I share my reflections on Kotter's 8 steps for change in driving transformation to achieve strengths-based practice.
To date councils have mainly focused on managing demand at the front door through strengths-based conversations with clients. While this has an impact, the extent of it may be limited unless it is accompanied by a focus on commissioning the local market in a way which promotes independence.
Below we explain how councils can ‘turbocharge’ the commissioning cycle in order to boost their demand management efforts:
- Customer journey: Use an approach such as Trajectory Management to understand demand at each stage of the customer journey and inform commissioners where to focus supply.
- Discovery Mindset: Commissioners must not see services in isolation from the practice and behaviours of frontline staff. There is a need to analyse the interaction between those staff and suppliers in order to design future services and systems.
- Available market: Understand what the existing market place offers and how it drives or avoids demand. Analyse how this supply can support the council’s objectives and understand the steps that suppliers will need to take in order to align themselves with the vision of a model that maximises independence.
- Internal culture: Consider how internal practice needs to change. Refocus commissioning activity away from savings within specific contracts and towards savings across the system through addressing avoidable demand.
- Relationships: Build strong relationships at the health and social care interface, including joint roles, a shared purpose, agreed outcomes and a joint plan to maximise the impact of joint funding.
- Strategies: Prioritise team activity by focusing on the commissioning contracts with the biggest impact on demand and outcomes.
- Commissioning practice: Shift from focusing contracts on time and task to focusing on outcomes, and enable a flexible procurement plan that allows services to develop according to need.
- Working closely with internal stakeholders: A shift in service design needs to be concurrent with a shift in social work practice, including strengths-based conversations and support planning that promotes independence.
- Right supply: Work alongside the market to ensure that they understand demand management and your desired outcomes for residents. Successfully managing demand relies on working in partnership to identify and resolve challenges.
- Innovative and sustainable markets: Build opportunities for innovation. Work with suppliers to create a safe space for alternative solutions for common market challenges.
- Continuous improvement: commissioning will constantly review and assess services to ensure they are meeting needs and managing demand.
- Understanding local spend: Commissioning is the biggest area of influenceable spend within local authorities (over £16 billion according to IFS), with the vast majority of this locked into traditional long-term care packages.
- Understanding demand: Regularly use primed metrics and demographic information to review your population needs.
- Relationships: Data should be used to support collaborative conversations with providers about demand and supply, build trusted relationships within the market and create a powerful feedback loop
- Commissioning practice: Trajectory Management helps prioritise service reviews, highlights supply needs and demonstrates where supply is not supporting outcomes.
Having the right services in place is essential to effectively manage demand, so encouraging an innovative and sustainable provider market will pay dividends in terms of maximising the independence of the residents you support.