Independent advocacy commissioning tasks
This section seeks to enable local authorities to think through the commissioning tasks that will help them to ensure that good quality advocacy is available for all adults who are entitled to it under the provisions of the Care Act. It can be used in conjunction with the commissioning self-assessment tool found to help commissioners think through where they are now and what they need to do.
In this section
Commissioning tasks: Analyse
Collect information to understand current and future demand for advocacy Open
Work closely with local colleagues and stakeholders (researchers, public health, project leads, CCG, VCSE, etc.) to gather information and data about the likely demand for independent advocacy under the duties.
The duties of an advocate under the Care Act are also more robust than other kinds of specific engagement. They focus more on enabling involvement, and this in turn may require more time and, therefore, resources.
Analyse information to understand current and future demand for advocacy Open
Consider demand since Care Act implementation in your analysis. Include any proposed changes in the assessment and care management pathway for people with social care needs (including children in transition to adulthood), and carers, along with engagement with self-funders, and the likely impact this has had or may have on the uptake of advocacy services.
Take into account the increase in demand on the system that will accompany any implementation of funding reforms, as well as any increase in demand as people have become more aware of their rights under the Act. A good starting point is the government’s impact assessment of the reforms.
Review current advocacy provision and uptake, considering:
- who currently uses advocacy services
- what local people understand about advocacy services and the potential benefits
- the barriers people currently experience in accessing care, which may best be addressed through improved access to advocacy
- the types of advocacy services people want and need
- how people currently access services
- how they might choose to access services in the future
- what people consider to be a good local advocacy service which meets their needs.
You should analyse demand for Care Act advocacy in conjunction with demand for needs and carers’ assessments in line with the duties under the Act.
You may want to test progress locally by undertaking a review of recent assessments or reviews and applying the Care Act provisions to them.
Complete a modelling exercise to confirm practice use Open
Even though the Care Act should be embedded practice now, modelling and ongoing assessment against the Care Act duties should be based on your understanding of how these variables will affect each area.
You might consider auditing a small sample of assessments, making a judgement about their need for advocacy in light of the changes, then extrapolating these findings. A judgement could then be made about what proportion of assessments may need advocacy in the future.
This modelling exercise should include analysis in conjunction with any proposed redesign of the assessment and care management processes.
Seek out and reflect on research and good practice evidence Open
Seek out good practice in the form of quality standards to understand the quality of services and decide what mix of services will meet and continue to meet local needs. These include:
- a quality standards for independent advocacy
- The ‘Advocacy Charter’
- The ‘Advocacy Code of Practice’.
Refer to the SCIE resources on advocacy, as well as the e-learning resource. This type of reflection on good practice in advocacy should assist you in specifying the types of services most appropriate to meet demand in your area. It may also help you identify good practice that is already taking place.
Understand the resources available Open
Ensure any review or evolving plans are linked with overall departmental and corporate aims in relation to Care Act implementation to meet your advocacy duties under the Care Act and project future financial commitments based on likely demand. This is your responsibility as a commissioner of independent advocacy.
Implementation plans should have begun with an analysis of demand (as described above) and commit appropriate resources to ensure compliance with the Act on an ongoing basis.
Benchmark the costs of commissioning plans Open
Communicate with comparable local authorities to benchmark demand analysis and resource allocations around any areas of commissioning. Seek out support from representatives of different councils through the Local Government Association and the Association of Directors of Adult Social Services if you need to identify potential partner authorities or critical friends to enable ongoing quality improvement.
Develop systematic processes of co-producing commissioning Open
Refer to SCIE’s guide to co-production.
Develop commissioning, purchasing and monitoring activity alongside people who use services and potential users of services to ensure that the supply of advocates meets local need effectively.
Seek to understand current levels of supply Open
Review what happens locally and seek to understand what works well now and how this could be expanded if required. This includes what currently works well, and where there is over- and under-supply of services.
Map current provision and uptake of services against the current level of demand and the service user pathway to understand fluctuations and barriers to accessing advocacy services.
Analyse and explore the impact of any changes to advocacy services on users, and seek to understand the implications of any changes in line with the Equality Act 2010.
Analyse the local performance and demand of existing advocacy provision Open
Consider the performance of existing advocacy services in your area (statutory and non-statutory). In light of this analysis, you may decide to review the provision of all services and consolidate them into one contractual arrangement
Commissioning tasks: Plan
Develop a clear, written strategy Open
Agree outcomes for the provision of advocacy to meet Care Act duties that signal your future commissioning intentions for the local area.
