Getting the balance of services right

Should buildings based services be externalised?

Should existing services be closed and new, more relevant services be commissioned externally?

Incremental change rather than step change?

Political accountability

Co-operation or Competition?

Overview

The balance between the amount of services managed and staffed by council employees and those contracted from the independent sector is essentially a political one. However, officers have a duty to appraise councillors of the implications of those decisions whether in budgetary or service quality matters. The balance of in-house and externally provided services should be considered in the context of the business planning cycle and the medium term financial plan. A prudent Council will keep its balance between in-house services and externally provided services under review for each service area and ask the following:

Key questions for councillors:

  • Are the higher unit costs of in house services justified by added value?
  • Are in-house services flexible enough to meet changing need?

Should buildings based services be externalised?

The cost benefits of directly externalising an in-house service have diminished in recent years due to:

  • the phasing out of the Residential Care Allowance
  • TUPE (Transfer of Undertakings (Protection of Employment) Regulations) .
  • Many Councils have improved the efficiency of in-house services.

Nonetheless council's face continual financial pressures which call into question whether the remaining in-house services can be sustained. A scenario in the Commissioning module examines this issue: "You have in house residential services for older people that are considerably more expensive than independent provision"

Key Questions for councillors:

  • Is the capital programme sufficient to maintain existing buildings?
  • Are current buildings below regulation standards or common industry standards?
  • How are older buildings to be replaced over the next 10 years?
  • Should existing buildings be disposed of and sold to pay for more corporate objectives?
  • Are there new service imperatives to renew buildings, such as a move away from large day centres?

Should existing services be closed and new, more relevant services be commissioned externally?

The focus of debate has moved from externalisaing existing services to replacing them with more appropriate services. For example most councils are exploring the replacement of residential care with extra care schemes, or supported living arrangements. The period of open access to transitional housing benefit prior to the Supporting People grant, encouraged that exploration. Some council's have moved to floating support teams which undertake some tasks previously undertaken by care staff but now entirely funded from the supporting people grant.

Key Questions for councillors:

  • Are current services able to deliver the commissioning strategy?
  • Are services purchased good value for money?
  • Are there market management issues to consider?
  • What are the set up costs, legal fees and transition costs
  • What will be the risks of failure?
  • Is the balance of services funded by Supporting People right and sustainable in the long term, when the basis of grant allocation changes?

Incremental change rather than step change?

Whilst the shift in the balance of buildings based services requires a complete change process, the shift in balance of community based services can be achieved in a more gradual way. Over recent years the balance of in house home care to contracted home care has shifted, often through a gradual process taking advantage of the natural turnover of staff . This has advantages such as reducing de-commissioning costs (eg redundancies) but there is a risk that the change is unfocused and the respective roles of the two sectors are not clear.

Incremental change is often done by increasing spot purchasing, this may have some initial advantages but in the long term is unlikely to be as cost effective as a cost and volume contract with a provider.

Key questions for councillors:

  • What are the cost benefits of incremental change as opposed to tendering to replace an in-house service?
  • Are the benefits of spot purchasing out weighed by the benefits of a cost and volume contract?
  • Is the role of the in-house sector clear ?

Political accountability

The service user is in receipt of a council service, regardless of whether the provider is in-house or externally provided. However the political scrutiny of the externally provided services is often under developed.

Key questions for councillors:

  • Is it clear to all councillors that people receiving an externally provided service are still receiving a council service?
  • Are contracted services adequately scrutinised?
  • Are fees charged acceptable?
  • Are any top up payments made by service users and their families at an acceptable level?
  • What is the role of councillors in ensuring that contract monitoring is satisfactory?

Co-operation or Competition?

Many councils have seen the in-house sector and external sector as quite separate. Others have started to use their in house service in a focused way and sometimes in partnership with external providers. For example the two sectors can work together in recruitment and training events.

Key questions for councillors:

  • Are in house services used to the full in working with external services?
  • Are the roles of the two sectors sufficiently differentiated?
  • What synergies are being explored between the two sectors?
  • Are recruitment and retention issues being dealt with competitively or collaboratively?