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This article describes a process undertaken to develop a set of commissioning principles to support the commissioning of secure learning disability services across England. The principles, shaped around the 11 competencies laid down in the World Class Commissioning competencies framework (Department of Health, 2008a), were produced following a scoping exercise that looked at provision and commissioning of secure learning disability services within each strategic health authority (SHA) area in England. Specific details were collected about types of services provided, including detailed service specification, quality indicators, how these (specialist) services link with local services (secure and non secure) and cost of services. Information collected about commissioning concentrated on strategic vision, practical commissioning arrangements, how the quality of services was monitored, how access to services was controlled and how ‘secure’ service users are reintegrated back into local (non secure) services and communities. This scoping exercise was augmented by qualitative data obtained from interview with a group of former service users. Themes generated through the interviews were integrated within the general guidance. A quality assurance framework based on the World Class Commissioning Competencies is proposed, against which specialist and local commissioners can benchmark their current commissioning arrangements.

The purpose of this study is to examine changes in the nature, form and range of commissioning arrangements for home care.

Data from two discrete national surveys of English local authorities with social service responsibilities were used. In the first, undertaken in 2007, responses from 111 of the 151 local authorities (74%) were received; in the second, undertaken in 2017, responses from 109 local authorities (72%) were received. A combined data set of 79 complete cases, 52% of local authorities, was created. Percentage point differences across the two time periods were calculated and tested to identify significant changes and a systematic analysis of the free-text responses regarding intended changes to the commissioning process in each data set was undertaken.

Findings identified substantial changes in some aspects of the commissioning of home care in the 2007-2017 decade. Collaboration between stakeholders had increased, particularly regarding the identification of future needs. Improved conditions of service and remuneration for home care workers were evident within the commissioning process. Standardised charges for home care (regardless of time and day) had also become more widespread. Initiatives to prompt providers to deliver more personalised care were more evident.

This paper describes the evolution of commissioning arrangements for home care in localities in response to national policy initiatives. It provides guidance to commissioners in meeting the needs of current service users and emphasises the importance of collaboration with stakeholders, particularly providers, in securing future capacity.

The purpose of this paper is to provide an overview of the process of commissioning adult social care services in England. It reflects the literature on commissioning at the strategic level followed by a section on operational or micro-commissioning. The rest of the paper focusses on the emergence of ideas about outcomes-based commissioning (OBC) in the field of adult social care and ends with critical consideration of the effectiveness of OBC in adult social care as applied to support and care provided in extra care housing.

The review of strategic and operational commissioning in adult social care in England (and Scotland in brief) is based on both policy documents and a review of the literature, as are the sources addressing OBC in adult social care particularly in extra care housing settings.

The core of this paper focusses on the challenges to the implementation of OBC in adult social care in the context of provision for residents in extra care housing. Of central importance are the impact of the squeeze on funding, increasing costs as a result of demographic change and the introduction of a national living wage plus the focus on the needs of service users through the idea of person-centred care and resistance to change on the part of adult social care staff and workers in other relevant settings.

Addressing the implementation of OBC in adult social care in England in the context of extra care housing.

Ideas about joint commissioning between the NHS and social care have been around for a long time ‐ since at least the publication of Practical Guidance on Joint Commissioning for Project Leaders by the Department of Health in 1995, and stemming from the roots of joint planning and joint finance way back in the mid‐1970s. Achievements have generally not been spectacular, but the issue is now squarely back on the policy stage with a rebranding: ‘integrated commissioning’. This implies a shift from ad hoc and opportunistic partnering to something more systemic and long‐term. However, the policy context is now very different, and the scale of ambition hugely heightened. This article examines whether integrated commissioning is an idea whose time has come.

The purpose of this paper is to complete a thorough needs assessment that would enable the development of a robust pathway of care for adults with a learning disability requiring secure care, and to assist commissioners to make informed planning decisions.

The paper identified people with a learning disability originating from London who were in secure care, and collected data about them. The paper used reference groups to inform the analysis.

The paper identified 249 people in secure services and was able to include 136 patients in the analysis. In all, 64 were in NHS provision and 72 in independent sector provision; 109 (80.1 per cent) were male and 27 (19.9 per cent) female; on average, patients were cared for 61.5 miles away from their homes; NHS patients were far closer to home; 69.1 per cent had a mild learning disability; 82.3 per cent had a history of violence; approximately one in six patients could not progress due to a lack of an appropriate ward, facility, resource and/or intervention.

Secure care for this population is a major public health issue. Many are placed a long way from home. Local services should be developed, and there should be sufficiently robust “step down” places for patients to be discharged to.

