Agenda item

(1)       The Chairman thanked Mr Wilson for attending, and those around the table introduced themselves. Mr Wilson said he had been interested to hear the last part of the previous interview, and he commented on a point raised about change management.  He added his view that it is essential to have an exit strategy at the end of a period of family support, and that good handover is vital. 

 

(2)       He then responded to questions from the Select Committee.

 

Please tell us about your role.

 

(3)       I am the Head of Strategic Commissioning for Children’s Services, so I have a responsibility for children’s social care transformation, 0 – 11 integrated service transformation and commissioning.  In this role, I need to have a broad view across all these issues.

 

(4)       The key points I would highlight from the written paper which I submitted previously are the importance of pathways, understanding journeys, the limitations of a 12-week involvement in supporting a family tackling issues which can be ingrained over generations, and the importance of community support in addressing issues of social value.

 

(5)       Whereas, in adult social care, some 80% of spending on commissioning is with the external market, with 20% being in-house, in children’s services, this pattern is reversed, with only 20 – 25 % of the spend being with the external market. This emphasis on in-house provision means that greater emphasis of children’s commissioning is focused on the County Council’s own practices, influencing what happens internally as well as making best use of the market.

 

(6)       I have recently met some providers and heard their views on the frameworks we use to commission services.  My view is that these meetings are a positive step as they allow the County Council the opportunity to work proactively with the market. However, as we become more sophisticated at commissioning, the County Council will need to be more sophisticated in the way it runs and uses the framework, ensuring providers know what to expect and how the framework will be used.  For example, I recently met a national provider based in Kent that does very little work in Kent but a great deal elsewhere.  The County Council has not seemed to be proactive at telling companies like them that it has many contracts in which they may be interested. It needs to focus on improving its communication and be clearer at telling providers what it wants them to do. The Council needs to be better at communicating with providers.

 

(7)       There is a tendency among local authorities to see commissioning as a ‘them and us’ situation, but we need to realise and understand that we are all in the same business of seeking to support children and families. Relations between commissioner and provider can be tense, as shown by the reference to ‘Head Teacher and pupil’ relationship in the previous speaker’s written submission.  However, sometimes you can have too close a relationship between commissioner and provider.  We need to work closely but be able to challenge. If the two are too close it can be difficult to criticise a provider over their performance or any other issue, if and when this is necessary, and hold them to account for not managing the situation.   

 

(8)       Regarding social value, I am not sure that many people yet have a clear understanding of what this means in practice. I think many people acknowledge that the voluntary sector brings social value but there is no clear understanding of how this can be calculated or quantified, and how we can identify which provider brings more impact. In children’s services, our first priority is to keep a child safe. However, the second is too often to balance the budget before focusing on improving outcomes.  As, at each budget cycle, it is usually only possible to know the next year’s proposed savings, the wider budget and resources are not known. Social value will drive long-term improvements, and savings in the future, and so is difficult to prioritise in the short-term.  There would need to be a strategic countywide approach to set out what must be taken into account to address social value issues.   Social value is easy to miss when focussing on a challenging savings target.  The County Council could look at ways to evaluate social value in the procurement process, such as awarding scores for social return. However, it is important that, whilst social value might be easier to perceive in local services, large national organisations and companies can also add value through local investment, bringing opportunities and services which cannot be matched locally. The priority is to provide the best service not just the most local service.

 

(9)       Children’s commissioning has improved much in recent years. In my experience of starting at a new Council, I am used to finding chaos, but that has not been the case in Kent.  In previous years, there was no monitoring of contracts, once let, but there has been much progress in this area and the County Council has a very good team.  The County Council is getting the basics right but needs to move to the next level of sophistication, moving from monitoring outputs to monitoring outcomes. Especially in social care, a huge cultural shift is needed and it is harder to measure outcomes.

 

(10)     We need to be more confident at listening to and working with the market, customers, families and children about what is needed then writing specifications, rather than the County Council taking a paternalistic view that it knows best. The market can be innovative, and the Council needs to take advantage of this.  Providers in the market are experts in service needs, whereas the County Council is expert at processes.  The County Council needs to be more confident of letting the market teach it about commercial understanding, and needs to listen to its customers as partners; it needs to acknowledge that it doesn’t necessarily know best.

 

At what stage are the key activities that you list in your written paper?  Are they planned, becoming embedded, etc?

