Following the recommendations by the Independent Review of Adult Social Care, the Scottish Government worked with a range of partners to develop ethical commissioning and procurement principles.
The Scottish Government’s adult social care ethical commissioning policy team then commissioned Iriss to work with a range of partners on developing an implementation plan with priorities to ensure the ethical commissioning principles become reality. One of the priorities was to develop training and support for commissioners.
Iriss is now running an Action Learning Set for commissioners on implementing the ethical commissioning and procurement principles. Commissioners and procurement leads from 14 Health and Social Care Partnerships have signed up to the group which has been meeting monthly.
Local authority commissioners have complex roles and are responsible for planning and commissioning social care support services. Their role may also involve: managing budgets, gathering data on local needs, working in collaboration with providers and individuals, managing contracts and quality assurance, and working with social work, finance, procurement and contracts teams across the local authority. Commissioners are also often responsible for reporting to the Integration Joint Board and ensuring support services are financially sustainable and deliver support to meet the needs and outcomes for individuals receiving social care support.
Outcomes
This project is part of the national implementation plan for ethical commissioning and
will meet the following outcomes:
- Commissioners have increased knowledge, skills and confidence in their commissioning practice
- The Scottish Government Adult Social Care Ethical Commissioning team and partners have a clearer sense of commissioning as a distinct profession and the skills and knowledge required to commission ethically
- Scottish Government and partners have a foundation on which to build future more formalised training in partnership with larger training focussed organisations
What commissioners told us they wanted support with…
Before the project started Iriss asked commissioners what they needed support and training with. These are the issues they highlighted and have formed the themes for the sessions of the Action Learning Set:
- Commissioning for Outcomes
- Collaborative and Alliance Contracts
- Procurement and collaborative contracts
- Costing Support
- Contracts and Contract Monitoring
- Decommissioning and Redesign of Support
Commissioners said…
‘It would be good to see what best practice looks like, but in each of the different care groups and care settings, and work on improving language in competitive tender documents.’
‘Work on innovations for commissioning (how to use the money we have and do better with it). Meeting the recommendations of the Feeley Independent Review of Adult Social Care in Scotland.’
‘Undertaking an ethical approach while maintaining financial sustainability.’
What have been the main challenges for commissioners
Commissioners have highlighted a number of challenges they are facing which are mainly focused on lack of resources and restricted budgets. Implementing change or making improvements to the way support is commissioned (planned) and purchased is difficult when the main focus is on reducing budgets and ongoing efficiency savings. These are some of the challenges raised by commissioners in the group:
- Lack of finances and resources, restricted budgets have made it difficult for local authority commissioners to focus on innovation or practice change
- Collaboration with providers and individuals takes time and is not always part of the commissioning and procurement process from the start
- Legal advice has sometimes focused on risk averse practices and bureaucratic contracts getting in the way of outcomes based commissioning or flexible support for individuals
- Procurement practices still vary across different HSCPs with a traditional focus on competitive tendering and competition still being implemented in some areas whilst many areas are adopting light touch regime or more flexible contracts
Progress and practice change
Many local authority commissioners and procurement leads are making good progress with implementing the ethical commissioning principles. Members of the group shared many examples of progress they are making on collaboration, service redesign, developing flexible and outcomes based contracts, moving from contract monitoring to a learning approach focussed on quality, and working hard to improve outcomes for individuals receiving support. These are some of the examples shared by commissioners:
- Embedding collaborative processes, focussing on improving outcomes for individuals and implementing fair work and self directed support
- Commissioners are working hard to make progress on moving from competitive processes to more collaborative approaches, using outcomes based flexible contracts and involving individuals and providers in commissioning plans and even in tender evaluations
All of the commissioners have spoken about the importance of working on ethical commissioning and continuing to work to improve the lives of individuals receiving social care.
This project is hosted by Iriss and funded by the Scottish Government.
