Planning your approach step-by-step

It’s important to take stock of how you are progressing and consider whether you need to reassess your goals.

Assessing progress and measuring achievements may be difficult to quantify. Outcomes that you may consider to indicate success include:

• winning a contract to provide Reading Friends universally in an area or for a target group
• exploration of new ways of delivering befriending services to meet the needs of particular groups or individuals
• increasing the profile of Reading Friends at a strategic level and being seen as a much more active collaborator
• embedding Reading Friends within a local social prescribing scheme

Whilst it is important to identify a range of funding sources to help sustain Reading Friends locally, engaging in commissioning requires a much wider approach than solely focusing on winning contracts.  Being prepared to invest time in understanding priority outcomes in your area and building relationships may open up other opportunities.

However, do assess the business implications of your progress during this review stage and evaluate whether seeking to engage in commissioning remains the right use of your time and resources.

Some preparatory thinking on where you are now, how you are going to approach this and who will be involved is vital.

Reviewing the position – Take stock of who you know already. This could be grant aid organisations or project funders. You might have relationships with learning and education commissioners, but not with commissioners in adult social care or health and wellbeing.

Scoping your approach – Think about how Reading Friends aligns with commissioning opportunities in adult social care and health and wellbeing. You might want to narrow this down from the start and focus on one of these areas, or even narrower, such as older people living with dementia. We recommend focusing on one area, and building relationships with commissioners in that field. This will help you understand their language, outcomes, measurement tools and quality standards.

Think about timescale – Bear in mind that setting up meetings with commissioners and then following up with a more formal proposal may involve long lead-in times. So plan and budget accordingly.

Coming soon: Create a ‘Plan on a Page’ – A useful tool for showcasing the Reading Friends offer in a visual and engaging way. We’re developing a template with generic suggestions for you to adapt to suit local priorities, outlining the outcomes and impact of the programme.

Commissioning is a process involving assessment of needs, identifying the priority outcomes to meet needs, allocating resources and procuring a provider to achieve the outcomes.

The involvement of users and communities is central to the whole process. The commissioning process is generally described as a cycle:

What happens at each stage in this process?

Users and communities	Users and communities must be at the centre of every part of the process. The Local Government and Public Involvement in Health Act (2007) sets out the requirements for contractual arrangements to be made for public involvement.
Needs assessment	Commissioning starts from a sophisticated understanding of needs. These are key documents that you should be able to access: – Joint Strategic Needs Assessment – JSNA – Director of Public Health annual report – Director of Adult Social Care annual report – Clinical Commissioning Group – Commissioning Strategy or commissioning intentions
Resources	Commissioners will assess all of the resources available to meet the needs. Increasingly this is being done on a public sector-wide basis of all partner resources through: – mapping public sector assets – community budget or ‘whole place’ approaches
Priorities	Decisions regarding the priority outcomes are set through the governance structures. The Health and Wellbeing Board (HWB), or similar body in Scotland, Wales and Northern Ireland, is a key body for local commissioners across the NHS, public health and social care, elected representatives to discuss how to work together to better the health and wellbeing outcomes of the people in their area.   By involving democratically-elected representatives and patient representatives, and bringing them together with local commissioners across health and social care the intention is to strengthen the legitimacy of commissioning decisions, as well as providing a forum for challenge, discussion, and local involvement.
Delivery options	Commissioners will explore the options for meeting the priority outcomes. This will include activities such as: – Developing the business case – Testing the market for different providers and approaches – Developing the market and building capacity – Exploring different ways of achieving the outcomes planning the procurement process
Procurement	Procurement is the process of acquiring goods, works and services, covering both acquisitions from third parties and from in-house providers. Procurement will involve: – Writing the specification, based on the options appraisal – Business case, clarifying the desired outcomes – Inviting tenders – Evaluating tenders – Awarding the contract
Delivery	Delivery of the service should continually engage users and communities and involve commissioners to work on the achievement of outcomes. The aim is not just to learn about successes, but to find solutions to difficult challenges and make the contract work for everyone, particularly the service users.
Monitoring	Commissioners are encouraged to monitor what is important in relation to outcomes. There will be contract compliance and monitoring of key quality standards and performance measures, but lighter touch monitoring of outputs and a focus on the achievement of social outcomes is the higher priority.   User and community involvement in monitoring is required.
Review	At appropriate points in the lifecycle, such as annually, commissioners will review the overall context and assess whether there are new needs or circumstances to be taken into account. The process of review will vary, but is important to ensure that the resources are having an impact and whether there are any changes of any sort that might be necessary.