 

(11)     The Independent Fostering Agency (IFA) framework has been embedding since June 2013. This project is showing interesting progress. A social worker trying to place a child would previously have contracted with the first IFA which could offer a suitable place. Now they approach all providers on the framework to identify the best placement. The County Council has encouraged IFAs to sign up to a framework under which it has set out the specification for working with it, with a guarantee that they will work with the County Council in a certain way.  There is much work planned on the Children’s Centres MarketReview, which follows on from ‘Facing the Challenge’. The Early Help Reviews are starting now. The County Council agreed its Early Intervention and Prevention framework about 18 months ago and contracts have been ‘called-off’ it. 

 

(12)     There is a longitudinal study which was undertaken to understand the impact of early intervention on children.  However, it is not always about whether services are responsible for the outcomes as no one service alone can keep a child out of care. Therefore we need to work with partners. For example, a social worker working with Families and Social Care would then arrange step- down from this intervention but would not cut off completely from giving any further support, if needed. There would need to be a pathway to allow further work if necessary, and the County Copuncil would need to be clear of its desired outcome. 

 

(13)     The County Council needs to work with providers to meet needs. When arranging market events, at which it meets and talks to potential partners, it needs to ask how a provider can help meet the Council’s key aims, and, as part of this, it should make clear its intention to include social value in commissioning and seek potential partners’ views on this.

 

I attended a ‘meet the market’ event for care leavers, which covered issues such as accommodation and support.  The next stage after this is to talk about potential partners’ ideas, but providers get concerned about this as they think others might copy their ideas and use them to win a contract at their expense.

 

(14)     If I were a provider, I would try to be guarded at giving away too much. I would feed in comments and be helpful in discussions about what would be good to do to build a specification but would keep my commercial secrets to myself. Then, at the procurement stage, at which prospective contractors are asked for expressions of interest and method statements, I would set out my delivery ideas and unique selling point to make me stand out from others tendering. 

 

(15)     The London Borough of Croydon Council has established a social value framework and process which it describes as offering a ‘competitive dialogue’.  I have never tried this method of identifying and engaging with potential contractors, and it has some risks, but it could be useful,particularly to address challenging issues such as provision of services to people with mental health issues. Having a competitive dialogue with potential contractors (weeding out unsuitable providers first) could allow the County Council to explore possibilities for future service provision and shape its model to a jointly-agreed service, to allow innovation, rather than undertake market engagement and then produce a set, rigid specification.

 

In the joint needs assessment which is prepared by social care and health colleagues, the County Council may have to change what it requires from the agencies with which it works.  How would this change be built into an existing contract?  Is there provision for an existing contractor to engage another provider in order to address a new requirement, for instance?

 

(16)     The key method for the assessment of need is the common assessment framework (CAF).  This method is not specified as mandatory in guidance but it is clear that Ofsted expects to see a similar model.  One agency would be identified as a lead in providing a service but would be able to engage other providers (who have already been approved by the County Council) to meet specific or specialised areas of need, for example domicilliary care or services dealing with drug dependency.  We would not ask any provider to meet a need which is beyond their specialism, ie to subcontract. However, one option we would explore would be to use a ‘prime contractor’ model.

 

In your view, what role could elected Members have in scrutinising the commissioning process?  Transformation brings an opportunity to review Members’ role.  What change in role would you like to see and how should this change happen?

 

(17)     My view is that we are lucky in children’s services to have a very strong portfolio holder who actively scrutinises our work. There is potential for elected Members to have more of an oversight of the commissioning process as they do elsewhere.  Transparency is important, and everything should be open to scrutiny. 

 

(18)     There should beoutcome-based methodology and accountability. A good test would be the ‘town square’ test: what would someone in the town square make of what the County Council does, and would its actions seem clear and comprehensible to them?

 

(19)     An effective model I have seen elsewhere is for one portfolio holder to sign off all contracts above a certain value. An option could be to set up a Members Board to oversee contracting and see which services are due for review, renewal or decommissioning. This would raise Members’ understanding of what is being commissioned, how performance is being monitored and the general direction that the County Council is taking.  Members should be able to call us to account for what we do and why we do it.  I have a view that, whenever an approach is exposed to daylight, it improves.  If someone knows that what they are doing will be scrutinised regularly, it will encourage them to sharpen their processes and be ready to account for what they are doing.

 

I agree that it is good to measure outcomes (for example, with smoking cessation, the aim would be to reduce the incidence of smoking-related illnesses), but I would not want to see the measure of outputs be completely lost. 

 

When commissioning any service, there is a hierarchy of priorities.  What if the two bodies in a joint commissioning arrangement have different priorities; how could these be reconciled?

 

(20)     In outcome-based accountability, there are three questions to be asked:- How much do we do? How well do we do it? Is anyone better off as a result? Joint commissioning should have a set of agreed targets and outcomes agreed before contracting the service.  There should also be one person monitoring performance and outcomes on behalf of both partners. If having two commissioning bodies is a challenge, consider that there are seven clinical commissioning groups (CCGs)!  An integration conference looked at improving joint commissioning.  We need to get the governance right and talk about agreeing priorities.

