Commissioning services from third sector organisations: some emerging themes from research on Mental Health Services in the West Midlands
Buckingham, Heather; Miller, Robin; Rees, James (2013)

James Rees and Robin Miller, Third Sector Research Centre, University of Birmingham,and Heather Buckingham, Health Services Management Centre, University of Birmingham

There has been an explosion in interest in commissioning in recent years in the UK thanks to a policy environment that has emphasised the promotion of greater supplier diversity in the provision of public services. Commissioning has offered the hope of a route through which services can be ‘purchased’ by the public sector in a way that is sensitive to a population’s needs, can help manage a local ‘market’ of suppliers, and can create well integrated, comprehensive services. Commissioning is viewed as of considerable importance for the third sector as it is likely to shape the crucial relationship between that part of the sector that delivers services and the state which funds them. This paper reports on research that set out to discover if, within a particular policy area, and in a defined geographical area, commissioning could be considered to be effective in meeting these aims, whether there were particular barriers to effective commissioning, and whether findings were of wider relevance to other services areas and to debates about ‘open’ public services, outsourcing and the ‘contract culture’ that has long been part of the debate about service delivery and the third sector.

Early messages from the research suggest that there is a combination of confirmation of some of the themes discussed in the literature around the commissioning of the third sector, and some challenges to conventional wisdom. We emphasise in this paper three themes:

  • Commissioning does not seem to work in the idealised way presented in many policy documents which posit a neat model of a commissioning cycle. Instead reality is rather more messy and there are strong continuities with how things have been done in the past, within particular local contexts, as well as the influence of other agendas such as the outcomes focus and cost savings;
  • The role of personal relationships, contacts, networks and trust are all crucial, and suggest that there is a complex trade-off between these and notions of transparent and market-based mechanisms. The ‘intent’ of particular initiatives is not always openly apparent, but can involve hidden agendas and ‘deals’;
  • There is a great deal of instability and uncertainty at present in local public services due to the widespread and disruptive effect of health reforms, and the impact of public sector austerity. It is very difficult therefore to generalise from individual instances, and to identify and try to generalise ‘best practice’ etc.

We finish with some reflections on the relevance of the research for current debates about public sector reform and the positioning of the third sector in recent policy and political debates.

James Rees and Robin Miller are Research Fellows at the Third Sector Research Centre, University of BirminghamHeather Buckingham is Senior Fellow, Health Services Management Centre, University of Birmingham

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