Tees Valley Pilot Workshop 3 Commissioning

Lisa Williams, BOND Consortium member and Independent Consultant

• 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 2004Joint Planning and Commissioning Framework for CYP and Maternity Services 2006

Patient/ public

Petitions

Published prospectus

Review service provision

Assessing needs

Seeking public and patient views

Managing performance (quality, performance, outcomes)

Referrals, individual needs assessment; advice on choices; treatment/ activity

Managing demand

Shaping the structure of supply

Designing services

Deciding priorities

National targets

Look at outcomes for children and young people Look at particular

groups of children and young people

Commission – including use of pooled resources

Identify resources and set priorities

Decide how to commission services efficiently

Monitor and review services and process

Develop needs assessment with user and staff views

Plan pattern of services and focus on prevention

Plan for workforce and market development

Phase 1Needs assessment and strategic

planning

Phase 2 Shaping and managing the

market

Phase 3Improving performance,

monitoring and evaluating

NHS - Building on ‘World Class Commissioning’ DH 2007http://www.ic.nhs.uk/commissioning

Identify needs

Outcomes?

Plan and design pattern of services

Look to the market - Does it provide what

we need?Tender & Procure

Disinvest?Develop market?

how well is the service delivering

outcomes?

What have we learnt

about needs?

Resources? Priorities?

Strategic process for allocating resources

• 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

• 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 Principles may include…

Weak Commissioning

Historically and provider led

Little effective challenge

Adequate Commissioning (status quo)

Good control over existing contracts

Narrow approach to commissioning around procurement and purchasing

Effective Commissioning

Commissioners engaging with communities on the pattern of services required

Commissioners shaping structure of delivery

Active redesign of services

Personalisation

Decommissioning

Intelligent Commissioning

Maximise value from total local public sector budget

Outcome driven

Empowering users and local communities

Widespread embracing of behavioural change

Some community led commissioning

Semi-autonomous personalisation

Driven by customer experience

Aiming to be here….

Many organisations operate here

REACTIVE COMMISSIONING

• ‘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?

• ‘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?

• 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

• 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?

• 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?

– 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?

• 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 TOUCHWebsite: www.youngminds.org.uk/bond

Email: bond@youngminds.org.uk

Telephone: 020 7089 5050