Commissioning: understand, plan, do, review. It sounds simple – understand need, plan what to do to meet the needs, execute the plan and then make sure its working. What could go wrong?
But when the ‘thing’ commissioned could have impact on child’s wellbeing that will have implications for the rest of their lives; the stakes are high. Add in shifting social, financial and political dynamics, a ‘dysfunctional’ children’s social care market (an uncomfortable term when talking about support for children) and lack of investment in children’s commissioning function, commissioning children’s services is very difficult.
With children’s social care spend being one of, if not the, biggest budget pressures for most local authorities, and the sourcing and purchasing of homes for children in care being the biggest cause of this, the conversation around children’s commissioning has been focused on finding homes for children in care. Often leading to a sense of ‘firefighting’ type commissioning – we need X type of homes now for Y. When I was a head of commissioning in local government, 99% of my time seemed to be about sufficiency of homes for children in our care at an affordable rate.
What this results in is knee-jerk commissioning which, while may ensure a child is safe, is often unlikely to be the best option to improve that child’s outcomes. They also come with weekly fees of £10,000+ per week – something I have noticed is becoming increasingly common the more local authorities I work with. You promise you are going to go back and find better provision, but then the next emergency arises and you are fire fighting again: to quote the country music act Jelly Roll, Smoking Section, “get so distracted fighting the alligators, that I forget to clean the swamp” (and according to Google, Ronald Reagan also said this, I’m sure there were others but I’m married to a Texan so country musicians will prevail!)
What’s more, strategic commissioning appears to have almost become a luxury in many councils. Whilst we would all love to take a long term approach to planning and managing service to meet the needs of our children and young people, ‘fire fighting’ has become the norm for many. Even local authorities with larger commissioning departments can find strategic commissioning difficult because leaders are so focused on the huge budget pressures, it’s difficult for any other decisions to be made.
But is that really a problem? What’s the big deal about strategic commissioning? Well, without it, not only are services less likely to be delivered as effectively as possible but are also unlikely to be sustainable and aligned to the strategic vision and outcomes of the local authority. So in summary, less than good outcomes for children, young people and their families.
It’s not just strategic commissioning that gets lost. Its all the other commissioning that should be going on. Children’s commissioning is not just about commissioning homes for children in care. I know. A shocker. Early help, youth justice, children’s mental health and services for children with special education needs and disabilities, to name just a few, all need a bit of commissioning.
So what can we do about it? First and foremost, leaders need to commit to commissioning. This doesn’t mean massive teams with endless resources; times are tough, we need to be lean but effective. To be effective, we need leaders who value and support good commissioning and we need to:
- Listen and engage with children – This is the most important thing for good, effective commissioning. Listening to children and young people about what really matters to them will result in better commissioning decisions. Yes: this takes time, but you don’t need bespoke workshops, you don’t even need to really plan, just join in at the local clubs and participation groups and have conversation with them. And don’t stop once the specification is written, constant feedback loops are an essential for successful commissioning.
- Ditto for families (in the broadest sense) of children and young people – as above
- Outcome based commissioning – I was hesitant to mention this as I feel it something we already know. But it would be remiss of me not to mention it. There is a lot of ‘outcome based commissioning’ that is more output than outcome based. Sometimes it is hard to measure outcomes but it is not impossible. By setting clear outcomes and measuring progress, commissioners can ensure that services are making a meaningful difference.
- Work together – the sometimes adversarial approach to providers who are ‘profiteering from our most vulnerable’ has to stop. Yes, there are some providers making obscene profits, but don’t paint everyone with the same brush. The vast majority of providers want to do the best for children and young people and they have the provision to deliver what is needed but they need to know what is needed and they need to be sustainable. The capacity of local providers to deliver high quality services is essential. Build relationships, share good practice, be genuine partners.
- Make decisions – good governance with the right people in the right room who make decisions is essential. The constant merry go round when the same discussions happen at the same panel week after week, is soul destroying. You could have the best plans following the best needs analysis but if no-one will make a decision, then nothing can be commissioned. This is a particular concern when what is being commissioned is a home or bespoke support for a child – delayed decision making results in delayed support, leading to bad outcomes.
- We’re on the same team – local authorities, ICBs, health services, schools, voluntary sector – we all want the same thing. Better outcomes for children and young people. So why the bickering? Fair funding is important, have open and honest conversations – no one is the bad guy. Decide on an approach together and apply it. Then make swift decisions and involve all partners as equals. Harness the local community, the voluntary sector, business and faith sector. Not in traditional commissioner/provider terms but as equal partners.
- Evidence based – using data and evidence is key to effective commissioning. Hard to do when data might not be the best, but use what you have – chances are there is quite a lot of good quality data already available. Talk to your data team/person – they will help. And follow the fidelity of the proven model. The approach of ‘our own version of [insert evidence based intervention] is just as good but costs less.’ It probably isn’t as good and will cost more in the long run. It is worth investing in evidence based programmes/practice. Good commissioners know when they don’t need to recreate the wheel.
- Flexibility – Good commissioning must be open to innovation and exploring new models of delivery, partnering with non-traditional providers and embedding flexibility into what we commission so it can adapt to changing needs (establishing good partnerships will help achieve this). Remember that constant ‘review’ is an essential part of the commissioning process so you will know quickly if it’s not working and can change approach.
None of the above take a lot of money. However, what all of this does take it time and commitment. Leaders need to commit to commissioning. It is essential for effective services, management of money, and achieving good outcomes for children, young people and their families.
For more information about our approach and how Peopletoo can support you and your organisation on this journey, please reach out to charlotte.humble@peopletoo.co.uk