How can you make better decisions in #complexity?

What is one thing you’d like to offer to adult social care commissioners to help them decide their approach?

How can you make better decisions in #complexity?

How do we ensure a better #future for citizens, communities – and ourselves?

How can we encourage #innovation in an over-pressurised and partly broken system?

Adult social care #commissioning is a fantastic space to explore these issues, as we’ve been doing for the last few weeks on an interesting project, and for years before that!

Commissioning in adult social care means shaping a complex system to get better outcomes for people with learning disabilities, physical disabilities or physical or mental health issues.

It can be as narrow (but challenging) as ‘procuring organisations to provide homecare’, and as wide and messy as ‘shaping a community where everyone can thrive’.

As a commissioner, you have varying levels of power, authority, capability, respect, and understanding in your organisation.

…you have to constantly respond to crises (most of them caused by ‘austerity’): a provider of care collapsing; problems recruiting and retaining workforce because they’re paid less than Amazon; 30% of carers off sick with COVID; an urgent need for particular specialist mental health services (say).

…and you have to work in a place, with all its complexities:

– do the chief executives of the council and the hospital trust get along, or can they not be trusted to be in the same room together?

– do our providers trust us, or are they still hurting because we clumsily tried to reduce their fees three years ago?

– do the community organisations agree with our ideas about ‘coproduction’, or do they see it as foisting the costs of care on to them?

What we’re doing is trying to produce a tool to help people doing this messy, complex job to assess their context, and:

1- put together a commissioning development plan to get more ability to influence the system of health and care in their place (or, even, the system of wellbeing)

2- decide which of twelve ‘commissioning approaches’ fits their place and their needs best

We’ve been running this as a #workoutloud process – so if you fancy diving in and contributing, you’re welcome! There’s an open Mural board and an open meeting on Wednesday 20 April at 2:30pm (links below).

Or you can give us a quick comment here:

What is one thing you’d like to offer to adult social care commissioners to help them decide their approach?

As well as the slides (scroll to the bottom), the draft working documents are on a Mural board for comment, at

Mural Board

And there’s a final meeting of our open group for anybody who wants to comment on Wednesday 20th 2:30-3:45pm which you are welcome to attend – registration needed at

About this work:

The Public Service Transformation Academy has been commissioned by the LGA (the Care and Health Improvement Programme, jointly run with DHSC and ADASS) to produce a tool for adult social care commissioners to go through strategic options appraisal – i.e. to assess their place and decide the best approach to commissioning.

The slides in PDF:

Long live commissioning! But what shall we call it?

What do you call an approach that moves #publicservices


  • ‘spending money on services to meet needs’


  • ‘intervening and learning in the complex systems that actually shape our lives’?
latest piece in the Municipal Journal

The former sees ‘services’ as the whole universe, brought into being by our public service cash.

The latter sees that people are busy living their lives and that funding is just part of the influence we can have on citizen and community outcomes.

The word we’re stuck with, like it or not, is #commissioning.

It’s been five months since I last wrote ‘it ain’t dead!’ (I checked). And I have to keep saying it.

Yet because commissioning covers that (still vital) process of deciding which services (in-house, outsourced, third sector) are funded and which are not, it still gets bracketed with procurement, outsourcing, and contract management.

It’s much more than that, and since 2011 we’ve been working to show how it much more deserves to be part of #systemschange #systemsleadership and what’s now called #humanlearningsystems

My latest piece in the Municipal Journal is at

How would you try to get this message across? What would you call it?

See also

Our core positioning piece: ‘commissioning is an approach to transformation’

Can commissioning truly start from the assets and capabilities of citizens and communities? As we inch towards the post-Covid era, what opportunities and risks are opened up by the massive release of citizen and community assets during the pandemic?

Commissioning is dead, long live commissioning

Have you heard of ‘commissioning’? Here’s why it’s important in all our lives

‘Commissioning’ is misunderstood, denigrated, reduced to something else, and important. Often seen as just procurement, outsourcing, or a commercial activity, in fact it is about really achieving our goals as a society.

There are three versions of commissioning

1.0 started as a way to try to buy things effectively, thinking about the real needs, and learning from results. Commissioners were the centre of the universe, their budget what made everything happen

Imagine buying street cleaning services. Complicated, tough – but you sign the contract and things happen

Now think about how you achieve the goal of clean streets – it’s a much bigger picture

2.0 got us thinking about the outcomes we need, and how to get to them – immediately making the commissioner a humbler part of a much bigger, complex system

3.0 means thinking about what people are already doing and achieving for themselves – how can we help our community and businesses to have clean streets?

In each step, the commissioner gives up their centrality. And gains more power

Where could you play on a bigger stage – and step up from clever buying to outcomes focus to a strengths focus?


This image has an empty alt attribute; its file name is commissioning-shifts.jpg

Commissioning is dead.

The idea, first seriously introduced in the UK around 2010, has been associated with the ‘purchaser/provider split’, competitive tendering, and outsourcing.

The integrated care white paper removes the NHS reforms which were most symbolic of this, so it’s time to acknowledge that the long-heralded event has come. It is a dead parrot.

But the idea that it’s the job of government to:

  • spend money…
  • for services…
  • to meet needs…


This puts the ‘commissioner’ and their budget at the centre of the universe. It assumes the solution is to provide services. And it focuses on needs, deficits, problems.

We need to replace it with

  • experimenting and learning…
  • how to influence complex systems…
  • to achieve better outcomes for citizens and communities.

It’s the difference between contracting for a street cleansing service, and trying to work out how to achieve clean streets.

That’s what, since at least 2010, we’ve been helping people to grapple with, and it’s the mission of The Public Service Transformation Academy

Commissioning is dead, long live commissioning!

Well, what else can we call it? The work is still needed.

The video of my recent presentation is here:

#commissioning #procurement #integratedcare #publicservices

My piece ‘commissioning is an approach to transformation’ sets out our concept of transformation:

It also acknowledges that the brilliant ‘clean streets’ example comes from Dr Carolyn Wilkins OBE.

And that effective, strategic procurement – the quality of thinking, of contracting, contract management, marketing shaping and market engagement needed to buy the street cleansing services that are needed as part of that – is still important and valuable.

The core approach that characterises the sort of commissioning that I believe now needs to be seen as just part of a much bigger picture has most recently been used by The King’s Fund, the identify needs/specify requirements/purchase/contract manage/learn cycle which was introduced in the World Class Commissioning programme in 2010 (predating the Lansley reforms).

And the model of thinking about the real outcomes that people get in their own lives, and the way commissioners can play a humble role in the complex system that creates those results, was also being talked about by Richard Selwyn at exactly the same period.

Of course, all these ideas have a much longer heritage, and are still being explored deeply, and not just in the UK. For thinking about commissioning’s long history and the significant contribution it still has to make, I recommend the work of Professor Gary Sturgess in Australia, where the word still has enormous value, perhaps because it was never simplified and standardised in the way it was in the UK.