Guest blogpost: Re-imagining value with Valuing Care – a new approach to commissioning

Toni Badnall-Neill was until recently the Strategic Commissioning Officer for Children’s Services at Central Bedfordshire Council

When refreshing our Sufficiency Strategy last year, Central Bedfordshire Council took the opportunity to look more holistically at our needs for accommodation provision and to embed IMPOWER’s Valuing Care within this approach.

Within a new project team, we were able to integrate the operational implementation closely with the commissioning workstream. We planned how we would develop Valuing Care within our case management system, and how to use it both as a practice tool and a focus for market engagement to commission placements for looked after children.

Our key challenge has been changing the conversation around placement cost and value. We needed to take our stakeholders on a journey to understand that Valuing Care was not a cost-saving exercise, but a method of codifying and expressing a child’s needs to enable better placement matching and a placement cost that was aligned more to outcomes than to risk.

Codifying needs, and the data this yields both at an individual and aggregate level, allows us to understand the placements and support that might be needed to meet those needs and deliver positive outcomes. Combined with a statistical modelling approach that predicts the numbers of placements needed in coming years, and ‘at the coalface’ knowledge of practitioners who know the needs of the children we find hardest to place, we are able to identify cohort-level needs and sufficiency gaps to develop provision.

Triangulating these sources of evidence, we developed a three-phase strategy for foster care, semi-independent accommodation and residential provision. Our plans will be released for public consultation on 24 June, and work on Phase I will commence this summer to align with the end of our current dynamic purchasing system for Independent Fostering Agency (IFA) placements in March 2020.

Using Valuing Care data, we plan to develop two referral pathways – one for in-house foster care and one for external. The appropriate pathway for each child will depend on children’s needs and which carers can best offer a placement. This will alleviate the pressures caused by an ‘in-house first’ culture where IFA placements are often sought at a late stage when other routes have been unsuccessful. For the majority of IFA placements, we will seek to call-off from a framework-type arrangement under light-touch procurement rules. We also plan to use Valuing Care to identify the types of needs which are hardest to meet, and to work with providers to pilot small specialist block contracts to ensure these children have a safe, stable placement when the need arises.

Valuing Care will be crucial not just to the referral process, but to how we monitor its success and manage contracts. Our next steps are to embed the tool within the Looked After Children review process to measure children’s progress over time, and to develop (in partnership with other authorities involved in IMPOWER’s Valuing Care programme), a service specification grounded in Valuing Care that puts outcomes at its centre. Our aim is to develop an understanding of value for money that is not simply a matter of cost, but a balance of cost, quality and outcomes that best serves the child’s needs.