Integrate the ongoing collection and analysis of demand information, good practice, financial resources, benchmarked costs, co-production and involvement plans as well as a wider analysis of advocacy in the local area to amend and review a clear commissioning strategy and/or plan.
Have a process of engagement with existing and potential providers, as well as local people who use services, around a clear strategy setting out legal duties and intentions of independent advocacy provision under the Act.
Remain vigilant about the risks of not complying with the Care Act or underestimating the possible increases in demand for advocacy services. Review contracting options and consider the use of outcomes-based service specifications that enable more flexible purchasing arrangements with providers. You may want to consider:
- arrangements in which an expected minimum level of support to individuals and core services (including awareness-raising), and a commensurate level of funding, are specified together with additional funding as demand increases
- arrangements for flexibility between different elements of advocacy provision, where these are combined, to allow for peaks and troughs
- arrangements whereby awareness-raising and service delivery are balanced: time can be spent on the former to enable your local authority to meet its duties
- joint commissioning arrangements with NHS colleagues, and with children’s services.
Facilitate dialogue with key stakeholders and potential providers Open
Develop mechanisms for ongoing dialogue with local partners (including the NHS and related local authority services) and existing and potential providers in order to build consensus on the implications of the commissioning plans for your area. These mechanisms might include forums, individual discussions, ‘meet the buyer’ events and feedback through email or online chatrooms.
It is important to involve potential providers at an early stage of the process. They will provide insight and constructive challenges to your plans.
Develop business cases for the commissioning of advocacy in line with the Care Act duties Open
Using your needs analysis, continuous assessment and monitoring, you should always model a range of options that will offer a good mix of advocacy services for your area (including maintaining the status quo). Review existing contracts to see how well they align with these models. Seek to understand the financial implications of each model.
Work with decision-makers to ensure they still understand the significance of the changes in the Care Act. Be clear about possible business risks and costs of non-compliance. Develop evidenced cases to present to senior staff and politicians.
Ensure that advocacy forms a key part of the business case and financial planning for ongoing Care Act implementation.
Develop a person-centred approach to commissioning advocacy services Open
Use co-production to assess and understand how advocacy is working in your area. This enables local people to contribute to the design of services and maximises control over services once they are established. Please see information on co-production and commissioning.
You should ensure that any current provision or future plans and strategies prioritise the ability of people to choose appropriate and proportionate support at each stage of their care pathway. Establish a clear link with your strategy for delivering Care Act duties to provide information and advice under the Care Act.
Ensure that any potential implications of new services have been analysed in line with the requirements of the Equality Act 2010.
Develop strategies for communicating commissioning issues with a range of stakeholders Open
Ensure advocacy entitlements are clearly linked with corporate and departmental communication plans for ongoing Care Act implementation. Be clear and consistent about messages to citizens, providers and staff about the process and timescales for commissioning any new service.
Commissioning tasks: Do
Review so that you have a clear picture of local providers and their strengths, weaknesses and future plans Open
Develop an understanding of providers through:
- market testing/‘meet the buyer’ events
- involving users of existing advocacy services
- site visits
- provider questionnaires.
Continue to influence the local market for advocacy Open
Engage in regular and productive dialogue with providers that encourages consensus and partnership-orientated relationships to develop services in line with your population needs, rather than the historical awarding of contracts. Continue to review, reassess and, where necessary, re-commission to meet your population needs.
Using the above mechanisms:
- work with providers to ensure diversity of available services and encourage collaboration where possible to develop the market
- work with people who use services, potential service users and providers to design services that meet the needs identified in the earlier or ongoing analysis.
Build any plans for commissioning advocacy services into market position statements, and work with providers to understand the market and the potential challenges your commissioning plans present.
Consider encouraging the development of partnerships between larger organisations and smaller, local ones. This could be developed through peer-to-peer evaluation and support or more formal consortium arrangements.
Develop service specifications and contracts that are flexible, evidenced-based, specific and outcome-focused Open
Be clear about the legal requirements for providers (see the sections ‘Background’ and ‘Advocacy duties’ in this guide). Consider and specify the requirements for organisations or consortiums to enable them to deliver this service and ensure compliance with your legal duties.
Consider the level of training and expertise individual advocates must have in relation to the wide range of processes through which they will need to support people. You should ensure that contracts allow for sufficient time and adequate arrangements for staff training and support, along with continuing professional development.
