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I am at the Guardian National commissioning conference in Birmingham this week which The Association of Directors of Adult Social Services (ADASS) have jointly sponsored. Most of the people here are primarily concerned with commissioning for health and adult social care. Personalisation and individual level commissioning was a major theme on the first day and speakers confirmed my belief that strategic commissioners should be leading in whole system reform. They should be commissioning services and the wider workforce to work with service users (children and parents) to co-produce outcomes. The budget-holding lead professional pilots showed that in some cases very small things can turn a family round more cheaply and effectively than traditional approaches. We should free frontline practitioners to apply common sense and work effectively with families, and they cannot do this without the support of strong leaders.
Some of the barriers to change that were identified at the conference were the following:
Fear of change seems to prevent leaders at all levels from using increasing levels of good evidence that shows what does and does not work. My question is why are commissioners at all levels not yet using evidence to drive change? During my informal conversations, people have speculated on various reasons for this – too much central government control, blame culture, activity and output based performance targets and so on. I have wondered if both directors of adult and children’s services need more support from chief executives of local authorities and leading elected members so that there is a clear corporate understanding of commissioning and commissioning policy and what commissioners are trying to achieve locally.
Considering the inevitable cuts in funding ahead of those working in public services, there was widespread agreement at the conference that ‘slash and burn’ and ‘salami slicing’ will not work. Several speakers said that there is a window of opportunity now for commissioners to focus resources on what really works to improve outcomes and to stop investing in services which work less well or not at all. This will require strong corporate leadership in which directors of children and adult services are clearly supported by chief executives and elected members working together to using evidence of what works to redesign local government.
Lastly I am surprised not to find more children’s commissioners here at this national conference. There is another opportunity for you at our national children’s commissioning conference on 18th November. Get the date in your diary now!
