Tracie Wills Senior Commissioning Officer

What is Commissioning? “Commissioning is the process we use to ensure the effective and efficient use of resources to achieve the best possible outcomes for the population of Moray. The process includes all the activities involved in assessing and forecasting needs, agreeing desired outcomes, considering options, planning the nature, range and quality of future services and working in partnership to put these in place”. Hello, my name is Tracie Wills one of the Senior Commissioning Officers for Health and Social Care Moray. I have been asked to talk to you about commissioning. Let’s start with the definition of commissioning. Health and Social Care Moray have agreed that the definition of commissioning is “Commissioning is the process we use to ensure the effective and efficient use of resources to achieve the best possible outcomes for the population of Moray. The process includes all the activities involved in assessing and forecasting needs, agreeing desired outcomes, considering options, planning the nature, range and quality of future services and working in partnership to put these in place”.

The Commissioning Cycle We also agreed to adopt this well known model which the Scottish Government has also adopted and which shows the various components which make up commissioning and the cycle of all the activity. The cycle is made up of 4 key areas – analyse, plan, do and review. The key principles of the model are that: All four areas are sequential and of equal importance. Equal time, energy and attention is spend on the four elements. The outer circle of the model, the commissioning cycle, should drive the inner circle, purchasing and contracting activities. Which can include formal tendering for services. What we learn from the contracting experience must inform the on-going development of commissioning.

Cycle - Analyse Clarifying the priorities through reviewing legislation, national guidance and local strategies and policy statements. Undertaking population needs assessment. Mapping and reviewing existing and potential services across agencies to understand provider strengths and weaknesses, and identify opportunities for improvement or change in providers. Identifying resources needed and risks involved in implementing change and/or continuing with the status quo. The activities involved in the commissioning cycle (the outer circle) are grouped into the four elements already mentioned which are analyse, plan, do and review. Analyse includes: Understanding the values and purpose of the agencies involved, the needs they must address, and the environment in which they operate. Clarifying the priorities through reviewing legislation, national guidance and local strategies and policy statements. Undertaking population needs assessment. Mapping and reviewing existing and potential services across agencies to understand provider strengths and weaknesses, and identify opportunities for improvement or change in providers. Identifying resources needed and risks involved in implementing change and/or continuing with the status quo.

Cycle - Plan Undertaking a gap analysis to review the whole system and identify what is needed in the future. Designing services to meet needs. Writing joint commissioning strategies which identify clear service development priorities and specific targets for their achievement. The Plan part of the cycle includes - identifying the gaps between what is needed and what is available, and planning how these gaps will be addressed. This element of the commissioning cycle involves activities such as: Undertaking a gap analysis to review the whole system and identify what is needed in the future. Designing services to meet needs. Writing commissioning strategies which identify clear service development priorities and specific targets for their achievement.

Cycle – Do Supply management and capacity building to ensure a good mix of service providers, offering individuals an element of choice in how their needs are met. Developing good communications and effective relationships with existing and potential providers. Purchasing and contracting of services and de-commissioning services that do not meet the needs of the population group. Do, includes ensuring that the services needed are delivered as planned, in ways which efficiently and effectively deliver the priorities and targets set out in the commissioning strategy. This element of the commissioning cycle involves activities such as: Supply management and capacity building to ensure a good mix of service providers, offering individuals choice in how their needs are met. Developing good communications and effective relationships with existing and potential providers. Purchasing and contracting of services and de-commissioning services that do not meet the needs of the population group. We don’t always need to formally tender for services. We also need to support communities to develop services and must remember that people can choose to purchase services and use their communities to meet their needs via non formally tendered service provision.

Cycle - Review Pulling together information from individual contracts or service level agreements. Developing systems to bring together relevant data on finance, activity and outcomes. Analysing any changes in population need and reviewing the overall impact of services to identify revisions needed to the strategic priorities and targets. Review includes monitoring the impact of services and analysing the extent to which they have achieved the purpose intended. This element of the commissioning cycle involves activities such as:   Pulling together information from individual contracts. Developing systems to bring together relevant data on finance, activity and outcomes. Analysing any changes in population need and reviewing the overall impact of services to identify revisions needed to the strategic priorities and targets.

Good Commissioning Person-centred and focuses on outcomes Promotes health and wellbeing for all Delivers social value Produced with people, their carers and their communities Promotes positive engagement with providers So that’s the formal cycle of commissioning. But what is good commissioning? Good commissioning is person-centred and focuses on the outcomes that people say matter most to them. It empowers people to have choice and control in their lives, and over their care and support. It promotes health and wellbeing, including physical, mental, emotional, social and economic wellbeing. This covers promoting protective factors and maximising people’s capabilities and support within their communities, commissioning services to promote health wellbeing, preventing, delaying or reducing the need for health and social care services, and protecting people from abuse and neglect. Good commissioning provides value for the whole community not just the individual, their carers, the commissioner or the provider. Good commissioning starts from an understanding that people using services, and their carers and communities, are experts in their own lives and are therefore essential partners in the design and development of services. It creates meaningful opportunities for the leadership and engagement of people, including carers and the wider community, in decisions that impact on the use of resources and the shape of local services and it promotes positive engagement with all providers of care and support. This means market shaping and commissioning should be shared endeavours, with commissioners working alongside providers and people with care and support needs, carers, family members and the public to find shared and agreed solutions. Good commissioning promotes equality of opportunity and is focused on reducing inequalities in health and wellbeing between different people and communities.

Demonstrates a whole system approach Uses evidence about what works Well led Demonstrates a whole system approach Uses evidence about what works Ensures diversity, sustainability and quality of the market Provides value for money Good commissioning is well led by Health and Social Care and convenes and leads a whole system approach to ensure the best use of all resources in a local communities. It uses evidence about what works; it utilises a wide range of information to promote quality outcomes for people, their carers and communities, and to support innovation. Good commissioning ensures a vibrant, diverse and sustainable market to deliver positive outcomes for people and their communities. Whilst providing value for money by identifying solutions that ensure a good balance of quality and cost to make the best use of resources and achieve the most positive outcomes for people and their communities.

Person-centred and outcomes focused Well led Person-centred and outcomes focused Sustainable and diverse market Finally for commissioning to be successful we need to ensure the voice of those with lived and living experience of mental health are at the heart of commissioning. Every person using health and social care services deserves the highest quality care and support, and the maximum opportunity to influence how that support is arranged and managed. Inclusive