Supporting People commissioning has grown into a monster - we need a new approach, says John Wade
Theresa and Steve need to buy a new washing machine. They are on a budget. They have £250 to spend tops. They’ve gone down to Currys to see what they can get. They want a machine that’s white; that will fit in the space they have (600mm wide) and that has a decent spin, say 1400rpm. They find two machines that fit the bill. The Beko is £20 cheaper so they go for that. Job done. Time taken? Six minutes and 28 seconds.
The first time I heard Domini Gunn talking about Supporting People commissioning (she was at the wonderful Audit Commission at the time) she said something so refreshing; something that really chimed with our thinking at Bromford Support. SP commissioners should stop obsessing about detail and focus on what they are trying to achieve by commissioning a service. She illustrated her point with the example of someone buying a washing machine. Domini’s washing machine buyer was just like Theresa and Steve - they knew what they had to spend and they looked for the machine that gave them the things they wanted (size, rpm and price). That’s it. Simple.
Compare this with Supporting People ‘purchasing’ by local authority commissioners - which has grown into a monster. Incredibly bureaucratic and risk averse, but also obsessed with prescribing what a service must look like to the nth degree and how a provider should operate as a business:
- how many full-time equivalent support workers will be employed to deliver the service;
- how much of a manager’s time will count as support;
- what proportion of a support worker’s time must be spent ‘face to face’ with a customer;
- what constitutes ‘face to face’;
- what sort of customer involvement there must be;
- what sort of environmental policy a provider must have;
- whether there are any annualised hours clauses in our contracts of employment;
- what proportion of the cost of the service can be spent on office costs or central overheads;
- what must be included in a welcome pack to new customers.
Interestingly there is often little, if any, mention of what outcomes the commissioner wants the service to achieve for its customers or any request to see either evidence of past outcomes achieved or projections for future ones.
The other day I was asked to sign an SP contract for a service worth £30,000 a year. It was 92 pages long and nearly 2cm thick. It was the culmination of a 13-week tender process that had itself entailed a 31-page PQQ and a 102-page tender (plus 27 appendices) that between them had taken goodness knows how many hours to complete.
We have recently started working as a third-tier provider on the Work Programme. This is a payment by results programme procured by the Department of Work and Pensions. What is so refreshing about this programme is the proposition: ‘This is what we want you to achieve - if you do, then this is what we’ll pay you. How you achieve it is up to you.’
This is the fabled ‘black box’ model. No one telling providers how they have to do things; what their management ratio should be; how much time a worker should spend carrying out specific tasks, what activities will or won’t be allowed.
What goes on in the black box will vary from provider to provider and will change over time. Things will be tried. Some will work, some won’t. Customers will make their views known. Providers will either adapt their service to ensure they deliver improved outcomes for customers (and improved value for the commissioner) or they won’t. The ones that do will thrive and grow, the ones that don’t … will go out of business.
John Wade is managing director at Bromford Support
Inside Housing has a range of articles on Supporting People on our website this week as part of our Care and Support Special. See below for links to all the content.