Systematic identification of the needs of a marginalised group to enable better more appropriate care pathways to be developed in the future.

In this first of two articles, the authors assess the implications of policy developments in partnership and contestability, commissioning and procurement, and local jurisdiction for adult services joint ventures. They argue for creative responses to service delivery in which policy implementation is seen as an opportunity for local health and social care agencies to honour the history of, and future aspirations for, local partnerships. A second article will detail the very different responses to the policy agenda of four case study sites, exploring the local contours and aspirations underlying their decisions, with the intention of provoking discussion about the art of the possible in the broader community of interest.The papers draw on the authors' work funded by the Integrated Care Network (ICN) and Care Services Improvement (CSIP), which comprised a series of workshops to inform the further development of the plans of four local health and social care communities ‐ Portsmouth, Wolverhampton, Barnsley and Milton Keynes ‐ for commissioning and provision of adult care services, providing a community of interest in which aspirations, challenges and emerging solutions were exchanged and explored. Here we summarise transferable learning for the broader community of interest, drawn from the more detailed reports available from the ICN (Freeman & Peck, 2006, 2007).

This paper aims to explore the learning needs of general practitioners (GPs) involved in commissioning mental health provision in England, and offer an evaluation of a leadership and commissioning skills development programme for Mental Health Commissioners.

Retrospective mixed method, including online mixed method survey, rating participants’ knowledge, skills, abilities, semi-structured telephone interviews and third-party questionnaires were used. Results were analysed for significant differences using the Wilcoxon Signed Ranks test. Open-ended responses and interview transcripts were analysed thematically.

Indicative results showed that participants perceived significant impacts in ability across eight key question groups evaluated. Differences were found between the perceived and observed impact in relation to technical areas covered within the programme which were perceived as the highest scoring impacts by participants.

The indicative results show a positive impact on practice has been both perceived and observed. Findings illustrate the value of this development programme on both the personal development of GP Mental Health Commissioners and commissioning practice. Although the findings of this evaluation increase understanding in relation to an important and topical area, larger scale, prospective evaluations are required. Impact evaluations could be embedded within future programmes to encourage higher participant and third-party engagement. Future evaluations would benefit from collection and analysis of attendance data. Further research could involve patient, service user and carer perspectives on mental health commissioning.

Results of this evaluation could inform the development of future learning programmes for mental health commissioners as part of a national approach to improve mental health provision.

Mental health problems in later life are common and damaging experiences for individuals, their families and those who support them. Some become almost the defining feature of the older person and, while they are challenging professionally and costly for society, they are also influenced by the twin discriminations of stigma and ageism. In this, the last in our series on older people's mental health, we pull together some other key messages from the series and set them in the context of current and future service commissioning and provision. We point to remaining gaps in provision and suggest how commissioners might approach the problems of mental ill‐health in later life in a context of declining resources.

The purpose of this paper is to present the perspectives of English adult social care sector partners on the qualifications and standards required for leaders as they prepare to meet the demands of commissioning personalised care. Continuing an action research cycle guided by Coghlan and Brannicks (2010, p. 4) organisational centred model (McCray and Palmer, 2009) it benefits from the previous experience and reflection in action of the partners and researchers. Set in a general social care context, lessons learned from the study outcomes will be of interest to both commissioners of services and service users with acquired brain injury.

A model of action research informed by Coghlan and Brannicks’ (2010, p. 4) organisational centred model focused on context, quality of relationships, quality of the research process and its’ outcomes was used. The role of the authors was to facilitate diagnosis of the leadership issues arising from the implementation of personalised care in the English adult social care sector and in collaboration with sector partners seek resolutions. Six focus groups comprising two commissioners, service providers, user group and care manager/social work leads were facilitated at two separate events in the south of England.

Findings presented are derived from focus group discussions with strategic and organisational leaders and service user partners from the English adult social care sectors. Analysis of focus group data identified a number of themes. The overarching themes of human resource management, gaps in industry standards and leadership are discussed here. Whilst industry sector standard qualifications and frameworks may be at the centre of strategic planning for transformation, findings here have identified that additional support will be required to create leaders who can commission successfully to create cultural change. New approaches to leadership development may be needed to facilitate this process.

The study offers a single method qualitative research approach based on two local authorities in the south of England. It presents a localised and particular view of leadership development needs.

The paper shows how action research can make a contribution to knowledge and practice.

The paper provides interesting new insights into the skills for commissioning in a changing public and third sector environment with reference to commissioning personalised support for people with brain injury.