many models of commissioning

What is ‘commissioning’?

Jeff Sussna asked this as a ‘dumb question’. Which is a great question. Commissioning means many things to many people — it’s probably a bit like asking ‘what is agile’. Much of the value of commissioning, I believe, is that it is an emerging field — not yet fully formed and devoid of inspiration. Yet there is much commissioning practice and activity out there.

As the Chief Executive of the Public Service Transformation Academy, which develops and delivers the UK Government’s Cabinet Office Commissioning Academy, it’s a question I’m often addressing, in one form or another.

Usually, it takes me between twenty minutes and a day to give people some useful insight into this — here’s a shorter presentation which might be useful:

link: https://www.youtube.com/watch?v=8WymIJ84ISM&lc

Let’s start with some more ‘traditional’ definitions, often drawing on something along the lines of this ‘archetypal’ (and fairly venerable) NHS ‘world class commissioning’ cycle:

Some good definitions for this include:

the process of arranging continuously improving services which deliver the best possible quality and outcomes for patients, meets the population’s health needs and reduce inequalities within the resources available
NHS Commissioning Board 2012
the entire cycle of assessing the needs of people in a local area, designing services to address those needs and securing a cost-effective service in order to deliver better outcomes
Norwich City Council — Commissioning Framework
the process of assessing the needs of people or users in an area, designing and specifying the services to meet those needs, and choosing the delivery mechanism to secure an appropriate service while making best use of total available resources 
DWP Commissioning Strategy 2014

Often, this involves, at heart, thinking about:

  • How can I spend my (diminishing) budget to buy services to meet (increasing, ‘cold data’ based) need?

This is a huge challenge particularly when analysis (especially across partners) can take months, an OJEU procurement definitely takes months, and then contract, change, and performance management are crowded out by other priorities — and very often, the final learning and review part is squeezed out by needing to reprocure. We spend a lot of time asking people to increase their room for manoeuvre by thinking about:

  • How can I identify and understand citizen outcomes? (This means warm data, in the context of people’s lives — individual and group outcomes)
  • What are all the resources (beyond budgets — individual and community strengths, innovation, community and voluntary sector etc etc) I can marshal and shape?
  • What interventions from resources to outcomes can I test and learn from?

This ‘whole systems approach’ is summed up by its’ originator thus:

‘Commissioning is deciding how to use the total resource available in order to improve citizens’ outcomes in the most efficient, effective and sustainable way’ Richard Selwyn

A formal version of it is found here:

the means to secure best value and deliver the positive outcomes that meet the needs of citizens, communities and service users’
The Department of Communities and Local Government

I’ve also talked about Commissioning particularly as a form of transformation and system leadership — an orientation and approach:

Better understanding, better range of options, better recommendations, continual learning
The essence of commissioning is constantly looking for ways to improve and learn from: how we do things now; user and business needs; and all potential delivery mechanisms.
Commissioning helps you get results by understanding a business activity area and determining its real purpose within the wider business. It sets out a richer range of choices offering more flexibility to achieve good value for money. And keep learning and improving!

The differentiator here is that most forms of change tend to be based on a fixed and arguably narrow view of what needs to be changed or how business or analysis should work. Instead of leaping to potential solutions and working backwards, commissioning focuses on the real needs that should be met by the business activity area, and takes a much wider approach to understanding user, business, and market perspectives which generates a broader and more innovative range of options including make/buy/borrow etc. This means that you never stop learning because you are constantly getting feedback from user, organisation, and market perspectives. (And it means that commissioning is, inherently, a metacontextual approach).

Another great thinker with a claim to having established the foundational thinking in Commissioning (especially but not only in New South Wales, and Australasia generally) is Professor Gary Sturgess, the New South Wales Premier’s ANZSOG Chair in Public Service Delivery. At a recent presentation, this diagram, illustrating Commissioning as ‘a necessary third layer (and middle class) between Policy and Delivery’ struck me:

Those of you versed in the Viable Systems Model will easily see that (at the appropriate level of recursion), this perspective has Commissioning squarely as a ‘System 3’ for government.

A couple of key quotes Gary uses:

The process of commissioning involves identifying and prioritising outcomes, and designing measurable performance objectives that will inform government whether outcomes are being met and whether they are being delivered in an effective and efficient manner. . .
It can be a tool for challenging policy makers to ensure they have clarified the outcomes that programmes and policies are meant to achieve.
Australian National Commission of Audit, March 2014
Commissioning is a set of inter-related tasks that need to be undertaken to turn policy objectives into effective social services. . . A wider range of skills and capabilities are required for commissioning than the more commonly used term procurement.
Commissioning organisations need to make informed, deliberate choices about diverse issues including objectives, needs, cost-effectiveness, funding, pricing, risk management, quality, eligibility, performance management, information flows, provider-market sustainability and interactions with other services.
NZ Productivity Commission, August 2015

I can also offer five questions to ask to think about commissioning as a system:

  1. What is the system (part of the system) we are investigating?
  • Understand key issues in delivery today (what’s wrong — what might be causing that)

2. What’s the underlying purpose of the system?

3. What is the actual activity to be delivered to achieve the underlying purpose?

  • What are the options for delivery of that activity?
  • What organisation and support services would enable delivery of that activity?
  • How could that activity best be governed and managed?

4. How do we get there?

5. What have we learned?

I hope these examples show how commissioning is developing as a subject, a mindset, and a transformation approach. Since commissioning is, at heart, about achieving collective or organisational intent, it does cover a lot of ground. I find it productively difficult to distinguish it from leadership and management — and I think that’s meaningful. It’s not procurement, or strategic procurement, it’s not outsourcing or new delivery models, it’s not outcome or results-based contacting — though those are all part of the toolbox.

What commissioning offers, ultimately, is a way to build a tool box of approaches which can serve the cause of better public outcomes. Before it becomes codified and constrained to apply to particular contexts, we all have the opportunity to shape, inform, use, practice, and develop what it really means for the better.