based – openness, transparency, fairness and
respect
 Field tested
 Mapped against World Class Commissioning
competencies
What is the model?
 Framework outlines three sequential phases:
 Pre-procurement
 Procurement and contracting
 Post procurement
 A systematic process
 Toolkit with detailed guidance
Commissioning Framework
Pre-procurement phase:
analyse and plan
Procurement phase:
do
Timescales
Service specification
Bidder feedback
Project
implementation
Procurement planning
Evaluation / contract
monitoring
Stakeholder
engagement
Procurement process
Impact assessment
Service user & carer
involvement
Contracting
Lessons learned
Health needs
assessment
Research
Financial modelling
Service model &
outcomes
Market stimulation
Post procurement phase:
review
Third sector feedback
 Lancashire Third Sector Consortium for Mental Health
(LTSC)
 Miracle question
 Developed a wish list
Do
commissioners
plan far enough
ahead?
Are commissioners
adequately
resourced?
It is then the role of
providers to specify
how they intend to
meet the need
Any changes that are made
should be based on an inclusive
needs assessment
Commissioning
resources
Service need/capacity
should be quantified
by commissioners and
included in the service
specification
Commissioners should
review all services in an
area before making
changes
Strengthen capacity
building initiatives. Build
consortia capacity –
funding for a network of
TSO’s.
Arrangements for monitoring
should be agreed at the
outset/commissioner specify
their expectations
More notice should be
given to allow TSO’s
time to prepare as
they don’t always
have the same
resource to allocate to
tendering
Improved
consultation,
separate events for
providers, SU/
carers
Commissioners
should broaden views
from the community
Commissioning
steering groups – little
TSO representation
Third Sector Wish List
Transparency regarding
funds available for the
tender
Improved
commissioner
communication
skills
Commissioners
should learn
lessons from best
practice
Outcome measurement – there are
TSO and
many measurement tools that can be
commissioners
used – would be good if
could jointly
commissioners understood more
develop
Set up provider
about outcome measurement
group – open measurement tools
invitation to work
LPB train cohort of
with commissioners
service users/carers
Be aware of SU/carer allegiances
to develop their
to sit on
with certain providers, try to ensure
tender process
commissioning panels
objectivity when scoring tenders
Service specification
should be clear to
understand
commissioner
More creativity from
commissioners about
how solutions could
be provided
More detail should be
given at the
Improve timescalesexpression of interest
for tender
stage
application,
presentation etc
Lack of notice for
tenders
Tender feedback –
could use a proforma
2 way feedback – but a better
mechanism that doesn’t damage
commissioner/provider relationship
Third sector provider
group – sit along side
steering group, for
any TSO to attend to
find out about the
commissioning
process
Longer spec
development period
beneficial – pilot
Bidders should be
funding to test
allowed to clarify their
models of working,
understanding of
specs that allow for
terms used by
innovation
contacting the
Early warning signs of
forthcoming tenders
Realistic
implementation
phase i.e. more
than 3 days
Move towards
outcomes
TSO’s could be used as a
consultative body in a
paid capacity, to help
define needs.
Contract monitoring
Commissioners should
have a better
understanding of costs,
17-18% running/
management costs is
realistic, not 10-12%
All the relevant
information is required
in order to create a
level playing field
amongst providers
Commissioners should take into
account the value of TSO local
knowledge
Commissioner should
give early warning if
they feel the provider
Commissioner &
Full Cost Recovery
is not meeting the
provider to collect
– a Compact way of
conditions of the
info, collate and
working
contract
compare
Produce tender
prospectus with
annual timescales
Pre-tender stage –
early notification of
commissioning
intentions
Ability to appeal if you feel your
tender presentation addressed all
requirements but you were
unsuccessful in your bid
Timescales
 Annual prospectus to indicate commissioning intentions
over the forthcoming year
 Distribute prospectus to all stakeholders
Timescales
Third Sector
 Consider which tenders
are most appropriate
 Increase bid quality
 Collaboration
Commissioner
 Proactive
 Planned
Market Management
 Develop the market
 Capacity building
 Market stimulation
 Reciprocal relationship between commissioners and
third sector
 Choice agenda
Market Management
Third Sector
 Services tailored to needs
 Opportunities for
development and
innovation
Commissioner
 Mixed economy
 Choice
 Quality
Contract Monitoring
 Monitoring service user outcomes
 Information and data collected is used more
effectively/purposefully
 Inform future service developments
 Service user role in contract monitoring
Contract Monitoring
Third Sector
Commissioner
 Expectations clearly
articulated
 Problems can be rectified
 Opportunity to
demonstrate quality and
effectiveness
 A useful exercise
 Quantitative and
qualitative feedback
 Demonstrate
effectiveness and efficient
use of resources
Service user & carer engagement
 Engagement at the right time for everyone
 Continuous programme of engagement and involvement
 Open and honest communications
 Transparency
Service user & carer engagement
Third Sector
 Maintain understanding of
local contexts
 Understanding service
user aspirations
Commissioner
 Harness creativity
 Innovative solutions
 Meet requirements of
World Class
Commissioning
Next steps
 Snap shot of the model
 Model dynamic and will change in response to feedback over time
 Toolkit being prepared for publication
 Contact details:
 clyons2@uclan.ac.uk
 michelle.lyons2@nhs.net
 01254 282229
 Questions