Being Commissioned

04.02.16

In the early years of commissioning I had this fond belief that being commissioned to provide a mental health service was a bit like being commissioned to produce a work of art. It appealed to the Grayson Perry in me, and I tried to respond creatively. Well, we live and learn, and I’ve long since abandoned my provider-as-artist fantasy. I still think we can find win-wins out of being commissioned, but it’s getting harder.

The cynical view is that, if the 2015 Guide to Public Sector Commissioning ever existed, it would probably start with how price trumps quality and conclude that compliance beats creativity every time. At its worst, commissioning and procurement have become interchangeable and, driven by ever more intense pressures on the public purse, aggressive commissioning / procurement behaviours have become commonplace. That sense of the commissioner investing in a relationship with their provider for the wider benefit of service users would be incomprehensible to many new commissioners. In such circumstances why would any 3rd sector organisation in its right mind be at all interested in tendering, being commissioned, and delivering public services?

And much of the rhetoric within our sector conjures up variations on these dismal themes. We still hear people harking back to a golden pre tender, pre contract-compliance era when we were given a grant and left to get on with it.

In fact, of course, neither the commissioning-killed–goose-that-laid-golden-grant, nor the ‘get real, get competitive or get out’ camps quite captures the whole truth, and there are signs that a somewhat clichéd debate is now moving on.

The NHS needs the 3rd sector, and senior NHS Managers are starting to say so, and invest in us. Sometimes via a competitive tendering route and sometimes through negotiation, we are being told that we bring independence, humanity, and a set of public engagement skills that the NHS envies. One of our Peer Support Workers on an acute in-patient ward was told last month: “I like the fact that you work for Solent Mind. It makes you different”

Even some local authorities in some circumstances are not averse to setting out a broad vision – defined by users of services – and asking tenderers to say how they would achieve that. This clearly plays to our traditional strengths.

Yes, competitive tendering is tough: margins are shrinking, contract terms are getting shorter, poor decisions sometimes get made and the endless round of TUPE transfers takes staff away from the organisations they chose to join. And all of that needs challenging.

But I’m not convinced that grants ever offered real security, or always enabled us to recover full costs. And grants – dare I say – sustained too many poorly performing charities for too long. Commercial discipline, the challenge of reshaping services to meet real and emerging needs, and sheer competition ( how can we do this better than our competitors?) arguably produce better services and healthier organisations.

And no one can tell us what we must or must not do. Every invitation to tender is different. If the money or the ability to deliver quality isn’t there, we should walk away. No one compels us to pay the lowest wages or accept impossibly low margins.

I think there is a prize which is worth fighting for here: our sector can help redefine public service for the benefit of those who need public services.