LaingBuisson's recent Social Care Summit NORTH and Innovation in Care brought together leaders across health, care, commissioning and the community to address the unique challenges and innovations of social care. 

With ever increasing pressures on budgets and the workforce, it would have been easy to fixate on the negatives. However, a carefully crafted programme and passionate speakers showed how a focus on local solutions is a driving force for good.

A system which supports and enables

The repeated challenge put forward at LaingBuisson's conference questioned how we reconcile the design and delivery the health and care ‘system', whilst acknowledging that true equity relies on a highly personalised system of care.  If we viewed this ‘system’ as a community resource, we might be better placed to help people flourish.

With current commissioning practice and a ‘purchasing’ mentality, we run the risk of rewarding an industry which imposes itself upon people and sacrifices personalisation in favour of process and efficiency. We need to find a way to work with the economic reality when asking “How can the system best serve you?”

Better commissioning

With more providers in attendance than commissioners, it comes as no surprise that panels found fault with current commissioning practice. Notable exceptions included:

• Lancashire County Council, which has partnered with Alternative Futures Group to invest in technology solutions that address both care and housing needs;
• Wakefield County Council that has taken a risk on new delivery models had frank conversations to say ‘If we fail to invest in solution X now, what will the alternative cost us in the future?’; and
• Wigan County Council, heralded as an example of good co-production - where long-term investment in staff culture has resulted in strong, local relationships with key stakeholders.

There was a plea for commissioners to invite providers into the room, so that they can share valuable insights into the needs and wants of their local population. If viewed as true delivery partners, their insight and expertise can help identify the processes that will result in better value for money.

One top tip shared with providers was to engage with and support their local, grassroots provider associations. Commissioners are focussed on local solutions to local problems, and those relationships are worth the investment. 

What do you look for in a partner?

Pre-market engagement gives commissioners an opportunity to present their wish list to providers and to identify the drivers for good competition. When done correctly, a good tender exercise should compel bidders to put their best offer on the table. If making a distress purchase, best value principles will lose out to fear of the unknown and the need to price in risk on both sides.

Commissioners and providers are missing out on key information which could be easily disseminated at the end of a contract or framework term. Reflecting on the contract and service delivery:

• What insights did the parties gain into the local population?
• What worked well and could be replicated in future? 
• Where are the opportunities for improvement?
• What motivated each party to work through unexpected challenges?

A dedicated feedback session enables genuine co-production. Both commissioners and providers need a forum to discuss how funds are best spent and make sure their expectations are aligned. 

New ways of thinking 

With the Procurement Act 2023 now in force, commissioners can use its flexible procedures to select providers based on quality and suitability rather than rigid price criteria. 

Service-user panels and service specification co-production can ensure the contract meets real needs. Commissioners can make use of local expertise by encouraging providers to propose their own service delivery models, as long as they meet outcome targets.

 Dynamic Markets can facilitate the continuous onboarding of qualified providers and the removal of underperforming suppliers, ensuring flexibility and responsiveness to changing service demands. Provider forums can encourage best practice,  cross-service collaboration, and enable providers to address challenges collectively.

All of these innovative approaches to commissioning will help local authorities fulfil their market shaping duty under section 5 of the Care Act 2014 and their duty to regard to the importance of maximise public benefit under section 12 of the Procurement Act 2023.