Commissioning for better outcomes Julia Prichard Regional 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

Find out more