What is the commissioning cycle in social care?

There are many reasons why the commissioning cycle in social care is important. Not only does it help individuals receive the care they need, it also ensures that it is at the right level and  that it is delivered at a high standard.  

1. Quality Assurance  

Through commissioning social care, local authorities can set quality standards. These standards can then be monitored throughout the commissioning cycle to ensure that they are met safely and effectively to the care receiver. 

This can reduce pressure on the NHS through delaying future care needs and potential hospital admissions by delivering a high quality continuity of care that is person-centred and mitigates risks.  

2. Value for money 

Equally commissioning in social care is important as it helps local authorities get a well rounded view of the social care market. Through commissioning social care, local authorities can identify and procure services that use their resources efficiently to deliver services at the best possible price.  

This helps local authorities to stretch their budgets further to ensure that individuals will still receive the quality of care they need without wasting resources or it being massively over budget.  

3. Builds partnerships and encourages integrated commissioning  

Another reason why commissioning in social care is important is it encourages collaborative and integrated commissioning amongst other local authorities, providers, carers and service users to efficiently tailor services to meet the needs of their community.  

Local authorities can therefore receive a better picture of the social care market and understand the resources that are readily available to meet different care needs quickly, safely, and efficiently.  

Commissioning in social care is important therefore as it keeps the individual and the impact a service will have on them at the heart of every decision made. It is vital therefore to keep in mind what good commissioning looks like. The Association of Directors of Adult Social Services (ADASS) defines evidence-based good commissioning as:

• Well-focused: Person-centred care with outcomes-based commissioning delivering measurable improvements
• Inclusive: Engaging service users, carers, and communities in commissioning decisions
• Well-led: Strategic leadership with clear accountability and performance management
• Promotes sustainable markets: Supporting provider diversity and financial stability

The commissioning cycle in social care is often similar to other commissioning cycles at first glance. The terminology of the stages in a commissioning cycle may vary and some councils may add in additional steps.  However, there is often four main steps at the core of every local authority’s commissioning cycle. These include: 

1. Assessment  
2. Planning  
3. Contracting  
4. Monitoring  

Other times the commissioning cycle stages can be referenced as: 

1. Analyse 
2. Plan  
3. Do  
4. Review  

For each commissioning cycle stage to be successful, the Social Care Institute for Excellence (SCIE) recommends evidence-based approaches including:

• Developing comprehensive needs understanding: Assessing practical, medical, social, and emotional requirements.
• Performance gap identification: Using data analytics to identify improvement opportunities.
• Service user engagement: Involving people and carers at every commissioning stage.
• Market intelligence: Understanding current service provision and provider capabilities.
• Outcomes-led approach: Focusing on measurable care improvements rather than process metrics.
• Continuous assessment: Regular service evaluation and quality monitoring.
• Independence promotion: Encouraging providers to demonstrate independence-building outcomes.
• High monitoring standards: Robust performance measurement and quality assurance.
• Sustainability considerations: Long-term viability of care delivery models.

1. Assessment  

The main objective of the assessment stage of the social care commissioning cycle is for local authorities to identify what the needs of your local population are.  

This can be where local authorities will adopt a population health management approach so local authorities can gather health outcomes across a population in a specific area to assess their care needs.  

Whether local authorities follow a population health approach or not, at this stage of the cycle local authorities will gather as much information as possible from relevant sources to understand the needs of a population.

Technology-enhanced assessment capabilities:

• Advanced analytics supporting identification of future care needs and trends.
• Integrated data systems connecting health, social care, and housing information.
• Population segmentation tools enabling targeted commissioning strategies.
• Comprehensive demand forecasting supporting strategic resource allocation.
  

Alongside assessing and understanding the care needs of their population, the assessment stage also involves analysing previous commissioning approaches, initiatives, and models to decide whether they are still relevant to your community’s needs, and if not how can they be changed or improved.  

Other activities involved can also include: 

• Clarifying commissioning territory  
• Identifying other areas of the health and care system, third sector, housing or other partners that could help provide better outcomes for people  
• Undertaking demand forecasting  
• Identifying what resources are currently available  
• Identifying what resources are needed 

2. Planning  

The planning stage of the commissioning cycles uses and takes the information collected from the assessment process to design ways in which those needs can be met best.  

