At a Glance…
In 2024, Peopletoo partnered with the London Borough of Harrow to understand the future potential that can be achieved through commissioning, establishing specific opportunities to deliver an excellent outcome for people and to be financially sustainable.
The first phase was a diagnostic of commissioning potential to identify opportunities for Adult Social Care (ASC) services. The second phase focussed on what Harrow Council will need to do to achieve these opportunities, resulting in an analysis and design of commissioning capacity for the Council. While the first phase focussed exclusively on ASC, the second phase considered an All-Age Commissioning service.
The Challenge
Harrow Council was investing almost £10m in ASC across three years, £9m of this to increase the budget for older people and working age adults disability placements. Even with the increased budgets, handling spend on placements was an increasing challenge. A key responsibility of ASC commissioning is managing this spend by shaping the local market to meet the needs of ASC, ensuring people achieve good outcomes in an efficient and effective way.
In addition, the CQC assurance visit highlighted gaps in commissioned provision, including the need for out-of-borough placements for more complex cases and a lack of culturally appropriate or specialist homes. It also noted that people’s views were not consistently included in assessing service quality, and there was an over-reliance on spot purchasing.
Our Approach & Delivery
Over four months, Peopletoo worked closely with the Council to carry out a diagnostic and develop solutions that realise the full potential of effective commissioning. Key elements of our approach included:
Outcomes Achieved
We identified over £8m of financial savings opportunities that commissioning could achieve. Key opportunities included:
To realise the identified opportunities, the minimum critical functions were established within an All-Age Commissioning function, and three costed structures were developed to support their delivery. Any of the three new structures proposed require some investment but considering the opportunities identified, the investment could bring a rate of return of 9:1.