Specify the funding model for the service, and use the intelligence from the last few years, considering the growth in demand over the life of the contract and your analysis of demand and available resources. Ensure flexibility and funding stability for providers. Carefully specify the expected outcomes, developed locally with key stakeholders, including potential users of services. Specify a mechanism for ensuring the independence of the service – it is good practice to identify the means of safeguarding independence in funding agreements and contracts. This would include, for example:
- Having a clear system for resolving disputes which could be included in an engagement protocol. For example, this could allow the service to raise issues in relation to independent advocacy referral at a senior level within the local authority.
- The commissioning authority not being involved in any matters of staff deployment or discipline. This would include not trying to determine whether a particular advocate does or does not support and represent a specific individual.
Be clear about the pathway for referral/instruction in any services and about how this fits with any redesign of the assessment and care management processes of your local authority.
Specify the need for clear feedback mechanisms for users of, and referrers to, the new service, to both provider and commissioner for ongoing monitoring and quality improvement. Specify a clear requirement to collect and provide information about protected groups, in line with human rights legislation.
Specify requirements for any provider to promote and market their service, both alongside the council in its duty to provide information and advice, and independently, particularly within ‘seldom heard’ groups. Ensure contracts enable access and influence for commissioners in relation to the effective operation of the service and consider the results of feedback from referrers and users of the advocacy service.
Treat all providers equally Open
Be open and transparent about any communication with potential providers. Ensure you offer the same opportunities for communication to all, and be clear about the requirements of any procurement process you seek to pursue.
Ensure procurement and contract monitoring activities are proportionate Open
Procurement should be led by the strategic analysis of need over the life of the contract and in terms of the relationship with other services. Consider joint commissioning with other agencies including other local authorities, health services and children’s services.
Work with providers to understand how you can build flexibility into the delivery of services and the ability to respond quickly to changes in demand.
Maintain good and consistent dialogue with providers and the users of services so that issues of delivery can be picked up quickly and easily, before they become a contractual issue.
Have effective strategies and plans in place to ensure staff, people who use services and their carers are aware of and understand the advocacy offer.
Training and development for staff should now be embedded as standard so that they are aware of the changes to advocacy arrangements under the Care Act, and how this might impact their roles and responsibilities.
Review the pathways for people using services and ensure that assessment processes are effective in picking up a potential need for advocacy services every step of the way.
Work with people who use services and their carers to test approaches and develop information and support materials to enable people to access services quickly and easily if they are required.
Ensure information and guidance support continues to align with the Care Act advocacy duty.
Commissioning tasks: Review
Bring together relevant data on activity, finance and outcomes for services Open
To judge whether they give value for money:
- review the service against specified deliverables
- ensure reviews are evidence- and outcome-driven
- consider the development of service user involvement in contract monitoring
- use measures that enable you to assess uptake and demand for services in real time and to work flexibly with providers to help them respond
- use continuous feedback from people and professionals to adapt and make changes as and when required
- create mechanisms or forums for shared learning, if you haven’t already.
Develop contract monitoring processes that focus on developing relationships with providers Open
Ensure that procurement and contract monitoring activities are proportionate to risk and promote the delivery of outcomes.
Work in positive partnership with providers to understand where performance may be falling short and how they might address any issues.
Decommission services where they fail to meet outcomes Open
Consider decommissioning when services fail to meet outcomes, provide value for money, and where efforts to work in partnership have failed to improve performance. This should be evidence-based with any proposed plans for recommissioning new or different services based on a detailed knowledge of supply and demand and the needs and knowledge of people who use services.
Seek to continuously improve your commissioning arrangements Open
Keep clear and consistent records of the commissioning activities described above. Work with commissioners in other local authorities and national improvement agencies (e.g. SCIE) to benchmark your own performance and keep up with good practice. Discuss and reflect on your commissioning of independent advocacy under the Act with colleagues.
Commissioning tasks: Self-assessment tool
Complete the self-assessment tool with the checklists above.
How to use:
- Score yourself green, amber or red under each commissioning area.
- For each area you score green, record your key strengths in this area in the box provided.
- For each area you score amber or red, identify areas for development.
- Once you have completed it, identify actions to address areas for development and how and who will be taking them forward. Prioritise areas you have scored red.
- If you identify an area in which you think your authority is particularly strong, please share it with SCIE.
As well as with the frontline workforce, this assessment may be worth completing with providers, people who use the services and carers.