Associate Feature: Leading the way in care commissioning

As the UK Government moves towards national care commissioning, Scotland has been leading the way in a national commissioning approach for a decade.
Scotland Excel launched its first care contract in 2011 and now has 10 national frameworks in place to support the commissioning of services in children’s, adult and older people’s care.
Julie Welsh, Scotland Excel’s Chief Executive, discusses the organisation’s social care journey.

How do you support local commissioning?
Our national arrangements support local commissioning by providing solutions which are clear, transparent and flexible to enable local variation and tailoring for different needs of individuals. Our care and support framework, for example, enables local commissioners to agree individual packages of care or to commit to the delivery of a group of care packages, where appropriate.
We’ve also undertaken detailed work in specific areas such as early learning and childcare. On behalf of the Scottish Government, we developed terms and guidance to support local commissioning practice in this area.

Is your approach collaborative?
Yes, it has to be, and is driven by a range of stakeholders. At Scotland Excel, collaboration is our day job; we never make decisions in isolation. We work closely with a range of partners involved in the delivery of care such as care practitioners from councils and health and social care partnershpis, and the representative bodies for care providers.
Care-experienced young people and adults with learning disabilities have also helped us to shape tender questions and assessments to help us get better outcomes. Going forward we want to do more to involve people with lived experience and their families.

Do you think the full picture of social care procurement has been conveyed recently?
I don’t think so. Discussions don’t often recognise good practice or the benefits that good commissioning brings. Procurement can sometimes be viewed as something that’s too rigid and overly concerned with price. But I believe this is an oversimplification of a very complex issue and is not the full picture. Good commissioning and procurement can help implement policy changes and drive social benefits as well as ensuring best value.
Our procurement and commissioning activity for care services has always been about transparency, sustainability and quality.  While being mindful of affordability, we never seek to reduce costs.  In fact, in partnership with the care home sector, we’ve developed a cost of care model that looks at the cost drivers for providing care – including paying the Real Living Wage to care workers – to inform discussions about the costs of providing these services.

So it’s not about driving down costs?
Providers on our frameworks do not compete on price. We don’t exclude or rank services based on price. We develop our care contracts based on quality, as ‘flexible frameworks’ which accept all bidders that meet our criteria for quality and business standards.  
But I think we need to recognise the impact that funding limitations has on procurement and commissioning activity.

Can procurement support choice, transparency and sustainability?
Absolutely. Our care and support framework is a good example of how procurement already supports choice, transparency and sustainability in social care. This framework is the product of collaboration with a wide range of stakeholders.
It incorporated payment of travel time and the Real Living Wage for care workers. The commercial element was based on a sustainable rate for the service and on achieving price transparency.
We reopen the framework frequently to include new providers and services. This provides greater choice for people accessing services.

Is there scope for greater collaboration and new models?
Absolutely. While we work to offer as much flexibility and choice for commissioners and people who use services, we want to work with partners and providers to improve framework processes and to explore new and innovative commissioning models.
Scotland Excel has been working collaboratively to deliver social care contracts for a decade. I look forward to using this specialist knowledge and experience to help support the reform of commissioning and procurement practice in the future.

This article was sponsored by Scotland Excel.