Involving people in commissioning
Lisa PattoniProgramme Manager
Innovation and Improvement
“involvement results in better information on which to base commissioning decisions, better quality services and better outcomes for people”
(Hough, 2008)
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Coproduction ladder
Why do it and what does it look like?
• dynamic and iterative;• recognises assets and builds on local
resources;• applies local insight and data;• builds collaboration;• opens up opportunities for innovation, and• takes a longer term view.
(NEF, 2012) 4
Where should we involve people?
Throughout!
1. Understanding assets and needs2. Shaping and delivering services3. Reviewing service performance
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Example 1: More power to their elbow
(Wistow, 2011)• Focus tended to be on process• Local people felt that their involvement was
worthwhile and had showed results. • There were concerns about the mix of older
people• Should older people be viewed as citizens or
consumers?
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Example 2: older people with high support needs (NDTi, 2014)
• Involved local communities to help develop a new commissioning strategy for older people with high support needs
• Design team of older people – the face of the exercise
• Visited people, rather than expecting them to come to them
• Started with the question ‘what supports help you have a good life?’
• Series of events over 4 months7
Example 3: Transforming services for young people
(Governance International) • From deliverer of services to commissioner of outcomes (focus on wellbeing)
• Decommissioned 4 historical services• Began with a comprehensive needs
assessment in partnership with young people• Young people as co-commissioners of local
services through decision making panels• Crucial involvement and buy-in from front-line
staff 8
Critical success factors• Why are you involving people?• It takes time and is a process• It can require independent facilitation• Build relationships - the focus has to be on
outcomes – not processes
(Schehrer and Sexton, 2010)
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…and some more
• Requires diverse views• Recognise that these are issues for all• Make operating context overt• Don’t over specify
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How can we practically apply co-production in commissioning?
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Co-producingCommissioning
CommissioningCo-productionINSIGHT
Some questions• Is this actually about a transfer of power or
about power residing within the partnership while being open to the influence of users?
• Do users want to have the responsibility for strategic decisions?
• Is there a tension between current and future service users; actual or perceived; between identified need and aspiration?
• To what level at each point can people realistically be involved in shaping services for the future?
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“service user involvement is not an end in itself, but a means of effective change, both in the outcomes of services and the behaviour of workers”
(Davies, Finlay and Bullman, 2000)
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