 

We have heard that local choice is good and a ‘postcode lottery’ is bad, but sometimes these can be the same thing.  When there is a disparity in service provision between East and West Kent, does this demonstrate local choice, a postcode lottery or different priorities in the two areas? 

 

(21)     When considering choice, we need to consider that people do not necessarily always want choice.  What they want most of all is high-quality services.  Having a choice and having to choose can sometimes be very stressful. We have to consider to what extent localism is the right approach.  Desired outcomes in Margate could be quite different from desired outcomes in Sevenoaks, and different sorts of interventions may be needed in each area.  

 

Those answers were helpful, and raise good points to think about.   The County Council has to bear in mind whether it wants to embrace localism or risk being/appearing patrician.

 

(22)     Strategy is important.  The County Council would need to define the approach is it going to take and decide what it most believes in. This will give officers a framework within which to deliver.

 

In your written submission you set out six actions that are needed to address key challenges.  Does the County Council currently do any of these six things or are they all new tasks?

 

(23)     1. Focus on key priorities ... our priority is to keep children safe and prevent them from needing to enter care. However in the past there has been a lack of key focus on what are the most important priorities. 

2. Improve as commissioners ... – we have been delivering IPC training to all commissioning staff to help them develop, and this has been excellent. We need to continue development and give people opportunities to use their skills.

3. Focus on integration ... – we don’t yet do this sufficiently, so this is an area for development. We need to move away from silos to more of an understanding of which needs can be met jointly

4. Engage more with service providers ... – currently, we don’t do enough of this.  We need to view providers more as partners rather than the way in which we may view utility companies

5. Embed transformation ... – this basically describes the role of my post.

6. Support the voluntary sector away from grant funding ... – some voluntary organisations are still firmly reliant on grants. They still have a role to play but need to be transparent about grants and arrangements.

 

What I have noted from what you have said so far is a role for elected Members, the need for trust when engaging with organisations and the issue of shared or conflicting priorities between people who are commissioning or delivering services jointly.  If the commissioning side were to become fractured, with an unbridgeable gap, would the current level of engagement with partners be lost?

 

(24)     There is always some level of risk that relationships will go wrong.  It is important to achieve a balance between supporting and challenging, and I don’t think the County Council has the balance quite right yet.  The Council has made changes but some providers probably don’t feel as valued as they could be, and are not clear about what the Council needs from them.  There is a risk that, if we do not integrate with partners, this will weaken the ability to get things done.  For example, it is our strategy to enhance our in-house fostering team to meet the needs of the majority of children, but to work in partnership with external providers to help us meet specialised needs which some children may have.  We need to work together effectively to knit together a high quality service to children.  In local areas this needs to be balanced and would need to be taken on by a local manager. 

 

When the County Council is unclear about what it wants or needs to commission, is there scope to add more details to a contract specification later, after it has started?  Is the Council’s lack of clarity due to unclear priorities or the reason for commissioning - for example, whether provision of the service is a legal requirement, discretionary or best practice?

 

(25)     My view is that we need a clear understanding of the benefit a service will bring to the service user prior to procuring it.  Local authorities are not good at identifying how to improve outcomes and we need to get better.   My team looks at other local authorities’ approaches, and what works well, from which the County Council could learn, and seeks their views also on what Kent could do.   This approach will be a key part of projects for this year.

 

Your paper says the County Council spends £175million on Specialist Children’s Services.  How much of that spend is on services which are a legal requirement, how much on discretionary and how much on best practice?

 

(26)     The majority of services are statutory. However, for others, there is still a legal requirement to consult on changes to service provision - for example, the review of Children Centres provision. In addition, services such as the Early Help Strategy were developed in response to a recommendation from Ofsted.  Some of the services commissioned by Specialist Children’s Services are non-statutory but this sort of provision - for example, support to a family in crisis - is invaluable in helping to avoid the need for statutory provision later. There are 1,000 children in care in Kent, and this figure has increased in recent years. Without prevention it will increase further.

 

Is it possible to take account of social value at all stages of contracting, or can it only be an outcome of service provision?

 

(27)     I am not sure on the technicalities – it depends how you intend to include social value in scoring.  This is an interesting question, and something I could look into.

 

Is there anything else you want to tell the Select Committee?

 

(28)     No, nothing I can think of.  The Committee’s questions have been very helpful in making me reflect on what my team does and why we do it.

 

(29)     The Chairman thanked Mr Wilson for attending.