ADASS / SCIE Seminar
02 July 2014
‘Care Act 2014 & Commissioning for Better Outcomes’
Commissioning for
Better Outcomes
Jon Glasby and Catherine Mangan
June 2014
Work so far
Literature review
 Interviews with 21 key stakeholders from a range
of perspectives – representatives of national
organisations, commissioner, provider and social
care users
 Two workshops at the ADASS Spring seminar
 Five stakeholder events: prevention, coproduction, market development, outcomes
based commissioning, workforce

Initial findings

Ambiguity of terms
– Commissioning
– Co-production
– People using social care
Findings from literature review
Evidence base for the impact of commissioning is
patchy and under-developed.
 Wealth of guidance and good practice to drive
quality and outcomes for health and wellbeing for
people using social care services and their carers.
 Often not clear on what basis examples of good
practice are being cited.
 Conclusions about how commissioning is working to
achieve better outcomes is limited.

Wicked issues
Financial pressures, increased expectations and
demographics
 Lack of evidence of impact for commissioning
 Challenge of meaningful co-production with social care
users, family, carers and communities
 Integrated commissioning and the need to adopt a
whole life, whole system perspective
 Potential tension between personalisation and
population focused commissioning.
 Intelligent use of information and data limited by
capacity, accuracy of data held and
information sharing issues

Wicked issues
Changing the relationship with providers
 Prevention or diversion?
 Tensions around cost and quality
 Economy of scale or granularity of services?
 Disproportionate attention given to the needs of
particular groups
 Challenge of equity
 Outcomes based commissioning – how to do it
and likely impact
 Workforce - commissioner capacity
and provider staffing quality

Draft principles – good commissioning……
1.
2.
3.
4.
5.
6.
Is supported within local Councils
Is coproduced with people and their communities
Promotes health and wellbeing for all
Focuses on outcomes
Is person centred
Is integrated with other public services
Draft principles – good commissioning……
7.
8.
9.
10.
11.
12.
Uses evidence about what works
Promotes equality
Delivers social value
Facilitates the diversity and quality of the market
Ensures sustainability
Provides value for money
Developing the standards

Two key areas:
Good commissioning is championed within local
councils
 Good commissioning is integrated with other
public services

Example: Good commissioning is supported through the leadership,
values and behaviour of elected members, senior leaders, and
commissioners of services. It is underpinned by principles of coproduction, personalisation and integration.
Example: Good commissioning coproduced with people and their
communities. Co-production is a relationship with social care users; their
family carers and communities that is underpinned by the principles of
equality, diversity, accessibility and getting something back from putting
something in.
Developing the standards
 What standards would you want to see?
 What might excellent/good/acceptable
look like?
 What evidence would you expect to draw
on?
 What format would be of most use?
 How could you use the standards?
Next steps
 Development of standards
– by end August
 Testing in areas in September –
volunteers??
 Development of peer challenge approach
 Launch at NCAS conference – October
Contact
#commissioning4outcomes
Jon Glasby
J.glasby@bham.ac.uk
Catherine Mangan
c.mangan@bham.ac.uk
Twitter: mangancatherine
ADASS / SCIE Seminar
02 July 2014
‘Care Act 2014 & Commissioning for Better Outcomes’