Constructive conversations: a three-way partnership

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One of the key ideas I have been promoting this year through my work with the Care Markets and Quality Forum is ‘constructive conversations’. But what is a constructive conversation?

One simple way of defining it could be a conversation which has a positive, and perhaps tangible, outcome. Have you ever been in a meeting which could be described as a ‘talking shop’ where lots is discussed, but little is done? There could be a number of reasons for this happening: a lack of clear agenda or terms of reference, poor chairing, lack of attendance of key players, or maybe because strained relationships and differences in standpoints between the parties have engendered a ‘bunker mentality’.

Co-production is a mechanism which, in our experience, can break down barriers and allow us to learn from each other, resulting in better understanding, better relationships and ultimately, better outcomes. With this in mind, commissioning or designing services in isolation seems inconceivable. People who use services, commissioners and providers are the three important and equal partners in constructive conversations.

Last year, growing concerns about the financial sustainability of adult social care reached a crescendo, heralded by reports from the King’s Fund / Nuffield Trust, Care Quality Commission and Local Government Association (LGA). It was against this backdrop that the October 2016 meeting of the Care Markets and Quality Forum was held. One of the themes that emerged was that constructive conversations between commissioners, providers and people who use services are key to ensuring that the limited resources are best employed to support the personal outcomes of those who may need it.

But this concept is not new – TLAP published Stronger Partnerships for Better Outcomes: A Protocol for Market Relations back in 2012, and it is just as pertinent today. It recognises that there are three core perspectives which must be brought together, namely:

  • people who use or will use care and support services;
  • organisations who provide them;
  • and organisations who seek to influence or secure them on behalf of others.

It was logical then, given the mandate from the previous Forum, that the Spring 2017 meeting should explore this theme further, with speakers who have been working on making ‘constructive conversations’ a reality in their localities. For example, we heard from Kent County Council who have adopted a collaborative approach to redesign Mental Health services through a competitive dialogue process.

This focus on constructive conversations struck has in fact struck a chord across the sector: In April, the LGA hosted a market-shaping event which had mature conversations between providers and commissioners as a key theme; Research in Practice for Adults (RIPfA) produced a strategic briefing on developing effective commissioner / service provider relationships and hosted a webinar on the subject in March. In May 2017, SCIE published a guide to brokering constructive conversations (in involving citizens in new models of care) and published a blog. Think Local Act Personal is now working in partnership with the Care and Health Improvement Programme to jointly develop a programme of events to support constructive conversations at the local level.

Although it is provider / commissioner relationships which appear to have become strained in some areas, in many places it is engagement with communities which has a long way to go. Constructive conversations between people who use services, people who provide them and people who commission them are critical to ensure truly co-produced and effective commissioning which serves our communities and leads to better outcomes for all.

What would you say is needed to make constructive conversations happen in your area? Please let us know in the comments.

You can find out more about the work of the Care Markets and Quality Forum, including details of past events, and how to join here.



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