Many people are involved in commissioning and some will not have the word commissioner in their job title. Indeed, there may be those who are called commissioning officers who are in reality contract managers – so the picture can be challenging. As councils restructure, commissioning roles are also being rationalised, so you may experience changes taking place.

In setting out who’s involved, it is important to be aware that commissioning occurs at a number of levels – place-based, strategic, locality and personalised.

Place-based commissioning involves joint working between commissioning bodies.  There is an increase in place-based commissioning, which recognises that people often face complex conditions and multiple challenges, whereby joined up approaches are needed.

Strategic commissioning takes place predominantly at the upper-tier council area (unitaries and counties) as they have responsibilities for adult social care, health and wellbeing and children and young people’s services. The JSNA is the responsibility of upper-tier authorities and their health partners.

Locality-based commissioning is where all aspects of the commissioning process are devolved to a lower local level, including the devolution of budgets, decision making and delivery of outcomes. For example Clinical Commissioning Groups take commissioning responsibility for populations of around 100,000.

Individual level commissioning is known as personalisation. This approach to social care commissioning is based on the needs and choices of the individual. It is sometimes known as ‘self-directed support’ and also as ‘micro-commissioning’. In some cases the individual’s personal budget is managed by their social worker and in other cases is it made as a ‘direct payment’ for the individual to manage for themselves.

Key people

Structures, job titles, roles and functions vary from place to place – the table below indicates the kinds of jobs and areas where there will be a commissioning function that is of relevance to Reading Friends.

However, you will need to ensure you investigate how these roles are assigned within your local context.

Service area	Indicative roles, titles or functions – examples
Adult social care	Assistant director of commissioning or Head of Commissioning Usually there is a senior person who oversees commissioning for all services in adult social care. Below them in the structure there might be: – older person’s commissioning manager – disabled people’s commissioning manager – carers services commissioning manager – learning difficulties commissioning manager – mental health commissioning manager In some authorities, these service leads may also have a geographical remit – pulling together care services in a locality. Other relevant functions to explore are: – Primary prevention services – those parts of the service seeking to prevent or delay people from entering the system. – Secondary prevention or ‘Re-ablement services’ – supporting people who may have had a stroke, fall or bereavement, to return to independence. – Community services and community care – this may include preventative services and support for independent living, but also other activities to promote wellbeing. In relation to personalisation, those involved in commissioning are: – individuals with personal budgets receiving direct payments – support planners engaged by people with direct payments – social workers supporting people with personal budgets – brokerage teams who seek to open up and support the options and choices of services for those on personal budgets.
Health	Upper-tier and unitary councils in England are responsible for public health and have established Health and Wellbeing Boards (HWBs). It is a statutory obligation to appoint a Director of Public Health and they are responsible for a range of public health functions including, but not limited to: – seasonal mortality – accidental injury – drug, alcohol and tobacco misuse – obesity – prevention and early intervention – social exclusion – physical activity If you work in England, The Public Health Outcomes Framework – 2016 to 2019 is a useful source to guide you in broad terms to those who will be commissioning to these outcomes. The framework provides the broad context within which HWBs develop local priorities.  Clinical Commissioning Groups – Clinical Commissioning Groups (CCGs) are groups of GPs that are responsible for designing local health services in England. They do this by commissioning or buying health and care services including, but not limited to: – rehabilitation care – most community health services – mental health and learning disability services. CCGs work with patients and healthcare professionals and in partnership with local communities and local authorities. Personalised health budgets are available in some areas, these are similar to those in social care, for people who have long term conditions which they want to manage at home.  In some cases health and care budgets form a joint or pooled budget. This means that many frail elderly, people with disabilities and those with serious mental health problems have been allocated integrated budgets.
Variances
Scotland	In Scotland health and social care are within a single, integrated system, with Integration Authorities responsible for funding local services.   Health Boards – in Scotland there are 14 regional NHS Boards, which are responsible for the protection and the improvement of their population’s health and for the delivery of frontline healthcare services.
Wales	In Wales the Public Health Outcomes Framework is linked to the Well-being of Future Generation Act’s national indicators and milestones, which have been set by Welsh Government Ministers.  Indicator 16 is the % of People 16+ feeling lonely according to the De Jong Geirveld loneliness scale.   Health Boards – there are 7 Local Health Boards (LBHs) covering Wales who are responsible for everything from planning, providing hospital care and community nursing to contracting GPs and arranging specialist treatment.
Northern Ireland	In Northern Ireland ‘Making Life Better’ is the strategic framework for public health.  Whilst it doesn’t currently specify loneliness and social isolation it has mental wellbeing as measured by Warwick Edinburgh Mental Wellbeing Scale as a key indicator. Local Commissioning Groups (LCGs) – there are 5 LCGs responsible for the commissioning of health and social care. They also have responsibility for assessing health and social care needs; planning health and social care to meet current and emerging needs; and securing the delivery of health and social care to meet assessed needs.

