Safeguarding Adults Boards – Commissioning

A SAB is not in the main a commissioning body. Primarily, SABs achieve their goals indirectly, through their agency members and through their partnerships with other boards and agencies. A SAB will want, for example, assurance from commissioning bodies that they are commissioning safe services and have the means and capacity to act when a provider does not safeguard its patients/clients, or does not do so in a personalised way.

However, SABs will have to commission safeguarding adults reviews and may wish to commission other pieces of work, including joint training, development of their websites, promotional materials and support posts. Some SABs develop strategies to describe how they will work in partnership across commissioning agencies to ensure that safeguarding is a priority. This can promote:

• consistency of commissioning procedures
• consistent specification of the expectation of provider agencies with respect to adult safeguarding
• avoidance of duplication of commissioning activity
• improved commissioning through monitoring and evaluation
• awareness among commissioning staff of their roles and responsibilities in safeguarding adults
• linking of quality assurance processes with review processes in health and social care and with providers’ internal quality assurance processes
• coordination of quality assurance processes with safeguarding processes to avoid duplication or gaps
• agencies managing large-scale investigations, which are not the direct responsibility of the SAB, having contingency plans to ensure they have the necessary additional resources available if required.

Examples of outcomes include:

• People feel safer, and those who have been involved in a safeguarding concern feel they have been listened to, have received the right information at the right time and were involved as much as they wished to be.
• People supporting those unable to communicate their views feel similarly satisfied with safeguarding services.
• People are aware of how to safeguard themselves and those they are supporting.
• Service providers implement the local procedures for safeguarding adults.
• Service providers cooperate with safeguarding adults reviews and other review processes.
• Commissioners evaluate the quality of provider services’ internal safeguarding policies and procedures.
• The SAB is assured that commissioned services are more likely to be safe.
• Commissioning activity is informed by the experience of people who use services.
• The workforce understand their respective roles and responsibilities, leading to improvements in multi-agency working and outcomes for adults who are safeguarded.
• Coordination of large-scale investigations: enquiries into individual cases of abuse and neglect are linked to enquiries into organisational abuse or neglect.

Issues to consider include:

• links to:
  • the Care Quality Commission
  • the Quality Surveillance Group (QSG)
  • specialist health services’ commissioning by NHS England
  • the commissioning of services for children and young people that will work across the transition to adult services
  • housing services
  • commissioning of other services such as domestic abuse, alcohol and substance abuse services
• utilising expertise, communication systems and resources across partner agencies
• how to engage people who use services in the evaluation of commissioning
• how the SAB will measure the impact of the strategy
• ensuring that high quality advocacy services are commissioned
• responses to whistleblowing and how these will be coordinated
• the need for support from commissioning and legal services for any commissioning activity the SAB undertakes

SABs may wish to commission some additional work themselves and secure funding to enable them to do so. This may, for example, be to test out an approach or to commission some research.

The statutory guidance reflects the need for SABs to engage with other partnerships to share intelligence, but it can also be important to share commissioning intelligence and other information between neighbouring SABs, or children/adults boards where they are separate in the same authority. For example, there may be situations in which one local authority stops commissioning services from a care provider because of safeguarding concerns, but a neighbouring local authority continues to commission. In instances such as this, sharing intelligence between commissioners could be helpful.