The flaw in the heart of commissioning
The commissioning of services for individuals and communities by public sector bodies is now normative practice and increasingly defines the boundaries of the modern state.
With the expansion of commissioning has come the need to ensure that it is done as effectively as possible – that when services are commissioned, they achieve the best possible results at the best value.
This has led to a wave of local authorities positioning themselves as commissioning councils in recent years and, although there are some technical differences between definitions, broadly speaking they all follow a similar cycle, albeit with an emphasis on different stages of that cycle. They key challenge for the organisations that accept commissioning is a helpful mechanism is: 'what next?' By continuing to diligently follow the cycle, the savings required of local Government will not be realised and so a new philosophy is needed to help stimulate what has become an embedded, and in some cases slightly fatigued, practice. Commissioning itself is not outdated but perhaps the accepted thinking that drives it is.
This need to ensure that commissioned services are as effective as possible led to the development of outcome-based commissioning. Originally developed by third sector organisations who wanted to be able to articulate the impact of their services rather than describe the volume of service they provided, outcome-based commissioning seeks to measure the changes that services achieve rather than what outputs they deliver. More forward thinking commissioners have recognised the value in this approach and, increasingly, are using outcome measures when managing contracts.
But, while outcome-based commissioning is no doubt an effective and powerful improvement over “output based” commissioning models as previously (and still) practiced there is an unacknowledged problem at the heart of this approach – and indeed within commissioning more generally.
Commissioning as currently practiced - including outcome-based commissioning – is still predicated on a deficit model of human need. It is founded on an approach in which services need to be commissioned for and on behalf of people who are expected in turn to be passive recipients. Whilst great strides have been accomplished in consulting and engaging communities in the design of services, commissioning ultimately sees services as a way to “fix” people and communities.
But this deficit model of commission-to-fix is becoming increasingly strained in these times of continued austerity, and the problem with trying to meet increasing needs with fewer financial resources means we enter “more for less” territory.
“More for less” are arguably the three words we hear more than any other from the voluntary sector. It can sometimes seem that charities have to choose between no funding or funding to do more than they possibly have the capacity to deal with. This, for many obvious reasons, is a dangerous path to tread.
But is more for less the only solution in these challenging times? We believe that communities can add real value to the commissioner-provider relationship through co-production and in doing so, move away from the current deficit, more for less model.
Co-production is the idea that people and communities should not solely be viewed in terms of deficits. Co-production is about seeing people and communities as active agents who have value in themselves. Co-production points to a new approach to commissioning in which the power of outcome-based commissioning is used but while harnessing the understanding that people are not just problems to be fixed but that they possess assets that can be used to drive even better outcomes. We are proposing aligning the power of outcome-based commissioning with co-production to create a new approach to commissioning: we call this Asset-Based Commissioning (ABC). For commissioners, this means stopping the mantra of more for less and learning that different for less can be effective.
ABC: A new approach to commissioning?
So what is Assets-Based Commissioning? It is an approach that starts with what works. It starts with the good bits in your community, the skills, resources and people and places that achieve positive things in your community. This means, in the Analysis stage of Commissioning, rather than asking “What’s the problem” or “What’s not working” commissioners should be asking “What’s great about our community? What are the assets?” The assets could be the small things: the independent community café, the church crèche, the person willing to run a street party or cook a meal for someone. What if these people and places could come together to solve outcomes you can’t meet with money alone?
Current deficit-based commissioning views those in receipt of commissioned services as vessels that need to be filled with what is offered by providers. But what if we viewed service users as assets in the community? What if they could be given a useful role to meet the problem they present?
As a simple example, preventing, reducing or delaying socially isolated adults entering into the social care system is a goal for every Local Authority wrestling with the Care Act. In traditional commissioning, the aim is to “fix” the issue by procuring a service that meets the assessed need. But with fewer resources, we have to look at different ways of achieving the same outcome without a more for less approach – asking providers to undertake more work for less money. Using an ABC approach would mean that commissioners would aim to build on the assets of the community being “fixed”. What if socially isolated adults that we wanted to delay entry into social care could be engaged into volunteering, for instance at a local crèche, reading children stories, talking to parents or simply being there to enjoy the interaction of others? Will all socially isolated adults be able to engage? No. But could some? Absolutely! This is the process of transforming a need into an asset. And what if we asked these adults and the crèche to design the service? The role of the commissioner would be less of a designer of services but more of a connecter of assets in the community, allowing communities to design the services that best meet their needs, and which they can be actively involved in delivering.
In all cases where we’ve seen inspiring, sustainable and asset-based solutions to commissioning to achieve better outcomes, two things have been in place:
- Genuine co-production - bringing residents and service users into the creative process of service design
- A focus on community assets where commissioners work hard to know what’s available in the communities they serve and work towards mutually beneficial arrangements that meet the outcomes of communities and clients
Could the future of commissioning really be as simple as 'ABC'?
Mark Napier – Managing Director, The Centre for Public Innovation
Chris Parker – CEO Volunteer Centre Sutton