Stronger partnerships for better outcomes - improving relationships between commissioners, providers and people who use services and carers

by Bill Mumford

Bill Mumford is Chair of TLAP's National Market Development Forum, which is working with partners to facilitate a greater choice of affordable, locally available, responsive services that people want. In his day job, Bill is the CEO of Macintyre and Chair of the Voluntary Organisations Disability Group. In this week's blog, Bill launches the new TLAP protocol for market relations.

"A plague on both your houses..!"

The dying words of Mercutio who was fatally wounded in a dispute between the feuding houses of Capulet and Montague, in Shakespeare's Romeo and Juliet, has been utter in frustration many times and in many different ways by individuals and families seeking support from feuding local authorities and provider organisations. In their eyes it is further evidence of professionals behaving badly, protecting their own interests, not listening and ultimately not caring; it certainly doesn't feel very personalised. Yet we professionals are appalled to be characterised in this way and as we fight each other to claim the moral high ground individuals and families are constantly telling us that they feel excluded and devalued.

In response to this criticism the National Market Development Forum which is part of the Think Local, Act Personal partnership has produced a protocol; a set of principles and good behaviours that is intended to enhance effective ways of working between people and family carers, service providers and local authority commissioners. Sharon Allen, Chief Executive of Skills for Care who chaired the task and finish group which produced the protocol comments:

"It recommends a co-production approach to local commissioning of care and support which fully complements Making it Real: marking progress towards personalisation and community-based support"

The protocol contains strong statements such as:
"..It should be incumbent on the statutory organisations involved to set the example for the behaviour expected...through their communication and behaviour...." And for all professionals to: "Create the space and conditions for positive, courteous and respectful engagement....".With the purpose of creating: "... mutual trust in other's intentions and abilities." So the three perspectives of people, carers and families, service providers and commissioners need to be brought together in a conducive and non antagonistic way.

It builds on the market facilitation model developed through the National Market Development Forum last year. Market facilitation is defined as:
"..the process by which commissioners ensure there is sufficient appropriate provision available at the right price to meet needs and deliver effective outcomes both now and in the future."

It follows a three stage process: firstly, gaining an understanding, then plan and finally, take action. All the evidence points that this is most effective if done well within a trusting partnership based on mutual respect and shared risk. The principles of engagement are clearly set out and then the key behaviours required of everyone involved.

The principles are:

• Sharing the risks - the building of confidence is essential to encourage change and innovation
• Reducing bureaucracy - hands up who really understands how Resource Allocation Systems work? The focus needs to be on outcomes not process as people and families say there is nothing more tiresome and irritating than listening to professionals obsessing about themselves
• Building Capacity and Skills - of all stakeholders- professionals will be trusted more if they are confident enough to admit they need to learn too!
• Understanding Success - being clear what you are each trying to achieve at the outset and agreeing what a win/win/win looks like. Win/lose outcomes are only for one off, never to be repeated exchanges and are therefore to be discouraged.

A series of scenario-based workshop exercises - Commissioning the Future: workshop materials to start a new conversation between people, providers and commissioners of services - have also been developed as part of this work. These are designed to support the adoption of the working principles and behaviours advocated in this protocol.

I should like to thank Sharon and her task and finish group and also the important contribution made by the North West Transition Alliance group facilitated by In Control and Groundswell in completing this work.

• Stronger Partnerships for Better Outcomes: A protocol for market relations
  This is a set of principles and good behaviours that is intended to enhance effective ways of working between people and family carers, service providers and local authority commissioners. The Protocol...
• Commissioning the Future: workshop materials
  This series of five workshop scenarios have been designed to help those involved in strategic commissioning to rehearse and explore new ways in which the public care market might develop. The Commissioning...