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A4. Relationships Between Levels Of Commissioning

A-Z of Commissioning. A4. Relationships Between Levels Of Commissioning. October 2010. Outline. Introduction and context Theory and concepts Benefits Practical tips Case study Group exercise. A4. Relationships Between Levels Of Commissioning. I. Introduction and context. Introduction.

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A4. Relationships Between Levels Of Commissioning

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  1. A-Z of Commissioning A4. Relationships Between Levels Of Commissioning October 2010

  2. Outline Introduction and context Theory and concepts Benefits Practical tips Case study Group exercise

  3. A4. Relationships Between Levels Of Commissioning I. Introduction and context

  4. Introduction

  5. Multi-level Commissioning Commissioning is practised on different levels across all children’s services partners. Different services require commissioning at different levels, depending on factors such as population, needs, service volume and price. Commissioners are therefore likely to undertake multi-level commissioning i.e. at a mixture of levels to suit the needs of different services and populations.

  6. A4. Relationships Between Levels Of Commissioning II. Theory and concepts

  7. The Different Commissioning Levels National Regional Sub-regional Area or strategic Locality or practice Individual

  8. Deciding Which Level is Best • The most appropriate level will be ultimately driven by ability to secure outcomes in the most efficient, effective, equitable and sustainable way. • The following factors will impact on this decision and the system design: • Delegation, local democracy, accountability, brokerage and control systems • Maturity of the local market and provider relationships • Safeguarding and risks • Cost of implementation and change management

  9. Personalisation • Personalisation – sometimes referred to as self-directed support - means starting with the individual as a person with strengths and preferences who may have a network of support and resources. • The underlying principle is the development of a culture and the tools to enable people to take greater control of their lives and the support they receive. • Direct payments and individual (or personal) budgets give people who use social care the opportunity to control the resources allocated to their support: • An individual budget is the amount of money allocated to meet an individual's needs. • A Direct Payment is one way a person can choose to take money allocated to them.

  10. Personal Budgets – Control Source: In Control

  11. Personal Budgets – Support Source: In Control

  12. A4. Relationships Between Levels Of Commissioning III. Benefits

  13. Benefits Economies of scale for specialist services Service competition and innovation Managing markets which cannot be managed at a lower level Meeting the needs of local communities Meeting the needs of individuals Democratisation of services, and user choice Accountability between different levels of commissioning

  14. A4. Relationships Between Levels Of Commissioning IV. Practical tips

  15. Practical Tips – Individual Ensure that individual professionals and young people / parents have appropriate (supported) access to information in order to make a commissioning decision. Provide brokerage and manage the markets at a strategic level, if required. User choice is a helpful technique to break up traditional markets that are not meeting local needs. Give responsibility for budgets.

  16. Practical Tips – Locality Provide needs assessment data to locality commissioners, to ensure they can make the most informed decisions. Look for natural alliances, e.g. clusters of schools. Ensure that any locality commissioning boundaries are coterminous across all services to optimise join-up and integration around the local population. Provide a commissioning framework for localities and hold to account for their budgets.

  17. Practical Tips – Regional Aggregate supply, demand, cost and effectiveness data across the region to help create a business case for regional commissioning, where appropriate. Develop effective relationships between local partnerships within the region at all levels, including political relationships. Take a practical approach and develop sub-regional commissioning where there is the will to do so – others can join in later.

  18. References OPM (2008) Developing Understanding of Multi-level Commissioning Kings Fund (2008) Practice-Based Commissioning - Reinvigorate, replace or abandon DCSF (2009) Budget Holding Lead Professional Pilots in Multi-Agency Children's Services In England: National Evaluation In Control, www.in-control.org.uk

  19. A4. Relationships Between Different Levels Of Commissioning V. Case study

  20. Plymouth Children’s Trust Six localities Groups of schools Locality commissioning group Plymouth Excellence Cluster Range of support services `Your child, Your School, Our Future’

  21. A4. Relationships Between Different Levels Of Commissioning VI. Group exercise

  22. Exercise • Consider the following services: • Short breaks • Residential care • Transport • Policing • What are the advantages and disadvantages of commissioning these services at the following levels: • Regional? • Locality or practice? • Individual?

  23. www.commissioningsupport.org.uk

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