Relationships have been a focus for the Care Review. It is likely they will be promoted. Child-centred. Good.
It would be unsurprising if it were different.
The guide to the Quality Standards Residential Child Care – key principles #1
Children in residential child care should be loved, happy, healthy, safe from harm and able to develop, thrive and fulfil their potential.
The principles direct Residential Child Care to be “outward facing, working with the wider system of professionals for each child, and with children’s families and communities of origin to sustain links and understand past problems”. Principle #6
The Care Review must take its value on relationships and make it central to commissioning – Relational Commissioning
The Care Review has expressed less about the ‘how’ of commissioning.
NCERCC has always held that commissioning is a parenting and child care activity
Providers and commissioners need a common set of values that they bring to the comprehensive mapping of existing services that creates the strategic framework and dialogue that go to make effective systems
Relational commissioning goes about ‘economy, efficiency and effectiveness’ and ‘challenge, comparison, consultation and competition’ in a different way than things have been done recently.
Relational contracting requires an appreciation that personal, professional and social values influence the nature and process of the working relationship.
Relationships build over time, trust has to be established or anticipated, mutual trust is greater than individual self-interest
Relational contracting is underpinned by interaction, negotiation, flexibility and mutual trust. this goes to build the ‘contractual community of interest’
The Care Review can give the lead to Relational Commissioning describing the changes necessary
- Shifting from product to learning;
- Developing explicit skills, attitudes, and abilities as well as knowledge;
- Developing appropriate assessment procedures;
- Rewarding transformative practice;
- Encouraging discussion of practice of both commissioner and provider;
- Providing transformative learning for all commissioners and providers
- Fostering new collegiality;
- Linking quality improvement to learning;
- Auditing improvement.
‘Thinking differently about commissioning’ Kings Fund (2022) describes the roue map for a new ethos of commissioning.
The commissioner is described as a ‘facilitator’, ‘enabler’ or ‘connector’.
Changing approach to commissioning
|From – Now||To – New|
|Care focus||Child/children focus|
|Provider focus||System focus|
|Contract enforcer||System enabler|
|Transactions||Relationships and behaviours|
|Decision maker||Convenor for collective decision making|
|High bureaucracy low cost||Low bureaucracy high trust|
|Monitoring provider performance||Monitoring system performance and improvement support|
|Following national guidance||Developing local solutions|
Strategic planning is a collective activity in which system partners come together to understand available resources, explore local population needs, agree priorities and make resource allocation decisions looking across health services (and in some cases, across health, social care and wider public services).
The Care Review needs to chart the development of Relational Commissioning.
Relational Commissioning requires different behaviours and involves navigating uncertainty. For some staff this can be challenging. It will require investing in organisational development.