Despite being an unfamiliar term in the Australian context, commissioning has been a firm part of the United Kingdom public service agenda for about 20 years.
This does not necessarily mean there is a substantial evidence base concerning this agenda, but there are some lessons from the UK experience that can inform attempts to adopt a commissioning approach in Australia.
- What is commissioning?
- Is commissioning different to other things?
- What evidence is there for the impact of commissioning?
- What factors make for effective commissioning?
- What might Australia learn from this evidence?
This report analyses commissioning evidence from the UK and other national jurisdictions, and derives four lessons from 16 findings …
Lesson 1. ‘A rose is a rose’ and that’s important in this context
The first lesson deals with the issue of definition and why it is important to have clarity over this and the implications of a lack of agreement about meaning. This lesson also highlights the fact that commissioning is a complex process which — in a text book sense — is about more than just simply contracting out or extending the outsourcing agenda.
Done well, commissioning is about a strategic approach to the oversight of public services, focusing on clearly defined outcomes and responding to community demand. The findings from this lesson are:
- Clarity about “commissioning” is important in building and sustaining relationships between providers and government agencies.
- Commissioning is more than just an extension of the outsourcing agenda. It’s a way to think about public services strategically.
- Commissioning is a process with multiple components and can operate at different levels. It involves both technical and value-based decisions.
- There are a range of different terms that are used interchangeably with commissioning and a number of different forms of commissioning in literature. Using the term commissioning in the wrong context may mean that this concept loses value in the longer term.
Lesson 2: There are best practices, but no silver bullet
Lesson 2 deals with evidence about the impact and processes of commissioning. It highlights that there is a paucity of evidence to demonstrate that commissioning “works” in a blunt, across-the-board way but also considers why this might be the case.
There is no single or simple process that can create effective commissioning and knowledge of local context is crucial in thinking about what will work in that area. A range of high aspirations have been tied to commissioning and these have not been achieved in practice, although we might question whether any one approach could tackle such difficult and pernicious issues.
- There is a lack of evidence to demonstrate that across-the-board commissioning approaches positively impact efficiency, quality of services or outcomes of services. Impact has typically been where organisations have clearly stated their objectives early in their commissioning processes.
- There is “no one way” to do commissioning. Processes that are appropriate to the local context need to be designed.
- Although the size of commissioning organisations is a crucial decision, there is no ideal size. Public service economies will likely comprise a complex patchwork of different commissioning arrangements.
Lesson 3. Appropriate competencies, data and incentives matter
Lesson 3 deals with the sorts of skills and conditions that are needed to make commissioning work. What we find here is the commissioning is both a science and an art and requires high quality data analysis skills and more relational capacities to be successful.
- Workforce skills are crucial to commissioning success and yet are often lacking in practice. Commissioning organisations need to think carefully about the competencies needed to fulfil their various functions.
- High-quality leadership is essential to drive commissioning approaches. Leaders need to be adept to political sensitivities and manage multiple relationships.
- High-quality, timely and appropriate data is crucial. However, commissioners often lack the right sorts of data and struggle to analyse it in practice. Investing in data collection and management functions is critical to inform decision-making processes.
- Incentives matter and if they do not align with commissioning aims then it will be difficult to achieve change in practice. An important task for commissioners is to influence “upwards” to ensure that the wider context supports their commissioning aims.
- Commissioning is both a technical and relational function, involving many value judgements and political astuteness.
Lesson 4. Community engagement is critical
Lesson 4 deals with an important but often ignored part of commissioning: community engagement. If commissioners are to have legitimacy and a mandate to act then it is important they fully engage with a range of different communities.
- Commissioners require a good understanding of local community needs to make good decisions. This is more than just a technical exercise and involves understanding the individuals and communities that will access services.
- Competition and choice can be important mechanisms in driving change but only in particular sorts of circumstances. Good-quality market management and consumer support need to be in place to support these mechanisms to work in the ways intended.
- Community engagement is crucial in building trust between partners and encouraging closer working relationships. It also builds the legitimacy in commissioning organisations that’s necessary to make difficult decisions.
If commissioning is to be more than just a fad or passing fashion then we need to think critically about this concept and the most appropriate way to operationalise it in our localities. To date it has often been used as a synonym to contracting out or procurement, but commissioning has the capacity to be about much more than this. It focuses discussions away from simply being about different modes of supply and encourages public services to think carefully about the demand side of the equation.
It may not be the answer, but its current political salience, vocabulary and framework may be helpful to public services when embarking on processes of reform.
Associate Professor Helen Dickinson will be speaking on ‘What you need to know about commissioning’ at the Commissioning Public Services Conference in March. Book your place by December 4th to save $400.
This article originally appeared on The Mandarin.