This is the key step in starting to engage and involves research and the start of relationship building.

Initial research

• Read the Joint Strategic Needs Assessment (JSNA). This will be available on the council’s website. This will give you the context in which commissioners are operating and the outcome areas needing attention in your communities. It gives you clues as to where Reading Friends might be able to contribute to making a difference to the outcomes for local people.
• Read the director of public health’s annual report. This will have some overlapping information to the JSNA, but may also go into more depth on key priority health outcomes.
• Find out more about the commissioning intentions of your Clinical Commissioning Group or similar and check whether a social prescribing scheme has been established in your area.

Make contact

Seek to set up some initial meetings if possible, this will give you a chance to explore in more detail the potential opportunities for Reading Friends to engage with commissioning. Try to set up sessions with:

• a lead officer in adult social care with responsibility for older people
• a lead officer in public health with responsibility for prevention
• a lead for primary care commissioning in your local Clinical Commissioning Group

The purpose of the session is to find out more about their priorities and key outcomes, how they operate and whether the Reading Friends programme can make a contribution to achieving their outcomes.

Be open to the fact that they may not see befriending as especially relevant at this stage and may not know much about the potential. This is a research and fact finding exercise.  However, do have an example of Reading Friends contribution to outcomes available to use in the discussion, but remember it is about beginning a relationship, understanding their perspective and not trying to ‘hard sell’.

A framework for the meeting

Below is a guide to the conversation, this is not a definitive list of questions, so allow the conversation to open up in the early stages to encourage commissioners to talk. Always ask for an explanation where you don’t understand the jargon or acronym.

Introductions

Background to why you are here – briefly outline what the Reading Friends programme is (you can cover it in more detail later), emphasise that you are seeking to understand their perspective and approach, how they do business and the opportunities for Reading Friends to make a contribution. 

Key priorities of their role

Q1. In general terms, what are the main priority outcomes and key challenges in the area and for the services you provide? (very broad opener)

Follow-up question: Do you use any particular models or tools for measuring outcomes or collecting evidence of impact?

Q2: When commissioning services, what are the key principles of how you approach commissioning?

Possible prompts:

• guiding documents – national/local
• published commissioning intentions?
• community/user involvement – any user forums?
• is there a joined up approach locally?  Any consortia that you need to be aware of?

Q3: What are your commissioning procedures and processes?

Possible prompts:

• any written procedures to take away?
• try to cover needs assessment and outcomes, but let them use their words and language
• governance structures – any details of membership or terms of reference?
• management structures – any organisational charts?

Q4: How do you involve provider organisations in the Voluntary Sector?

Possible prompts:

• any provider forums or capacity building activity?
• any practical examples of working with befriending services and/or libraries.

Q5: What are the opportunities and barriers for Reading Friends to support local priority outcomes?

Having listened to the commissioner, it may now be appropriate to discuss in more detail how Reading Friends might contribute. If there is a clear outcome area where the programme can contribute, agree how this might be taken forward and what information they would like to receive from you.

