Commissioning in Children's Services: What works?

Study author Simone Vibert (2016)

At a time when greater responsibility is being placed on local authorities, not just to deliver services, but to shape, plan and facilitate them, effective commissioning is one of the central skills that local authorities need to hold. Commissioning can be described as an art, not a science; there are no simple rules that can be followed. Instead, the commissioner must use a range of skills in order to increase the chances of successful service provision. These include technical skills, such as being able to make sense of data, but also soft skills, such as being able to build relationships with diverse stakeholders.

Aims and methodology

This mixed-method study used evidence from a review of the literature, two case studies and interviews with professional experts; to identify what works well when commissioning children's services. The review also focuses specifically on innovations and responses to failing children's services.

Findings

This research has sought to identify what successful outsourced children's services tend to have in common, and what pitfalls exist that can prevent outsourcing in this area from working well. There are three key messages that can be drawn from this study:

1. Commissioner-provider relationships are critically important to the success of outsourced children's services. Where these relationships are collaborative, with high levels of communication and trust, and mutual respect between both parties, outsourcing tends to achieve better outcomes.
2. Engaging with the wider community when making changes to the way children's services are delivered. For example, by calling on community members to help define outcomes. With this, local authorities can help fulfil two objectives: improving their focus on outcomes; and improving their engagement with the wider community. The paper suggests that the new What Works Centre for Children's Social Care could play a role in guiding local conversations such as these. See the article from SCIE's Ewan King on commissioning and children's services.
3. Responding to failure. The research suggests that outsourcing may not be the best way of responding to failure or cutting costs, and that using outsourcing in these circumstances can undermine its effectiveness. For the purpose of responding to failure, measures such as mentoring, performance management and a longer-term review of outsourcing processes may be more appropriate. However, if a local authority is required to outsource rapidly in the context of a perceived failure this research suggests that there are measures that can be taken to improve the chances of success:
   Expertise from elsewhere can be brought in to enable the local authority to learn from others where outsourcing has been successful;
   The local authority might be supported by being incorporated into a consortium. However, removing a failing local authority from its own responsibilities would miss out on an important developmental and learning process for that failing local authority.

What works?

Three common factors/features/components that outsourced children's services that are working well have in common include:

Having strong relationships. This was found to be key in a number of contexts, not only commissioner-provider relationships, which are critical to the success of outsourced children's services. Also important are relationships within and between local authorities, and relationships between a given local authority, providers and the local community. For example, several respondents to the survey cited one of the top three pieces of advice they would give to local authorities looking to improve their commissioning, as having greater engagement with the market.

Using data effectively. The evidence in this review shows that commissioners who make strategic use of data tend to secure better outcomes for the children and young people in their area, compared to those that do not.

Having clarity on outcomes. The evidence here shows that a strong focus on consensually agreed outcomes is a typical feature of local outsourced services that have worked well, giving all parties involved in planning and delivery a clear vision of what they should strive towards.

Pitfalls to avoid

When it comes to the things that get in the way of good commissioning, three themes emerged:

• Underfunding - the fundamental impact of budget cuts is that commissioners are forced to make decisions on the basis of cost rather than quality. In effect, it reduces the range of placements offered (as standard placements are favoured over specialist offers), meaning those who suffer most are vulnerable children and young people.
• Using outsourcing only in the context of failure. The research here suggests that outsourcing may not be the best response to failure, in that failure does not always create the right conditions under which outsourcing can succeed. Commissioning outsourced services is complex, time-consuming and currently under-supported. It is not easy to get right at the best of times, and certainly not always when a local authority is in crisis.
• Poor planning. Preparation is critical to the success of outsourcing; and the decision to outsource should mark the start of a long period of planning, piloting and transitioning to the new system.

Conclusion and limitations

Outsourcing can be successful but only when relationships are strong, when data is used effectively, and when outcomes are clearly defined and worked towards. The traps of underfunding, poor planning and using outsourcing as a response to failure must be avoided.

Everyone involved in commissioning and delivering children's services needs to share knowledge, to support each other, and to work to cultivate better understanding and support from others, with the particular aim of developing an outcomes-based approach.

A more positive, proactive approach to commissioning, making it part of a collaborative and outcomes-based improvement process, is the only sustainable way of improving children's services country-wide against a backdrop of reduced resources and growing demand.

Implications for practice

The findings from this review, which can help policy makers and practitioners to exploit the benefits of outsourcing while minimising the risks, include:

• Local authorities and central government should consider adopting an "outcomes first" approach to outsourcing, so it is seen not as a way of responding to failure or cutting costs, but as a way to improve outcomes in a planned and strategic manner.
• Local stakeholders, including community representatives, facilitated by local authorities, need to define what desired outcomes ought to be for looked-after children and children with complex needs in their area: Working in this co-productive way brings two key benefits. First, relationships between all parties involved will be improved because participants will be able to put names to faces, and will have a greater understanding of each other's viewpoints; second, it will create a coherent vision and mission, for all those involved in children's services, to strive towards.
• Local authorities should prioritise data collection across their children's populations, costs and outcomes, as a central plank of market shaping - and commissioning strategies.
• A new national children's social care forum is suggested, to bring people together to help develop outcomes-based strategies, and to identify ways of cutting costs while maintaining quality and promoting innovation.
• A Commissioning Support Programme is suggested, to support commissioners to learn from the latest developments in commissioning and to continually refresh their skills, plus gain from other's insights and advice.
  
  Click here to read more in the Commissioning Children's Services Special Report

FURTHER READING

Arranging Services for People With a Learning Disability and Behaviour That Challenges: A Quick Guide For Commissioners, National Institute for Care Excellence & SCIE (2018)

Commissioning Independent Advocacy, Version 2, SCIE (2015)

Commissioning Advocacy Under the Care Act: Emerging Good Practice, SCIE (2016)

www.scie-socialcareonline.org.uk Use Social Care Online to keep up to date and search for new research, policy and guidance related to commissioning