What is commissioning?

Commissioning is the process of making sure that health and care services meet the needs of the population in each local area. Commissioners set priorities and organisations are selected to provide health services for local people.

NSUN seeks to improve service user involvement by supporting people with lived experience to gain proper input into the commissioning of services they use.

Our work with commissioners Since its establishment under the Health and Social Care Act 2012 NSUN has worked with NHS England, which commissions primary care and specialist mental health services.

In particular we have worked with NHS England’s mental health clinical director Dr Geraldine Strathdee on a number of areas including the National Mental Health Intelligence Network (see here), the training of clinical commissioning group mental health leads, and a range of events promoting the involvement of people with lived experience.

Through our Mind Community Engagement Pilot scheme, our Mental Healthwatch scheme and through our National Involvement Partnership (NIP) we have also worked with local authority and clinical commissioning group commissioners in Lambeth, Hackney, Suffolk, Newcastle, Bristol and Leicester.

NSUN is also a member of the Joint Commissioning Panel for mental health hosted by the Royal College of Psychiatrists and the Royal College of GPs.

With them we have helped develop Value-Based Commissioning(VbC), which aims to properly involve those who use services at every stage in the commissioning cycle.

Values-based commissioning

Traditional commissioning relies on scientific and research evidence to make decisions about what kinds of services should be prioritised and paid for. This can overlook the experiences and opinions of people who actually use the services, so what’s provided might not meet people’s needs. In ‘values-based’ commissioning, the views and experiences of people who use services have equal weight to the scientific and research evidence.

“Values-based commissioning is a practice where everyone becomes equal partners. Service users, carers, clinicians and managers all become part of the commissioning model regarding mental health. There’s joint ownership and there’s no power issues really. So, services users and carers have more of a say in what goes on in the services they receive”. (Service user and carer)

We know that this is far from the reality in many places at the moment. Many people aren’t happy with the mental health services in their area and some have had poor or even traumatic experiences. Values-based commissioning could be your chance to have a say and change services for the better. Telling commissioners how it feels to be on the receiving end of services and suggesting improvements could make a real difference to health services and the people who used them.

If you would like to get involved in commissioning, you can read more in the guide Influencing Mental Health Services, guide to Values Based Commissioning that NSUN has produced in partnership with Mind.

Our work in the West Midlands

In 2013 NSUN produced a report reviewing values-based commissioning in the West Midlands.

Through an evaluation of the West Midlands Mental Health Commissioning Modelling Group and interviews with service users, NSUN wanted to explore how people could actively participate in, and ultimately take joint ownership of the design and delivery of services.

The review took place during the course of 2012. The Mental Health Commissioning Modelling Group included representatives from social care, PCTS, public health and GP practices. It aimed to set out principles of best practice with regard to the concept and delivery of values-based commissioning. In addition to this evaluation, three group interviews and 11 one-to-one interviews were conducted with service users from NSUN and Suresearch, a network of service users based at Birmingham University.

Key findings of the review:

· There continues to be comparatively little service user leadership, or joint decision-making in relation to service design and delivery.

· The rhetoric of ‘service user involvement’ needs to be made a reality. Service users need to be at the centre of the commissioning process and work in partnership with the new clinical commissioning groups.

· Service users want to work with managers and clinicians as equal partners, but think that a culture shift in attitude and approach is needed before this can happen.

· In order for partnership working to be successful, ‘professional commissioners’ need to communicate without jargon, and be prepared to share their power and the label of ‘expert’ with people who use mental health services.

· The concept of ‘commissioning’ and ‘values-based commissioning’ needs to be made easier to understand.

· There needs to be a greater diversity of service users who are involved in mental health commissioning. Creative and inclusive practices need to be developed in order to make this happen.

The review identified that service users need to be more involved at all stages and at all levels of the commissioning process.

NSUN aims to take the recommendations of the review forward by identifying practical ways in which service users, particularly those who are marginalised, can become more influential with regard to the design and delivery of mental health services.

Document by this project:

Values based commissioning report

Please contact us for a hard copy of the report.

Get in touch Telephone 020 7820 8982 or email [email protected]