The challenges facing social care commissioners
The drastic cuts to social care budgets mean commissioners have had to venture out in to the world.
It's 10.00am and I'm in to my third meeting of the day. We are discussing performance measures for commissioners; it's telling that nearly all of them involve savings targets and decommissioning rates. Today's climate has changed significantly from when I started ten years ago.
Now the people chairing are likely to be from the finance department and the note takers from a firm of consultants. But the question is always the same from both, not how do we make it better, but how do we make it cheaper?
No matter how many ingenious ways of redesigning care and reducing costs you come up with, however, it's never enough. The demand for more savings is a constant one. So where do you go when the traditional routes are exhausted?
The answer for many councils has been to look at coproduction, the new buzz word in social care, the elixir to solve all ills. What is there not to like? Devolving power from commissioners to the people who use services and setting the power balance right. Great in principle but in practice?
For many commissioners the joys and challenges of working in a truly equal partnership with those who access care, are having to be balanced with the short-term demands of chief executives and accountants, who hold social care responsible for the black hole in many council finances.
Partnership working, building trusted relationships and understanding what people need, all takes time and for those not in urban areas, even the logistics of getting everyone in the room at the same time can be a challenge. There are many examples of outstanding co-production out there, but it is still seen by many as a solution rather than a mechanism to achieve change. No matter how you cut the funding cake, there is still only one cake.
The drastic cuts to social care budgets though have forced commissioners to start taking a different approach to commissioning. Local authorities were born out of a paternalistic and hierarchical tradition; resulting in a top down approach that saw those who use services as very much at the bottom of the chain. This approach is no longer possible. Commissioners have had to venture out in to the world, away from the safety of traditional council ways of working and reliance on a few trusted providers.
The challenge for commissioners and their managers has been not only to let go of the purse strings, but also explore what is out there in terms of alternative and less traditional funding options. It has meant being more creative, freeing up funding from elsewhere and hunting it down in the most unlikely of places.
For once the term "thinking out of the box" really is appropriate. It is increasingly about recognising people are still people and want to do the same things as everyone else. Yes I know this is stating the blindingly obvious, but for too long we have used disability and ageing as a way of segregating people off in to separate services because that way it is easier to oversee and feels much safer than asking an individual, what do you really need?
For many the answer won't be services at all, but instead a reduction in bureaucracy and flexibility in funding so they can access the right support for them, in whatever form that takes - scary territory for commissioners.
Above all for the first time we are beginning to look at people in terms of what they can do not what they can't. We are still at the beginning of a long and difficult journey, but for me at least this is an important step forward. After all, commissioners are people too; we need to make sure we continue to ask ourselves the question, would we be happy if this was us?
By Ela Farrell a children's social care commissioner: Follow Ela on twitter @elafarrell
Read the original article on The Guardian Social Care Network
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