Commissioning aid is terminated despite saving councils millions

Significant variations in the expertise of commissioning staff fuel doubts over councils’ ability to maintain efficiency savings as the government’s Commissioning Support Programme draws to a close.

A government-funded support programme for commissioners that ceases next month has saved councils more than £200m over the past three years. The Commissioning Support Programme (CSP) was set up in 2008 to help councils deliver more effective commissioning in education, health, social care and 14 to 19 provision. The Department for Education and Department of Health-funded programme is now drawing to a close as councils have to manage major cuts.

But a report into the CSP’s work, due to be published in March, has revealed the sizeable impact of the scheme.

The programme offered free, tailored support to all 152 local authorities in England. It has helped councils and their partners save in excess of £200m in efficiencies and smarter steering of resources, while outcomes for children, young people and their families have been maintained or improved.

The CSP’s findings, which are based on self-assessments from local authorities, also suggest that commissioning has been overhauled in many areas. Councils reported an average 25 to 30 per cent improvement in their commissioning in terms of savings and outcomes since the scheme began.

But the CSP is warning that local authorities could struggle to maintain the improvements after the scheme comes to an end because there is still significant variation in the capability of commissioning staff. The turnover rate of professionals is also leading to a loss of expertise according to the report, with 25 per cent of staff in senior commissioning posts and 20 per cent of directors of children’s services leaving every year.

The CSP is concerned that in most areas, services are retreating to old-fashioned “silo” ways of working.

Relationships with primary care trusts, which had improved over the past two years, are now deteriorating due to reorganisation and job cuts and there is anxiety about GPs gaining responsibility for commissioning.

Earlier this year, children’s minister Tim Loughton said that councils needed to continue to focus on what works and improve outcomes after the life span of CSP. He said: “We need to build on initiatives like the CSP. Above all, we need to concentrate on what produces quality outcomes and disseminate that best practice.”

SMARTER, JOINED-UP COMMISSIONING IS VITAL IN A PERIOD OF CUTS

Lorraine O’Reilly, programme director, Commissioning Support Programme (CSP)

When we first started, most local authorities felt they were working well as commissioners. That was not quite true. Two years ago, commissioning practice in children’s services was varied and inconsistent and most people working in children’s services did not recognise themselves in the role of commissioners.

We have come a long way since then. There is growing understanding that commissioning isn’t just procurement. We are seeing a greater focus on developing services around users’ needs and how to make greater use of data and intelligence.

So children’s services commissioning is now in a much stronger position, but CSP always recognised that transformation in commissioning would take many years to complete.

There is still significant variation across the country and across children’s services. As cuts begin to bite, there is a danger that people retreat to old ways of working – decisions being made in silos and short-term procurement activity replacing integrated commissioning thinking.

The significant turnover in leaders of children’s services is creating real concern about loss of expertise to the sector, while improved relationships with health partners are deteriorating amid anxiety about the demise of Primary Care Trusts and how GP commissioning will work.

There is also the issue of the removal of ringfencing of children’s services money.

Councils have had so little time to take decisions about cuts that they’re not able to make intelligent commissioning decisions. Many have had to make cuts in siloed service areas, which is storing up trouble for the future.

People may have got through this year’s budget but the service cuts will really bite next year. If you make savings in a short-term “salami slicing” way, you can’t do that again in the second year, because you’ve already cut off all the fat.

Lots of local authorities have also been restructuring to cut posts. But reorganising often doesn’t save you money because the cost of doing it is often either equal to or outstrips the savings you make. A lot of local authorities have restructured based on very short-term service cuts. They may find that those structures are no longer fit for purpose in two or three years’ time.

Despite the risks, the commissioning of children’s services is increasingly carried out by professionals who have a true understanding of what commissioning means. Colleagues in this role require continued support. This is a real challenge to government, to ensure that the sector continues to respond constructively and flexibly to this demand.

I have seen enough commitment from the sector to be optimistic about the future – even in these most difficult times.