I’ve got an existential question about commissioning. Although it’s a question about commissioning it relates in just the same way to people who commission services and those that provide them. When working with organisations to achieve our Quality Mark for Evidence this is probably the single biggest issue that addresses why your organisation exists.
So my question; if you have to make a choice between seeing more people or being sure you make a real impact with a few, what do you choose?
This isn’t an unusual tension for a service or a commissioner to face but it is frequently a question that is not explicitly addressed.
Look at this example. You have won a tender to provide services to a defined client group. You know that you need to do a certain amount of work with individuals to help them achieve the change in health and wellbeing that both you and they want.
The service took a bit of time to get set up, there were issues about premises, maybe it took a bit of time to get referral paths in place. Consequently, you’re a few months behind where you thought you would be at this stage of the contract.
Undoubtedly your contract has a mixture of key performance indicators, some activity based, some outcome based. You know with a finite number of sessions you can offer people; you can get more people through the door or you can complete work with fewer individuals.
This is a common scenario but how often do you get the chance to sit down with commissioners and agree where your emphasis would be best placed?
In our experience the default is to concentrate on throughput. Getting people engaged with the service tends to become a priority over impact. There are a number of reasons for this but generally it comes down ease of measurement. It’s much easier to measure people that have come through the door.
Have you ever considered how different the conversation about differing priorities would be if the people who receive the service were actively engaged in contract management?
Do you look busy or do you demonstrate effectiveness?