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commissioning
Get creative with commissioning

Focusing on ‘basic needs’ is the worst thing a commissioner
could do, argues Mark Stables. Bold approaches in the face of
budget cuts are the only way to provide sustainable services

re we “living in troubled times”? work that social workers do with users and
i was once asked by someone carers to achieve certain outcomes.
awanting a meaningful discussion. That sounds straightforward but it is often
in terms of social care, anyone would misunderstood. Now, more than ever, we
agree that we are. need to be clear about commissioning and
We would probably also agree that a big what we should and should not do.
part of this is there is not enough money. Statements set out everything that
It is so tough that we get a mention on the people find difficult so they can get
news along with health and education. support in these areas. A need is not
Peter Gilbert, a great advocate of social something that I can’t do. A need is what
work, wrote: “Our task as social workers is gets in the way of achieving an outcome.
to look, see, think and speak positively As part of the SEND reforms, statements
and beat the predictions of pessimism.” of need have been replaced by education,
To be hopeful is not about wishful health and care plans. Statements set out Above and below left: Raki Chowdhury exhibits
thinking. It is about being clear about our everything that people found difficult in his work at Sotheby’s
response to problems and being order to get support in those areas. EHCPs
determined to try always and never give up. from 14 years focus on outcomes in work, assisting people to have the outcomes
Glen Garrod, the president of health, relationships and independence, they want – those that they have often
Association of Directors of Adult Social making what they want clear and offering been denied the opportunity and support
Services, has encouraged commissioners support to realise their goals. The Care Act to realise. You cannot ration human rights;
to have “more swagger” and he is right if 2014 talks about the role of social care in they do not apply only some of the time.
he means we need a confident approach. delivering these outcomes.
This requires us to be clear about our role What does this mean for Being presumptuous?
in addressing the situation we are in and commissioning? It means “need” cannot Commissioners need to design stuff that
upholding the values that underpin what be reduced to something a person cannot will deliver outcomes. In Portsmouth, we
we do. do or cannot do without. decommissioned 70% of day services and
When funding falls, it means we cannot used the money freed up to support
Big picture think of our role as keeping body and soul services and activities that provide
Commissioning is about putting things in together and meeting basic personal care opportunities in work, health,
place to meet people’s needs. This can needs. It means we should not reduce day independence and relationships.
mean drawing up contracts, working on the services across the board or ration them. The approach was met with some
big picture and plans for day opportunities The role of social care is to support criticism. It was seen by some as
or housing and support. It also covers the people’s human rights, which means presumptuous: how did we know this is
what people wanted? We were absolutely
clear that people with a learning disability
wanted to focus on these outcomes
because they are what we all want. It will
mean different things for different people
but no one wants to be ill, have purposeless
days, have no friends or be dependent.
The transformation has been remarkable.
The services now feel as if they belong to
the people who use them, and their
confidence has grown across the board.
many more people are in work settings,
social enterprises are flourishing and
people who were often passive recipients
of support are now active contributors to
their communities. Projects have been Lara Arnott, Sotheby’s: Sotheby’s images
developed by service users. A recent sign
of success was that the police approached
a local service because they knew this was
a group that helped people.

14 Vol 31 No 4 | Summer 2018 community Living www.cl-initiatives.co.uk