Skip to main content Accessibility help
×
Hostname: page-component-788cddb947-jbjwg Total loading time: 0 Render date: 2024-10-11T15:03:37.217Z Has data issue: false hasContentIssue false

3 - Dilemmas in the commissioning of adult social care

Published online by Cambridge University Press:  23 December 2021

Bob Hudson
Affiliation:
University of Kent
Get access

Summary

The nature of commissioning and outsourcing

In broad terms, ‘commissioning’ refers to the process of the planning and strategic purchasing of services. While there are many models available, they all fundamentally break down into four key areas:

  • analysis: understanding the value and purpose of the agencies involved, the needs they must address, and the environment in which they operate;

  • planning: identifying the gaps between what is needed and what is available, then deciding how these gaps will be addressed;

  • doing: securing services and ensuring they are delivered as planned; and

  • reviewing: monitoring the impact of services and ensuring future commissioning activities take review findings into account.

The danger is that these complex activities are, in practice, reduced to a competitive tendering activity, often framed by a rigid set of costed outputs and complex contract conditions. As seen in Chapter 2, local authorities were required to radically shift their role from direct provision to commissioning. In so doing, they stepped into an unfamiliar world, one that is normally found in commercial business, such as sourcing providers, negotiating contracts and monitoring arrangements. The research conducted in the 1990s by Wistow et al (1994, 1996) revealed what a culture shock this was at the time for local councillors, officers and front-line staff, who were more accustomed to a traditional ‘welfare state’ model. It might be expected that since that time, there would be greater familiarity with the task and less resistance to the principle but this is not necessarily the case.

Today, around a third of all public expenditure is outsourced via ‘procurement’ (Pritchard and Lasko-Skinner, 2019) even though the record of achievement is, at best, mixed. The most spectacular recent failure was the collapse of the outsourcing giant Carillion, which had managed services across education, the NHS, prison services and transport. Other outsourced public services that have run into difficulty include the probation service, the prison service, rail franchising, the forensic science service, Learn Direct, court translation services, housing for asylum seekers, welfare benefit assessment, free schools and academies, and the NHS. Overall, evidence of successful outsourcing is remarkably thin on the ground.

Type
Chapter
Information
Clients, Consumers or Citizens?
The Privatisation of Adult Social Care in England
, pp. 31 - 46
Publisher: Bristol University Press
Print publication year: 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×