Overview of commissioning independent advocacy
This section aims to provide an overview of good practice in commissioning. It draws on work from:
- the Institute for Public Care, Oxford Brookes University
- the Institute of Local Government Studies, University of Birmingham
- the Care Act and Care and Support Statutory Guidance.
In this section
I think sometimes we can get too stuck on, 'Okay, we’ve commissioned a contract for this through IMCA, commissioned a contract for IMHA, got one for NHS complaints advocacy and now we’ve got one for Care Act advocacy.' We want to encourage people to think creatively about the different duties.Co-production workshop participant
What is commissioning?
‘Commissioning’ is a broad concept with competing definitions. For our purposes, it represents a systematic approach to planning and resourcing public services. The aim of all social care commissioning activity by local authorities is to achieve the best possible outcomes for the community as a whole and for individuals who require care and support.
This includes people who may need care and support at some time in the future. Commissioning should ensure that there are personalised approaches to meeting people's needs, in all services and settings. It must also achieve the best value and comply with legislation.
When we say commissioning, we don't always mean buying a new service, but what it might be is looking at a number of different options to fill the demand that might come along with these new duties.Co-production workshop participant
This resource provides a clear definition of commissioning:
This resource provides guidance for commissioners that may help them support providers during the COVID-19 pandemic:
- Commissioning and COVID-19 (SCIE)
The Care Act did present local authorities with a number of challenges in relation to commissioning advocacy services, not least ensuring there is enough provision to meet current and future demand, along with making sure that advocacy services can be aligned and developed with other ongoing developments in assessment and review. However, the commitment to commission in asset-based ways presents opportunities to develop statutory duties as well as collaborate to deliver them.
While there are many models of commissioning and purchasing available, they all fundamentally break down into four key areas (illustrated below):
- Analyse: understand the values and purpose of the agencies involved, the needs they must address and the environment in which they operate
- Plan: identify the gaps between what is needed and what is available, and decide how these gaps will be addressed
- Do: secure services and ensure they are delivered as planned
- Review: monitor the impact of services and ensure any future commissioning activities take the findings of this review into account.
Importantly, commissioning and procurement are closely linked. Take a look at the illustration below.
Highlighted in the outer circle are commissioning activities. They must inform the ongoing development of procurement activities, which are illustrated in the inner circle.
Each set of activities are grouped against the four elements of the commissioning cycle and are equally important, and these must be equitable and transparent – offering opportunities for all stakeholders to influence the types of service provided.
Market shaping and commissioning for advocacy
The Care Act itself does not specifically mention commissioning, but it is included in the vocabulary of the chapter of the statutory guidance ‘Market shaping and commissioning’ and is seen as a core part of implementing the changes proposed by the Act.
The Care Act promotes the following commissioning principles:
- focusing on outcomes and wellbeing
- promoting quality services, including via workforce development and remuneration and ensuring appropriately resourced care and support
- supporting sustainability
- ensuring choice
- co-production with partners.
Commissioners may use the Care Act as an ongoing opportunity to review all advocacy services within their area, and to further develop strategies around how best to meet the needs of their local population.
Standards for good commissioning
Here we reproduce the key principles of good commissioning identified by the Commissioning for Better Outcomes programme at the University of Birmingham in partnership with Think Local Act Personal.
Good commissioning is:
person-centred and outcomes-focused Open
- promotes health and wellbeing for all
- delivers social value.
- is co-produced with people and their communities
- promotes positive engagement with providers
- promotes equality.
well-led by local authorities Open
- demonstrates a whole-system approach
- uses evidence about what works.
an advocate for a diverse and sustainable market Open
- ensures diversity, sustainability and quality of the market
- provides value for money.