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Transforming the market for social care paper 3: perspectives on market facilitation - commissioner/provider views

Briefing paper | June 2009

This paper brings together the views of commissioners and providers of social care on the strengths and weakness of their existing relationships, constructive ways in which those relationships can be realigned, and the implications of a transition in local authorities’ roles from purchasers of care to ‘market facilitators’.

The first part of the paper is based on a transcript of a discussion between three directors of adult social services and two chief executives of provider organisations, and the second on findings drawn from national research and three commissioner-provider workshops.

Specific areas of analysis in the former section include:

  • Establishing skill sets for facilitation – can commissioners move beyond the limitations of joint strategic needs assessments and understand market supply in a more sophisticated way? Is there a skills gap in local authorities when it comes to market stimulation, and will they need to cast the net wider in recruiting those skills?
  • Personalisation of care – has the advent of individual budgets actually delivered real user choice, and if not what needs to happen so that it can?
  • Providing incentives – can commissioning be done in a way that better incentivises improved provider performance?

The second section focuses on specific areas of mistrust and miscommunication on both sides, including:

  • Early engagement – are providers still excluded from local authority planning processes?
  • Procurement – is the cost and complexity of the tendering process excluding too many providers, especially smaller and third sector ones?
  • Contracting – do prices fairly reflect provider costs and make businesses sustainable, and is risk shared?
  • Monitoring – are monitoring processes fair, proportionate and transparent in their objectives?

A final section, setting out a checklist of constructive attitudes and actions at each stage of the planning, tendering, contracting and monitoring process, illustrated by examples of good practice drawn from a selection of local authorities, concludes the paper.