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commISSIoNINg                                                                                                                                                                                                           commISSIoNINg
                           IS THErE ANy poINT                                                                                 engagement often promoted through   commissioning decisions.             A quote from a contributor to the
                                                                                                                              ‘discovery sessions’. As long as the
                                                                                                                                                                                                       Guardian Social Care network puts
                                                                                                                                                                  Understanding that is also crucial
                           To commISSIoNINg                                                                                   invitations are open there is no    to good commissioning and also       the point succinctly:-
                                                                                                                                                                  to developing flexible and
                                                                                                                              danger of falling foul of even the new
                                                                                                                              procurement regulations.            responsive services.                 “Those holding the purse strings and
                                                                                                                                                                                                       making the funding decisions need to
                           mike Webster poses this question and comes to the conclusion that,                                 The key skills are in pulling together   Organisations like the Care     respect those who need caring for...
                           yes, there is a point to commissioning when it is a creative force that gets                       ideas and creating an environment   Quality Commission now use           Compassion and understanding
                           the best out of people and organisations.                                                          where providers feel on an equal    ‘Experts by Experience’ and as a     at the highest levels are what is
                                                                                                                              footing and safe enough to speak
                                                                                                                                                                  result their inspections have gained
                                                                                                                                                                                                       needed. When that happens things
                                                                                                                              openly. Such discussions can die a   credibility and their findings are   may change.”
                                                                                                                              painful death if because of commercial   harder to argue with.
                                                                                                                              sensitivity providers are not prepared                                   It’s no good saying it takes too
          o be honest, I’m not sure        establishing systems that mean, even in   structure (Commissioning Cycle)          to share ideas or good practice.    Real user involvement                long or finding the right people is
       T that anyone would admit           hard times, for local government at   bring a rigour to service development        It is not unknown to hear complaints   Involving people in all areas of the   too difficult.
       to having had the ambition          least, the money has not quite run out.   and crucially evidence-based reviews.    that commissioners do not include   Commissioning Cycle can similarly
       to be a commissioner when           In fact in the early 1990s and the                                                 providers in discussions but then,   strengthen both the result and      So the answer to my question,
       they grew up. Add the goal          introduction of community care the   A key skill is being able to harness          when the opportunity is offered, they   allow changes and good practice   ‘Is there any point to commissioning?’
       of doing the role in today’s        system would have cracked without    creative ideas and adapt them.                use it to take notes for future tender   to be introduced at all stages.   is yes, when it is done well.
       social care or health economy  some financial expertise. Let’s not forget  The ideas may not be new but                submissions and are unwilling to talk   Much time and energy is given to   Certainly there are skills and
       and it is even less likely.         that social security funding of private   being able to re-invent and implement    in front of the ‘competition’.      the high profile aspect of initial   knowledge that are needed.
                                           residential care was out of control.  them in a different setting is a                                                 commissioning and service            There is also an underlying
       However, there are no shortage of jobs                                   precious talent.                              Good commissioning needs            procurement but often the real       theoretical base and process
       with commissioning in the title and   According to the Daily Mail,                                                     co-operation from all sides.        dividends occur through on-going     to follow.
       seemingly no shortage of applicants.   social workers interfere when they   Dangerous                                                                      review (and contract management).
       Finding a common idea of what       shouldn’t and ignore when they should.  Commissioning, when it works well,         Users of services know how it feels    That cannot effectively be done   But the most undersold skill is
       commissioning is and should do is   Yet they form a critical part of the   can simply be about pulling together        to be on the receiving end of       without real user involvement.       an ability to ‘hold the ring’.
       much harder. Blurred lines are all too   system when they work well.     ideas and using them to offer solutions                                                                                Commissioning can become
       easy to find between people who say   Skilled assessment and solution    to new problems. It becomes dangerous                                                                                  a creative force that can
       they commission and those who       finding assists both at the wider    when commissioners think they know                                                                                     get the best out of people and
       procure and contract. Health and    strategic level and in making        best and have all the answers.                                                                                         organisations. It can also bring to
       social care commissioning adds      arrangements that are individual and                                                                                                                        life the often over-used concept
       another layer of complexity.        often economical.                    Reasons given for keeping to this                                                                                      of co-production.
                                                                                apparently safe approach are:
       There is no doubt that provider     Is there any redemption                                                                                                                                     The best services are those with
       organisations, users of services (and   for commissioners?               • It takes too long to consult                                                                                         the best input, centred on users’
       probably readers of this article) often   Most commissioners come from social      or engage;                                                                                                   needs and experiences, and the
       feel that they know more about what   work, management or business                                                                                                                              worst are those put together in
       is needed than those who are paid to   suggesting that commissioning is a   • It’s too difficult to find the                                                                                    ignorance and isolation.
       commission. Put more                ‘bolt on’ to other skills and professions.      right people;
       bluntly they are                                       Although some                                                                                                                            Mike Webster is Assistant Director,
       sometimes seen as                                      qualifications are   • Social/health care is too complex                                                                                 Health & Adult Services,
       just another layer                                     starting to emerge     to involve people;                                                                                                North Yorkshire Council.
       of bureaucracy       At its best, commissioning        these are a long
       that leaves fewer   can build on a range of ideas      way behind;       • Procurement rules do not
       resources in          and through a structure          for example,         allow providers to influence                                                                                         crEATIVE
       an already             (Commissioning Cycle)           procurement          service specifications.
       stretched system.     bring a rigour to service        (MCiPS – Member                                                                                                                           commISSIoNINg
                            development and crucially         of the Chartered   Use of these excuses is both arrogant                                                                                  IN THE fAcE of
       With the              evidence-based reviews           Intuition of      and short-sighted. Expertise comes in
       public sector                                          Purchasing        many forms and no-one, especially                                                                                       bUDgET cUTS
       and especially                                         and Supply) or    commissioners, have the monopoly
       local government                                       an MBA.           on it.                                                                                                                  Mark Stables, Commissioner for
       facing unprecedented financial                                                                                                                                                                   Services for People with Learning
       restraints the incentives to be a   Health and social care organisations   Provider organisations know most about                                                                                Disabilities in Portsmouth, talked to
       commissioner are few and far between.  therefore have a strong (and probably   how to provide services. On issues                                                                                Seán Kelly about how he is dealing
                                           expanding) commissioning section     around workforce, logistics and even                                                                                    with a £3 million budget cut
       Unpopular                           made up of people from varying       simple things, like putting together an                                                                                 but is still determined “to make
       As often with unpopular professions   starting points which contributes   effective staff rota, they are likely to                                                                               things happen”.
       (or dare I say ‘scapegoats’?) this is   valuable diversity and potential for   offer both efficiency and innovation to
       fine until you try to do without them.   innovation that is desperately needed.  a service.                             This adaption of the ‘Ladder of Involvement’ contrasts the jargon that is often used   This article in Volume 29, No. 3
       We could surely do without                                                                                              with (on the right) how that actually feels for people                   can be accessed from our website:
       accountants but their advice and    At its best, commissioning can build   Good procurement and commissioning           Source: New Economics Foundation – Ladder of Participation – Arnstein 1969  www.cl-initiatives.co.uk
       guidance has been invaluable in     on a range of ideas and through a    should involve early market

      24      Vol 29 No 4 | Summer 2016     Community Living                                    www.cl-initiatives.co.uk     www.cl-initiatives.co.uk                                                Community Living      Vol 29 No 4 | Summer 2016     25
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