Commissioning in the Dark

We are all only too aware of the ever-increasing challenges local authorities are facing across the children’s and younger person health and social care landscape. 

Due to the chronic supply issues of services across the country costs are wildly inflated and young people are being placed further and further away from their home base. Speaking to children social care teams across the country, it is clear that they are all intensely aware that they are paying too much for these out of area placements, but when asked the question of what they believe they should be paying many simply did not know.  

This is no one’s fault, rather the result of seeing inflated prices, high-cost new placements and unprecedented uplift approvals over the last few years making it close to impossible to knowing what the ‘true’ cost of any given package of support should genuinely be – and give a clearer view on profit margins. 

Without having a powerful evidence-base to understand this variance between what we ‘do’ pay and what we ‘should’ be paying, we are commissioning in the dark, trying to overcome a challenge that is continuously changing, and one you cannot see!

There is, however, some light that can be shined on this incredibly difficult challenge. The variance between ‘price’ and ‘cost’ can be sourced and provided by the tool CareCubed and the unique national and regional data sets that sit within it. The variance between the benchmarks in CareCubed and what you are currently paying providers is your current ‘market position’ giving you a starting point for change. Change, that the system makes achievable by understanding your market better and modeling, developing and commissioning both in-house services and external services, all the while working alongside strategic provider partners in local co-production. 

To put this in context, it is important to understand that the Children’s market is where the Adults market was 15-20 years ago. But by introducing the old ‘Care Funding Calculator’ in 2004 and its more recent cloud-based big brother ‘CareCubed’, the national market across adults is now more balanced, with demand no longer outstripping supply in many areas. 

The journey will not be quick, there is no ‘silver bullet’, but at least there is now the opportunity to do something locally, regionally and nationally to take action and rise to the challenges ahead! Councils are now seeing immediate benefits through better governance and cost control and have a basis to strategically plan to deliver bigger medium to long term benefits – such as shaping the market differently. Now that the obstacles can be seen, they can be overcome. And gradually change the Children’s market service-by-service, region-by-region to improve the lives of all young people that we all so desperately want and need to protect. 

For more information about CareCubed, please contact nik.jones@iese.org.uk.