BACKGROUND TO COMMISSIONING POLICY DEVELOPMENT
Services that are funded by the Government to the citizen in Ireland are generally provided either directly by the State and employees of the State (e.g. social welfare payments, primary and secondary education, hospital services, passport services etc.) or by non-direct provision (e.g. home care for the elderly, certain disability services, community employment schemes etc.). Non-direct providers are a very important aspect of how the State secures interventions to help our citizens by using the knowledge, skills and experience that community organisations, voluntary groups and other expert bodies have developed over many years. The majority of these services are provided by what is generally referred to as the ‘Community and Voluntary Sector’.
Traditionally in Ireland, services to the citizen secured through non-direct provision have been funded by a ‘block-grant’ system. Parts of this system generally rely on funding decisions being made on the basis of what a group or a provider received historically rather than because of the needs of the communities or end-users in question. As a result, this block-grant system has been criticised as being non-strategic, whilst at times also representing poor value for money for the taxpayer. Additionally, it can make medium and long-term planning for interventions to address the growing needs of citizens difficult.
A “Commissioning” model presents a more strategic approach to the delivery of services than the traditional block-grant funding model. This model purports to assess and identify the needs of a population, ascertain desired outcomes for that population, pinpoint service priorities and goals, secure service providers that can deliver those priorities and goals; and release funding in return for achieving the identified outcomes on foot of evidence-based evaluations.
There has been a growing interest in the application of Commissioning approaches; and elements of Commissioning processes are in place in some sectors in Ireland. These include the assessment of needs to inform service priorities, using evidence to inform service design, purchasing, procurement, and monitoring and evaluation of outcomes. In more recent years, there have been developments in the thinking and application of Commissioning by a number of public bodies and agencies, and growing interest by the Community and Voluntary sector in the implications of Commissioning.
Commissioning, when used as a strategic planning approach linking resource allocation with meeting assessed needs, has a strong rationale. Using evidence of need and best practice to underpin spending decisions, rather than funding on the basis of historical spending and funding patterns, is a logical approach. The challenge for Government, however, is to ensure that all of the ingredients of a strategic approach are in place and are implemented according to their purpose, without undermining existing systems that are working well. The introduction of a Commissioning framework in Ireland would need to take account of the historical role of the Community and Voluntary sector, legislative requirements, and the cultural and political context. A proportionate approach would be necessary so that the benefits outweigh the costs of the processes and infrastructure required.
In view of the strong case for change in this area. the Departments of Public Expenditure and Reform; Health; Children and Youth Affairs, and Environment, Community and Local Government have come together to drive a Government commitment concerning the increased use of Commissioning in the delivery of services. This commitment was outlined in the Government’s Public Service Reform Plan.
As part of this proposed change initiative Centre for Effective Services (CES) were engaged to conduct a rapid evidence review on Commissioning. The review examined the evidence base on the concept and application of Commissioning in human, social and community services in order to achieve better outcomes for service users. It explored definitions and models of Commissioning; the benefits, challenges, outcomes and cost of Commissioning; key concepts and features of Commissioning processes; and key considerations for introducing Commissioning in Ireland. A copy of this review can be found here.
The four Government Departments leading this initiative held an Open Policy Debate on Commissioning in October 2015. Stakeholders from Government Departments, Public Service Bodies and Agencies, intermediaries, representatives of the Community and Voluntary Sector and members of academia, amongst others, were invited to attend. This represented the first stage in a public consultation process that is expected to consult widely on how to best ensure that public money spent through non-direct service provision can be maximised. A report outlining the agenda for this debate, the emerging themes, supporting documents and the feedback received from participants may be found here.
A full public consultation on Commissioning commenced in December 2015 and concluded on the 12th of February. We received 64 valid submissions in response to the consultation. A full summary of the themes that emerged from the consultation, as well as a copy of the consultation document can be found here.
Copies of all submissions received are available here.