What is commissioning?
The statutory guidance to the Care Act says that commissioning is:
"The [council's] cyclical activity to assess the needs of its local population for care and support services, determining what element of this needs to be arranged by the authority, then designing, delivering, monitoring and evaluating those services to ensure appropriate outcomes".[19]
Commissioning is a council's role to plan the services that are needed by the people who live in the area that it covers, and make sure that services are available.
Commissioning is not the same thing as procurement. Procurement is about acquiring services - in other words, the process of putting a service out to tender.
Commissioning involves using all the resources that are available to support people to have better and more independent lives through understanding, developing and delivering services and support across an area. Commissioning can use different ways of paying organisations for the work they do including through grants and agreements for the organisation to do certain types of work or provide a certain type of service. This resource covers a range of commissioning mechanisms, such as alliance contracting (See Lambeth Living Well Case Study) that is being developed to enable a more collaborative approach.
Services in social care have changed a lot over the last twenty years. In the past, the majority of services were directly designed and delivered by councils. In some places this still happens; but the majority of services are now provided by charities, social enterprises and private companies commissioned by councils.
Also, personalisation, that has been increasingly introduced over the last decade has led to people realising that services should be provided in ways that mean that people have choice and control over their care and support. Part of this change has been increasing numbers of people buying their own care and support directly with personal budgets and direct payments:
''At the heart of personalisation is the commitment to giving more choice and control to people using social care services. This may mean exploring personal budget options but it could also mean working with individuals in residential settings to ensure that their personal needs and preferences are identified and met. It is about self-directed support and enabling people to make their own decisions about what care and support they require to lead a full and independent life''.[20]
The Institute for Public Care developed this diagram to explain the changing roles of councils in social care:[21]
The changing role of local authorities
Post 1945
Local authority as provider of care and support
Post 1980's
Local authority as the purchaser of care, predominantly provided by others
Post 2014
Local authority as the shaper of a care market where individuals purchase care and support
Increasingly, the role of councils has changed from providing and delivering social care services to making sure that good and different types of personalised support are available.
As the statutory guidance for the Care Act says:
"High-quality, personalised care and support can only be achieved where there is a vibrant, responsive market of service providers. The role of the council is critical to achieving this". [22]
[19] Department of Health. (2014). Care and Support Statutory Guidance: Issued under the Care Act 2014. (opens new window) pp.22-23
[20] Think Local Act Personal. Making it Real: marking progress towards personalised, community based support.
[21] Institute for Public Care (2014). DCMQC Briefing Paper 1: The Basics of Market Facilitation. (opens new window) p.3
[22] Department of Health. (2014). Care and Support Statutory Guidance: Issued under the Care Act 2014. (opens new window) p.41