Reflecting on the meeting

Capturing the words and perspectives of commissioners from the interviews is especially valuable.  After the meeting use the notes with your team or group to:

• review and consider the needs of the community you work in
• learn about services, their priorities, language, guiding documents and aspirations
• do further research and reading where necessary to grow your understanding
• consider what the realistic opportunities and potential barriers are for Reading Friends to be commissioned locally

Your notes will be a snapshot in time and there may be movement and change. 

Assessing the potential of a commissioning opportunity

Securing funding through providing commissioned services may not be a viable route for Reading Friends programmes in all locations; it involves the investment of a significant amount of time with no guarantee of success.  So before you continue further consider the following questions:

1. Can you align your programme of activities with the priorities expressed by commissioners?
2. Do you have the resources to develop the opportunity without detracting from your core aims?
3. Can you express this as a clear business model, including unit costs of delivery?
4. Can you evidence your outcomes in the way that the commissioners will require?
5. Could you win a contract alone or would you need to find an appropriate partner?  If you need a partner/s who would that be?
6. If you are successful in securing a contract or new project funding, do you have the capacity to deliver?  If not, are the commissioners prepared to pay for additional resources or capacity building, training and development?

If you answer ‘Yes’ to most of these questions, then it is likely to be worth further engaging with the commissioning process.

If you answer ‘No’ to most of the questions, then commissioning is unlikely to be the right approach at this time.

Following up

The intention is that the initial contact will be a beginning. So regardless of whether you decide to pursue a specific opportunity, it’s important to follow up the first meeting to illustrate that your organisation is a strategic partner and you are interested in building relationships.

If a specific opportunity has arisen that you wish to pursue further, then the next step might be a session to explore in more detail how the Reading Friends activity can be developed locally to align with priority outcomes, what monitoring and evaluation tools the commissioner favours, what the key indicators will be and how evidence should be presented.  Depending on the scale of the commission, it may be necessary for you to apply through a specific contracting process.

The challenge is to position the Reading Friends offer strategically in the whole commissioning process. You will need to be proactive in your approach and remember that building relationships and understanding is the key.

Finding ways in may be time consuming, below are some suggestions for potential entry points in the commissioning cycle.

Stage	Potential entry points
Users and communities	Use existing community networks. If you already have a strong base of participants and volunteers, listening to their ideas and aspirations and feeding these into the process up front is how good ideas and community-led solutions can develop and grow.
Resources	Feed into exercises to map community resources or pilot community budgets. If you have a capital asset, ensure this is included in the mapping exercise. It may lead to discussions about sharing spaces which could save money, bring new income streams or bring new users into your services.
Priorities	It will not be possible or realistic to be represented on the key boards and decision making bodies. However, establishing a link to these bodies is important. For example the Health & Wellbeing Board may include a voluntary sector representative. Identifying them and make sure they have an awareness of what Reading Friends can offer and ask them to feedback from time to time to keep you informed of the issues under discussion. Study the strategies and any emerging commissioning intentions to identify the priorities where Reading Friends might play a part.
Delivery options	Attend market development sessions, provider forums or capacity building opportunities. These may have different names in different places – but they are opportunities to engage with commissioners and find out what’s on the agenda.
Procurement	Ensure you have the basic ‘organisational health’ in place to enter a procurement process.  This will include your own governance structure, financial accountability, health and safety including safeguarding, equality and environmental policies. Going into a tender process can be very time consuming so having the basics ready is essential so that the energy can go into addressing the service specification. Here you will also need evidence of how your service impacts on better outcomes for communities and represents value for money.
Delivery	If you are a chosen provider, build in ongoing mechanisms for involving users and communication with contract managers. If you are not the provider, there may still be opportunities, especially with larger contracts there will be subcontracted work and partnerships.
Monitoring	Ensure you are monitoring and evaluating your existing work so that you are building your own evidence base. Understand systems for measuring outcomes. There are a number of systems for monitoring and measurement used by commissioners.  Find out which ones are being used locally by commissioners that you are interested in working with and build these into what you do now to prepare for future relationships.
Review	Engage with exercises which refresh the strategic direction for the council and the CCG. Keeping abreast of changing needs and emerging priorities and contributing to shared solutions remains important. It establishes or retains the positioning of your organisation as strategic thinking.