This case study is based on a speech given by Sinéad Cregan, Adult Commissioning Manager at Leeds City Council, at Locality’s annual convention in Bristol, on 8 November 2018.

It aims to provide those with an interest in Keep it Local commissioning methods with an insight into the practical steps commissioners can take to keep their services local, in the context of Leeds’s community- based mental health service.

This is part of a collection of Keep it Local Network case studies.

Key facts about the service

  • A service to provide community based mental health support across Leeds
  • Value of £1.3 million for each year of the contract
  • This service includes a contribution from the Leeds NHS CCG
  • Merged four contracts into one, but also wanted to ensure small, local providers are part of the mix
  • Final model: a partnership of three providers, with one lead provider responsible for contract compliance and sub-contracting, and 16 smaller neighbourhood based providers
  • The service will go live in April 2019.

Key pieces of advice for commissioners on the contracting process

Make the service specification as clear as possible. The complexity of service specifications can put many smaller, local providers off even bidding for contracts. As well as clarity on what the provider is bidding for, it was also important to make the expectations of Leeds City Council clear as well.

Look to others for inspiration. In this case, Leeds City Council’s commissioning team looked to Kent Council for inspiration as they had used this model.

Bring people with you. Taking a different approach often requires getting staff across the council on board. In this case, that involved emphasising the benefits of a neighbourhood-based approach to senior Directors, procurement colleagues and elected members. This takes time.

Ask what you CAN not what you CAN’T. Leeds City Council’s commissioning team had to ensure that their procurement colleagues would support this approach. The latter felt that they needed to ensure that this approach would be compliant with procurement regulations.

However, a shift in dialogue and a request from Sinéad Cregan to see what Leeds can do, made a huge difference in pushing the process along.

Think about simplifying processes and recognise the limitations of excessive procurement regulations. Some procurement rules are prohibitive for small, local groups. They stop many qualifying organisations even filling out the pre-qualifying questionnaire, never mind getting to the next phase. Whilst contracts do have to be subject to competition, ensure there is a level playing field which allows for small providers to be involved.

 

Key principles which underpin the contract

Involve service providers and people who use services regularly. In this case, they were involved in the procurement process as consultants. This is vital in ensuring the service provided meets people’s needs and is something providers can deliver effectively. Sinead had conversations with people who use services and other interested stakeholders over a three-year period, which fed into the final service specification.

Commission for ‘organisational emotional intelligence’. Front-line staff dealing with people with complex needs need to be able to be personable and relatable. Sinéad wanted to ensure that providers are challenging themselves on how they’re delivering frontline services. It might have felt tricky to ‘measure’ this, but it was included in the service specification, due to its importance.

Commission for love and care. Again, this is a tricky thing to measure, but Sinéad believes these types of services need to be ‘aspirational’ and one of these aspirations needs to be that people feel cared for.

Pursue a richness of providers. Sinéad recognised that specific groups were under-represented in Leeds’s community based mental health services – LGBT and Gypsy and Traveller groups, for example. A diversity of local service providers, with links to such groups, is vital in tackling this.

Commission to consider ‘organisational service fatigue’ over the five years of the contract. As this is a five-year contract service fatigue is a risk to the successful delivery of this service, therefore it is important for the providers to ensure their approach remains fresh and innovative and not complacent.

Commission to account for ‘unconscious bias’ in all processes such as recruitment and service delivery.

Make every contact count. ‘Failure demand’ – which Locality have researched in more detail – accounts for a majority of demand for public services. Making sure every interaction people have with a member of staff is meaningful is vital in ensuring such services transform lives.

Account for ‘burnout’. This is about ‘futureproofing’ services, so they last. Staff working on the frontline work with challenging issues every day. Commissioners are in a position to make sure providers have systems in place to ensure their staff are well-cared for.

 

For more on Leeds’s community based mental health support service contract, please do email Sinéad Cregan on Sinead.Cregan@leeds.gov.uk

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