Insights: Commissioning in Focus - Rutland County Council

Commissioning is a process that public sector organisations use to plan, procure, deliver and evaluate services for local residents. As a process (and also a concept) commissioning has a corporate “ivory tower” undertone and is not often connected with social work practice.

 

John Campbell and Karen Kibblewhite explore Rutland County Council’s new approach to empowering social work practitioners with the tools required to establish their own effective commissioning practices, when placing individuals with care providers.

After spending many years working within Local Authorities from frontline social workers to health and care staff, managers, directors and executives of all shapes, sizes and backgrounds, one phrase in particular stands out when we have attempted to match the ‘right’ service for each individual with value for money and ultimately, providing a sustainable model for all.

 

'That's a commissioning responsibility'

Statements like this are not uncommon, nor is the idea of social work being seen as an ‘operational’ service – the two camps are often perceived as very different from one another. So, let’s strip back commissioning to its fundamental components and ask, what is commissioning?

Like project management, the commissioning process, or the title of ‘commissioner’ can bring up complex connotations.  Project Management, in its purest form, is the management of a process (taking something from point A to B).  Similarly, commissioning is just the process of analysing, planning, doing and reviewing.  Sound familiar?

 

The key components of social work practice include:

  • Assessing the individual to identify any eligible needs (ANALYSE),

  • Considering how these needs can be met, for example through a carer, formal support, or assistive technologies (PLAN),

  • Sourcing the support through provider and brokerage conversations (DO), and

  • Checking that needs are being met through 6-week and annual review meetings (REVIEW).

 

In this case, the social worker has operated as a commissioner.  Albeit at an individual level (also called a ‘micro commissioning’).

 

 

Feedback Loop?

So how does this link to the corporate, “ivory tower” style commissioning that we all know and love?

Efficient commissioning is the micro-activity feeding back to the wider ‘macro’, and vice-versa.  There is a wealth of insight available at the ‘individual’ commissioning stage (trends, root causes to support prevention) and also some key decisions which, when made in isolation, have impacts on the whole system (and budgets in particular).

Commissioners at a macro-level can (in many cases) only respond to how care and support is being provided, analyse what is being spent, what outcomes are being achieved, and make decisions on how sustainable this pattern is, given their knowledge of the wider system and the environment.

So, more detail than ever (from individual cases, to providers in the market and future technologies) is being sought to make this process smoother, faster and more efficient.

 

Workforce Development in Practice?

The most effective method is not to burden some of the most hard-working staff, in the most pressured and challenging environment (i.e. frontline social workers) with increasing administrative expectations. 

Instead, we must recognise that the modern social worker is having to adapt to become a micro-commissioner, especially as organisational budgets are squeezed and back office functions reduced.

Therefore we must challenge, train and develop the workforce using the ‘macro’-commissioner’s toolkit, to recognise these trends and adopt new practices, not just to meet individuals’ care needs creatively, but to commission creatively as well.  This requires growth of some skills that may not have been given much focus in the past. Additional skills in the social work toolbox include:

  • Considering the whole system and the implications beyond one case (critical thinking),

  • Considering and challenging the proposed package to maximize best value (business acumen),

  • Identifying new opportunities and solutions to problems (creative problem solving).
 

It's easy to feel that endless recording of information can steal time from doing the job at hand

 

A Different Approach

In August 2016, Rutland County Council devised an innovative solution to analyse all of their macro-information, establish what an effective approach to commissioning looked like for their customers; and establish and deliver the learning and the ‘toolbox’ to their frontline social work practitioners to put this into practice. 

The first phase involved commissioning ICS to conduct a comprehensive cost review of children and adult placements funded by social care and education.

As the geographic boundary of Rutland is small, the Council had been required, at times, to utilise provision ‘out of area’ which had historically been commissioned by frontline practitioners.

The second phase, strengthening social worker knowledge and experience of commissioning, will help to build strong foundations for the future and establishes that commissioning is the responsibility of all professionals.