The planning stage will often start with a quick review of the key findings from the assessment to identify gaps and then establish how these can be filled. During the planning stage a more detailed review will often take place to decide what is needed, what is available, and what the supply and demand capacity currently looks like.  

Strategic planning benefits trough technology:

• Market intelligence dashboards providing comprehensive provider performance data.
• Financial modelling tools supporting budget optimisation across care categories.
• Scenario planning capabilities enabling testing of commissioning strategies before implementation.
• Stakeholder collaboration platforms facilitating integrated planning across departments.

At this point for the planning stage to be successful it is vital that local authorities work and collaborate with other stakeholders and care providers to understand the full social care market.  

Through doing this, it will often result in the production of a commissioning strategy that outlines what actions will be taken and why, as well as the targets to be achieved.  

This is where the expected impacts upon service provision, the care market, and other areas like the purchasing process will also be highlighted.  

During the planning process it is also recommended to consider: 

• How pre-existing services will be re-configured or decommissioned  
• Analysing the risks involved when implementing the changes you are planning  

3. Contracting  

The contracting step of the commissioning cycle is where independent providers and other organisations that can provide the services your local authority needs are founded, sourced, and assessed for their suitability, to then be finally selected to deliver the service. 

Digital contracting advantages:

• Automated compliance verification against CQC standards and local requirements.
• Streamlined procurement processes reducing contracting complexity and timeframes.
• Comprehensive provider performance monitoring enabling proactive contract management.
• Integrated payment systems improving cash flow and provider relationships.

Ultimately this stage helps to ensure that the services needed are available and are being developed as planned. Through this quality assurance criteria can be established and be included in all contracts to ensure your care providers meet the standards required.  

At this stage other considerations have also been noted including how providers will be paid and by what method. However, due to changes in the way social care can be purchased such as through direct payments, many local authorities have renamed this stage in the cycle to ‘Do.’ 

4. Monitoring  

The monitoring stage is where local authorities will assess the performance of providers, the authority itself, and its impacts, to analyse what targets have been achieved against the commissioning strategy put forward in the planning stage.  

Advanced Monitoring Capabilities:

• Comprehensive performance dashboards tracking quality outcomes and financial efficiency.
• Automated alert systems identifying potential provider risks before service disruption.
• Outcomes measurement tools demonstrating care impact and value for money.
• Continuous feedback systems enabling rapid commissioning strategy adjustments. 

Historically, most social care services were commissioned on a unit basis, and this was typically done in bulk. For example, deliver this number of hours of care per week to this many people.  

However, this way of monitoring outcomes is now very outdated. This is because it would heavily concentrate on value for money instead of  putting the welfare, dignity, and quality of life of an individual at the centre of how care is commissioned.  

It is for those reasons  outcomes based commissioning has been increasingly encouraged and is now heavily seen as best practice.  

During this stage it is also important to consider: 

• Encompassing an ongoing review of the strategy itself e.g. are there any new legislations or are there any funding changes  
• Reviewing root causes for performance problems e.g. are they linked or have they been caused by strategic miscalculations  
• Developing systems which bring together relevant data on finance, activity and outcomes  
• The effectiveness of service models across the market to respond to different needs when they change 
• Putting in place processes to analyse service user, carer, and provider feedback  

For a commissioning cycle to be effective and at its best it needs to be data rich. Digital tools and software enables this by improving communication, data collection, and analysis. This can help streamline the assessment process to improve accuracy and make more evidence enhanced decision making.  

Digital transformation delivers measurable commissioning improvements:

• 25% faster decision-making through automated data analysis and reporting.
• 40% reduction in administrative burden enabling more strategic focus.
• 99% accuracy in demand forecasting supporting proactive resource planning.
• 20% cost savings through optimised provider selection and contract management.
• Real-time market intelligence enabling rapid response to changing needs.

Digital tools can also help enhance collaborations with other stakeholders to streamline procurement processes further and aid evaluating your commissioning strategies to get the best outcomes.  

To be able to invest in digital technology, local authorities need to be able to have access to reliable funding streams to help overcome the challenges facing the social care market and reach the increasing demand. In January 2024, the government announced an additional £500 million of social care funding.

This additional funding will offer great opportunities for local authorities to digitally transform their adult and children’s social care services to drive innovation and improve performance. This, in turn, will offer better data insights that will be centralised in one place to lead to better data-led commissioning decisions being made for your community.

Access Group: Proven Commissioning Technology Solutions