'No one direction' for commissioning differently?

Published in Features on 24 Jan 2023

Is there one direction for commissioning differently in social work and social care?  Is one direction the dream, or is it important to have many ways to cut it? 

That's what we explored in our December webinar which was hosted with In Control Scotland. It provided space to discuss the progress of NHS Highland in commissioning services differently in a time of change. And by differently we mean more collaboratively, creatively and ethically.

“(Events like this)... help to remove fear for some local authority commissioners. They inform. They offer opportunities for relationships to be built.“

The reshape

NHS Highland is currently working to restructure SDS Option 2 – to reshape core processes and focus on place-based commissioning. In Control Scotland has been working alongside them to increase flexibility in the implementation of Option 2. 

Scottish Government has set out eight ethical commissioning principles for organisations to apply. However, in the Highlands it was the practice that made the principles, and not the other way round. 

Ian Thomson (Head of Service: Quality Assurance; Adult Social Care, NHS Highland) told us that in the Highlands there is a desire to try out new ways of working, so people in remote communities can access and use resources that they really need. These new ways have the potential to free up social worker time with reduced bureaucratic processes, so they can focus on working closely with people and building relationships.

In Ardnamurchan and Morvern space is being made to scope the finance that people could access to redesign how sustainable support is planned and provided in the local area. We were joined by Ali Upton (Urram) and Becs Barker (Community Contacts, Carr Gomm), who shared insights into how that collaborative, community-based work is developing. Permission is given to try things out for the benefit of workers, providers, people and communities.

Ways to make it happen

For collaborative, creative and ethical commissioning to happen there is a need to:

  • Understand the context for supporting people to live a good life in their community.
  • Build strong and equal alliances between providers, supported people, and create flexible care and support plans.
  • Recognise that support usually isn’t required in regular 15-minute blocks of time and task. A contract based on an honest appraisal of what is needed to provide the right support.
  • Use the SDS Standards on promoting autonomy and review what level of resourcing workers can approve without going to an approval panel. This includes creating a suite of supports that can be made available to the individual and their worker to meet their needs.
  • Work more closely across a wider network of teams in communities, making connections and growing knowledge of what, and who, is available to form that support offer.
  • Get other colleagues on board and look at how bureaucratic processes can be reviewed or removed to allow for flexibility. 

Participants at the event also identified strengths such as strong relationships based on trust; leadership for risk taking; and seeing hope and living and working with it.

No one direction

We discovered that there really is ‘no one direction’ for how commissioning differently can take shape, or indeed a ‘right’ starting point for getting going. But don't go it alone. If you’re looking for ‘your tribe’, your people are out there and resources are available to support conversations, build relationships, identify common causes, and plan for action.

If you have any questions about the work that In Control Scotland is doing on SDS Option 2, commissioning support, or the work in Highland, contact Pauline Lunn.

Find out more about the Ethical commissioning in social care online course, or have an informal chat with Louise Bowen about how Iriss could support how you approach commissioning.

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Self-directed support in Highland - making the change together (NHS Highland Sway presentation)