Why is this needed?
- The advent of the ASF has led to unprecedented levels of commissioning and procurement activity in adoption support
- Adoption services often have little experience of commissioning activity leading to ASF funded services being commissioned in ad hoc ways with a lack of due process or evaluation of delivery and outcomes.
The Department for Education (2017b) evaluation of the adoption support fund, undertaken by the Tavistock Clinic, highlights the need for investment in intelligence gathering and strategic thinking around local need and workforce planning. It highlighted the following challenges:
The market for independent post-adoption support services expanded in response to the increased funding available and the limits on the capacity of local authority adoption support services.
In addition, local authority adoption support professionals raised quality concerns about the market, and this is exacerbated by the stretched capacity of independent providers struggling to meet the sudden demand. (p13)
Local authorities might consider how they can influence workforce development of local therapy providers. Good practice identified by some case studies included mapping and sharing information with other local authorities and including independent providers in strategic planning. Local authorities may benefit from these collaborative approaches to help influence local markets to meet upcoming support needs. (p17)
NMS 15.1 Where services are commissioned by an adoption agency, a three-way working relationship is developed with the adoption agency and the Adoption support agency working in partnership to most effectively meet the needs of the service user. Commissioning arrangements are underpinned by a written agreement and are reviewed at regular intervals.
The Department for Education and Mott McDonald have produced a good practice guide to commissioning adoption support services (available from the Adoption Support Fund).
An AdoptionUK survey revealed:
A quarter (of adopters) felt the therapy they received via the ASF was not appropriate
More than 80% confirmed the therapy received via the fund had a positive impact for their family
More than two-thirds of respondents said that although the support they received was welcome, more was required to meet their family’s needs
Some adopters, for whom the ASF has been a life-line, have strong views on which services and individual providers they want to access. These views have not always been easy to accommodate within local authority assessment and commissioning processes.
A number of LAs and RAAs (Yorkshire and Humber, Birmingham CT, Adoption Counts) have instituted a structured approach to commissioning and a formal procurement process following EU procurement rules. These approaches have much in common.
Key elements include:
A formalised assessment process
A commissioning framework with a standardised application and vetting process
A mini competition process, in which the type of therapy is specified, and which gives providers on the framework the opportunity to bid for the work
Tailoring of the service where necessary to meet individual needs
An application process for funding from the ASF
The Adoption Counts framework is available to all north west local authorities.
All three RAAs in Yorkshire and Humber (15 LAs) use the same commissioning framework.
Key challenges have included:
Obtaining an expert view of the most appropriate service for children and families
Implementing a quality assurance process to monitor the effectiveness of the therapy provided which includes:
An expert view of the quality of service
Adopter, child and professional feedback
Capturing the view of providers about what adoptive families need
Bringing contracts to an end at the appropriate time when providers may wish to continue the work and adoptive families fear that the end of therapy will mean an end to any kind of support.
Understanding the overall needs of adoptive families and the current capacity of the provider market place
Influencing the market to fill any gaps and meet unmet need
Agencies with in-house expertise (e.g. Birmingham CT) have been able to use their Psychologists to quality assure external services. Adoption Counts has implemented a Multi-Agency Resource Panel, bringing together Clinical and Educational Psychologists with Social Work Managers to review the more complex cases and to assess the quality of the services provided. The Panel meets monthly and has kept a learning log. The purpose of the panel is to:
Consider applications for funding of services through the Adoption Support Fund (ASF) that exceed the Fair Access Limit and require match funding
Assist Adoption Counts to make the most effective use of high cost specialist resources
Reduce duplication of services and offer access to high quality high impact therapeutic services
Monitor the quality of the therapeutic provision that is registered with the Adoption Support Framework
Enhance the delivery of therapeutic services in terms of both scope and quality, based on feedback from families
Consider requests to ‘block purchase’ services through the ASF to meet service need
Undertake the role of professional advisors to the adoption team helping to identify the right services at the right time for adoptive families and to offer constructive feedback on practice
Adoption Counts has also set up a commissioning and procurement group to deal with the details of a commissioning strategy and procurement process. The work of this group includes:
Evaluation of applications to join the framework
Reviewing the framework to identify gaps in provision
Finding ways to stimulate activity in the market place where gaps exist
Liaising with providers to improve the procurement process
The group is in the process of gathering information from both providers and social workers to review the success of the framework after its first year of operation.
Possible future developments
Many third sector providers deliver services in more than one region. There would be clear benefits to RAAs of sharing learning and intelligence in this area.
Comments received from agencies in the survey include:
- Sufficient commissioning capacity and expertise is not always readily available within the adoption sphere, but commissioning activity is inextricably linked to the successful implementation of the ASF.
- Lack of certainty about the future of the ASF will eventually affect both commissioning processes and provider development.
- The ASF has driven a spot purchase model of commissioning. RAAs find it very difficult to do any strategic procurement due to fact that the ASF works much more effectively for spot purchasing rather than block purchasing. RAAs therefore lack procurement power to be able to negotiate improved prices with the providers. In turn, providers cannot plan for viable growth due to lack of certainty about funding.
- VAAs, in particular, comment that where they deliver services across more than one region, or to multiple RAAs, the individual commissioning processes are administratively burdensome and therefore not cost effective. Agencies have adapted to work within current practice but the longer-term viability of such a model to deliver system capacity is a major concern.
- Some VAAs have expressed the concern that commissioning is leading service provision, not best practice. The issue of what works in adoption support is again a key issue.