commissioning for better outcomes julia prichard regional lead for london commissioning support...
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Commissioning for better outcomes
Julia PrichardRegional Lead for London
Commissioning Support Programme
There are Significant Challenges for Children’s Services
10 years of increased
spend
Increase in demand
10% to 30% budget cuts
Rising public expectation
Complicated by…
• CEs and politicians are likely to set efficiency targets through input-based salami slicing rather than outcome-based commissioning approaches
• Capacity and capability across central and local government to achieve efficiency savings at the same time as improving outcomes is limited
• Across government there is a lack of commercial skills, or these are not drawn into commissioning
• Small Children's Trusts must collaborate with others to manage the market and secure the best deals
• Non statutory services such as early intervention and prevention are an easy target for savings
• Children's Trust partners under financial pressure often become insular• Efficiency savings through commissioning require a thorough
understanding of resources, costs, needs and outcomes• Private and voluntary children’s services providers are vulnerable to
turbulent markets and reduced cash flow
Approaches to Efficiency
• Historic– Salami slicing and cuts– Higher thresholds to control demand– Stronger procurement and negotiation– Back office reductions– Delayering of management/recruitment freeze
• Emerging– Category management (procurement)– Shared services and collaboration– User centric design– Lean and Systems thinking– Total place – New relationships between state and citizens
How can Commissioning Help?
‘Commissioning is the process for deciding how to use the total resource available for children, young people and parents and carers in order to improve outcomes in the
most efficient, effective, equitable and sustainable way.’
Future Efficiencies – Resources
• Understanding the resources available and disaggregating budgets
• Making best use of all resources including finance, workforce, providers and the market place, buildings, the community and co-production with families
Future Efficiencies – Targeting
• Targeting the right point in a child or young person’s pathway to ensure that universal and specialist resource is used most efficiently and effectively, e.g. through early intervention
• Targeting the population that is most in need, narrowing the gap, and ensuring resources are not wasted on those that do not need help
Future Efficiencies – Mechanisms
• Improving our use of commissioning and procurement mechanisms, e.g. frameworks, cost / volume contracts, SLAs with internal services, market management, influence, co-production agreements
• Developing commercial skills across the public sector
Future Efficiencies – Whole System
• Using approaches such as Total Place to map all resources across the system that can be influenced, and understanding through life costs
• Using more sophisticated system design methods, rather than silo teams, organisations and service design
• Partnership working and collaboration with neighbours
Identifying
needs of the
local
community
Monitoring
and
evaluating
Specifying a
service to
meet those
needs
Developing a
service through a
service agreement
The
Commissioning
Cycle
What is Commissioning?
Procurement and Contracting are…• Procurement is the process of acquiring goods,
works or services from (usually external) providers / suppliers and managing these through to the end of contract.
• Contracting is the process of negotiating and agreeing the terms of a contract for services, and on-going management of the contract including payment and monitoring.
• Commissioning Support Programme guide to commissioning
• Sets out the sector’s view of commissioning and identifies the 18 most important components to get right
What are the Characteristics of Effective Commissioning?
Eighteen components of effective commissioning
www.commissioningsupport.org.uk
Find out more